Top

Published in:

01-01-2015 | Original

Type III procollagen is a reliable marker of ARDS-associated lung fibroproliferation

Authors: Jean-Marie Forel, Christophe Guervilly, Sami Hraiech, François Voillet, Guillemette Thomas, Claude Somma, Véronique Secq, Catherine Farnarier, Marie-Josée Payan, Stéphanie-Yannis Donati, Gilles Perrin, Delphine Trousse, Stéphanie Dizier, Laurent Chiche, Karine Baumstarck, Antoine Roch, Laurent Papazian

Published in: Intensive Care Medicine | Issue 1/2015

Abstract

Purpose

A specific biomarker of post-ARDS fibroproliferation could be useful in the identification of patients who could benefit from therapies aiming to modulate fibroproliferation such as corticosteroids.The aim of this prospective study was to determine the best threshold of the N-terminal-peptidetype III procollagen (NT-PCP-III) in non-resolving ARDS to validate this threshold according to the outcome.

Methods

Concerning the best threshold of NT-PCP-III, all consecutive patients with a non-resolving ARDS were included if all the following criteria were fulfilled: moderate to severe ARDS lasting for at least 5 days, lung biopsy performed, serum and alveolar NT-PCP-III obtained within 1 week prior to biopsy, and no documented infection contra-indicating the corticosteroids. In the validation cohort part of the study, patients were included at day 7 if they presented a persistent moderate to severe ARDS.

Results

Nineteen of 32 patients had fibroproliferatio nonbiopsy. Serum and alveolar NT-PCP-III were higher in patients with fibroproliferation. Using a threshold of 9 µg/L, alveolar NT-PCP-III had the highest accuracy for diagnosing fibroproliferation (sensitivity = 89.5 % and specificity = 92.3 %). Regarding the 51 patients included in the validation cohort, the mortality rate at day 60 was increased in patients presenting an alveolar NT-PCP-III level higher than 9 µg/L (69 vs. 17 %, p < 0.001). The mean alveolar level of NT-PCP-III on day 7 was 8.1-fold higher in nonsurvivors (p = 0.03).

Conclusions

The determination of NT-PCP-III on BAL done at day 7 in persistent ARDS is able to identify patients with fibroproliferation who could be included in a trial of corticosteroids or any other treatment that might help resolve lung fibroproliferation.

The Acute Respiratory Distress Syndrome Network (2000) Ventilation with lower tidal volumes as compared with traditional tidal volumes for acute lung injury and the acute respiratory distress syndrome. N Engl J Med 342:1301–1308CrossRef

Ware LB, Matthay MA (2000) The acute respiratory distress syndrome. N Engl J Med 342:1334–1349PubMedCrossRef

Tonelli AR, Zein J, Adams J, Ioannidis JP (2014) Effects of interventions on survival in acute respiratory distress syndrome: an umbrella review of 159 published randomized trials and 29 meta-analyses. Intensive Care Med 40:769–787PubMedCrossRef

Wang CY, Calfee CS, Paul DW, Janz DR, May AK, Zhuo H, Bernard GR, Matthay MA, Ware LB, Kangelaris KN (2014) One-year mortality and predictors of death among hospital survivors of acute respiratory distress syndrome. Intensive Care Med 40:388–396PubMedCrossRef

Dos Santos CC (2008) Advances in mechanisms of repair and remodelling in acute lung injury. Intensive Care Med 34:619–630PubMedCrossRef

Anderson WR, Thielen K (1992) Correlative study of adult respiratory distress syndrome by light, scanning, and transmission electron microscopy. Ultrastruct Pathol 16:615–628PubMedCrossRef

Martin C, Papazian L, Payan MJ, Saux P, Gouin F (1995) Pulmonary fibrosis correlates with outcome in adult respiratory distress syndrome. A study in mechanically ventilated patients. Chest 107:196–200PubMedCrossRef

Meduri GU, Marik PE, Chrousos GP, Pastores SM, Arlt W, Beishuizen A, Bokhari F, Zaloga G, Annane D (2008) Steroid treatment in ARDS: a critical appraisal of the ARDS network trial and the recent literature. Intensive Care Med 34:61–69PubMedCrossRef

Meduri GU, Headley AS, Golden E, Carson SJ, Umberger RA, Kelso T, Tolley EA (1998) Effect of prolonged methylprednisolone therapy in unresolving acute respiratory distress syndrome: a randomized controlled trial. JAMA 280:159–165PubMedCrossRef

10.

