RT Journal Article SR Electronic T1 Tryptase+ mast cells associate with fibrotic regions in the lungs of idiopathic pulmonary fibrosis patients; a multiplex staining approach JF European Respiratory Journal JO Eur Respir J FD European Respiratory Society SP PA3412 DO 10.1183/13993003.congress-2016.PA3412 VO 48 IS suppl 60 A1 Elena Miranda A1 Rebecca Dunmore A1 Doris Rassl A1 Helen Parfrey A1 Catherine Overed-Sayer A1 Arthur Lewis A1 Lorcan Sherry A1 Matt Sleeman A1 Richard May A1 Deborah Clarke YR 2016 UL http://erj.ersjournals.com/content/48/suppl_60/PA3412.abstract AB Background: Idiopathic pulmonary fibrosis (IPF) is a chronic fibrotic lung disease characterised by a progressive decline in lung function and a mean survival of 3 years post-diagnosis. Several studies have documented the presence of mast cells (MC) in the lungs of IPF patients, but despite this association the role MC play in the fibrotic process remains undefined. This study aimed to characterize specific MC phenotypes including chymase+ (MCC), tryptase+ (MCT) and chymase/tryptase+ cells (MCTC) in IPF lung.Methods: Lung biopsy specimens from IPF patients (n=17) and normal individuals (n=20) obtained from Papworth Hospital underwent dual IHC staining for chymase and tryptase. Samples were analysed using image software analysis algorithm (Indica Labs HALOÒ software) to quantify the MC density per area (mm2) in both IPF and normal lung tissue, and within annotated fibrotic and non-fibrotic areas.Results: MCC and MCT were significantly increased in the IPF lung (11.24±2.41 and 100.3±19.36/mm2) compared to controls (2.25±0.73 and 24.9±4.98/mm2 respectively; p<0.001) and were associated with fibrotic regions. MCT increased in both non-fibrotic (p=0.03) and fibrotic areas in IPF samples compared to the same regions in normal controls, whereas no difference was observed for MCC or MCTC.Conclusions: These data demonstrate that MCC, MCT and MCTC are significantly increased in IPF lung compared to normal controls and are associated mainly with fibrotic regions. Furthermore, multiplex IHC combined with image analysis are important technological tools to enable detailed quantification and interpretation of specific cell populations involved in IPF.