Abstract
Background: Human Neutrophil Peptides (HNP) are cationic peptides with a broad spectrum of inflammatory activities which have been found increased in plasma and BALF of individuals with sarcoidosis.
Aim: We designed a study to analyze HNP's role as markers of pulmonary involvement and functional impairment during sarcoidosis.
Methods: We enrolled 42 consecutive individuals with sarcoidosis, and 12 normal volunteers. Participants underwent pulmonary function tests, fiber-optic bronchoscopy and radiological evaluation. HNP concentration in BALF were measured by an ELISA test.
Results: Patients with sarcoidosis had higher BALF HNP concentrations as compared to volunteers (3.9±0.3 ng/ml vs 0.4±0.07 ng/ml, p< 0.0001). Individuals with parenchymal involvement had higher BAL HNP levels than subjects without parenchymal involvement (4.5±0.3 ng/ml vs 2.2±0.3 ng/ml, p=0.02). A negative correlation was observed between HNP levels and pulmonary functional impairment (HNP-%FEV1 rho= -0.33, p= 0.03; HNP%TLC rho=-0.33,p=0.03). ROC curve analysis revealed HNP as markers to discriminate patients with sarcoidosis from normal volunteers (Area Under the Curve =0.99, with 95%CI: 0.98-1.00; positive likelihood ratio equal to infinity, negative likelihood ratio= 0.02), and patients with pulmonary parenchymal involvement from patients with only bilateral hilar adenopathy (AUC of 0.83,with 95% CI: 0.69-0.96 positive likelihood ratio=2.7, negative likelihood ratio=0.09)
Conclusions: Our results suggest that HNP may have a role as biomarkers for sarcoidosis diagnosis and as indicators of parenchymal involvement, functional impairment and disease severity during pulmonary sarcoidosis clinical course.
- © 2011 ERS
