Potential of bronchoalveolar lavage in diagnostics of progressive pulmonary fibrosis

Introduction. Progressive pulmonary fibrosis (PPF) represents а poor prognosis in patients with interstitial lung diseases, including hypersensitivity pneumonitis (HP). Currently, along with common functional and radiological diagnostic criteria for PPF, an active search for laboratory biomarkers of PPF is underway.

Aim. To study of the dynamic of metalloproteinase levels (MMP-1, MMP-7, MMP-9), monocyte chemoattractant protein-1 (MCP-1) and vascular endothelial growth factor (VEGF) in bronchoalveolar lavage fluid (BAL) and their relationship with IPF criteria in patients with IPF and GP.

Materials and methods. The study included 62 patients with ILD over 18 years old, the diagnosis of ILD was established based on the diagnostic criteria of the American Thoracic Society (2022). The levels of markers in bronchoalveolar lavage fluid were determined using Vector-Best kits (Russia) for quantitative determination of MCP-1 and VEGF levels and RayBiotech kits (USA) for determining the level of MMP-1, MMP-7, MMP-9. The study was conducted on a Hydro Flex enzyme immunoassay analyzer (TECAN, Austria). Statistical data processing was performed using the Statistica 10.0 program.

Results. Baseline levels of MCP-1, VEGF, MMP-1, MMP-7, MMP-9 in BAL fluid were higher in patients with IPF and PLF in GP compared to patients with GP without signs of PLF. When studying the levels of MMP-7 and VEGF, a reliable association was found between an increase in these biomarkers and a decrease in FVC ≥ 5% and DLCO ≥ 10% of the predicted value within 1 year.

Conclusion. Increased levels of MMP-7 and MCP-1 in BAL fluid have an inverse correlation with the dynamics of FVC and DLCO indicators during the year, which corresponds to the FVC criterion.

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