Abstract
Background: The elusive nature of the cause of most diffuse lung diseases has led many to postulate an infectious etiology. In this regards, the aim of this study was investigate the presence or absence of virus infections in patients with pulmonary fibrosis disease.
Methods: The study sample comprised 38 patients with open lung biopsies, 13 patients with IPF/UIP; 8 with NSIP/NSIP; 13 with AIP/DAD and 4 with ICLF/CLF. The clinical/radiology and histological diagnosis was according with the 2001 ATS/ERS consensus. Microarray samples was analyzing by immunohistochymistry for measles virus (MV), cytomegalovirus (CMV), hepatitis-C virus (HCV), adenovirus (ADV), respiratory syncytial virus (RSV), Epstein-Barr virus (EBV), herpes I and II viruses (HVI and HVII). We also correlated sex, age, AIDS and immunosuppression therapy.
Results: We detected by immunohistochemistry the epithelial alveolar infection of MV and CMV in 30.8% and 15.4% in DAD pattern, respectively. Endothelial CMV infection was observed in 25% of CLF pattern. When we divided the age in two groups' patients with ≤ of 43 years old and ≥ of 72 years old, the first group had more infection of MV, CMV than the second group. The Spearman's correlation showed a positive correlation between epithelial and endothelial CMV infection and AIDS (r=0.472; p=0.003).
Conclusion: The epithelial and endothelial viral infections observed in these diseases reinforce the possible viral participation in the pulmonary fibrosis disease. These findings are particularly relevant given the increased interest in the epithelial injury and repair as it relates to the pathogenesis of many diffuse lung diseases.
Financial Support: FAPESP, CNPq.
- © 2012 ERS