Steinberg KP, Hudson LD, Goodman RB, Hough CL, Lanken PN, Hyzy R, Thompson BT, Ancukiewicz M (2006) Efficacy and safety of corticosteroids for persistent acute respiratory distress syndrome. N Engl J Med 354:1671–1684PubMedCrossRef

11.

Papazian L, Doddoli C, Chetaille B, Gernez Y, Thirion X, Roch A, Donati Y, Bonnety M, Zandotti C, Thomas P (2007) A contributive result of open-lung biopsy improves survival in acute respiratory distress syndrome patients. Crit Care Med 35:755–762PubMedCrossRef

12.

Kivirikko KI, Myllyla R (1985) Post-translational processing of procollagens. Ann N Y Acad Sci 460:187–201PubMedCrossRef

13.

Gonzalez-Lopez A, Garcia-Prieto E, Batalla-Solis E, Amado-Rodriguez L, Avello N, Blanch L, Albaiceta GM (2012) Lung strain and biological response in mechanically ventilated patients. Intensive Care Med 38:240–247PubMedCrossRef

14.

Clark JG, Milberg JA, Steinberg KP, Hudson LD (1995) Type III procollagen peptide in the adult respiratory distress syndrome. Association of increased peptide levels in bronchoalveolar lavage fluid with increased risk for death. Ann Intern Med 122:17–23PubMedCrossRef

15.

Chesnutt AN, Matthay MA, Tibayan FA, Clark JG (1997) Early detection of type III procollagen peptide in acute lung injury. Pathogenetic and prognostic significance. Am J Respir Crit Care Med 156:840–845PubMedCrossRef

16.

Farjanel J, Hartmann DJ, Guidet B, Luquel L, Offenstadt G (1993) Four markers of collagen metabolism as possible indicators of disease in the adult respiratory distress syndrome. Am Rev Respir Dis 147:1091–1099PubMedCrossRef

17.

Definition Task Force ARDS, Ranieri VM, Rubenfeld GD, Thompson BT, Ferguson ND, Caldwell E, Fan E, Camporota L, Slutsky AS (2012) Acute respiratory distress syndrome: the Berlin Definition. JAMA 307:2526–2533

18.

Ferguson ND, Fan E, Camporota L, Antonelli M, Anzueto A, Beale R, Brochard L, Brower R, Esteban A, Gattinoni L, Rhodes A, Slutsky AS, Vincent JL, Rubenfeld GD, Thompson BT, Ranieri VM (2012) The Berlin definition of ARDS: an expanded rationale, justification, and supplementary material. Intensive Care Med 38:1573–1582PubMedCrossRef

19.

STARD (2008) http://www.stard-statement.org/. Accessed 25 August 2014

20.

Hanley JA, McNeil BJ (1983) A method of comparing the areas under receiver operating characteristic curves derived from the same cases. Radiology 148:839–843PubMedCrossRef

21.

Dean AG, Sullivan KM, Soe MM (2014) OpenEpi: Open Source Epidemiologic Statistics for Public Health. http://www.openepi.com/Menu/OE_Menu.htm. Accessed 26 June 2013

22.

Newcombe RG (1998) Two-sided confidence intervals for the single proportion: comparison of seven methods. Stat Med 17:857–872PubMedCrossRef

23.

Simel DL, Samsa GP, Matchar DB (1991) Likelihood ratios with confidence: sample size estimation for diagnostic test studies. J Clin Epidemiol 44:763–770PubMedCrossRef

24.

Shahzeidi S, Mulier B, de Crombrugghe B, Jeffery PK, McAnulty RJ, Laurent GJ (1993) Enhanced type III collagen gene expression during bleomycin induced lung fibrosis. Thorax 48:622–628PubMedCentralPubMedCrossRef

25.

Watanabe Y, Yamaki K, Yamakawa I, Takagi K, Satake T (1985) Type III procollagen N-terminal peptides in experimental pulmonary fibrosis and human respiratory diseases. Eur J Respir Dis 67:10–16PubMed

26.

Bjermer L, Lundgren R, Hallgren R (1989) Hyaluronan and type III procollagen peptide concentrations in bronchoalveolar lavage fluid in idiopathic pulmonary fibrosis. Thorax 44:126–131PubMedCentralPubMedCrossRef

27.

Low RB, Giancola MS, King TE Jr, Chapitis J, Vacek P, Davis GS (1992) Serum and bronchoalveolar lavage of N-terminal type III procollagen peptides in idiopathic pulmonary fibrosis. Am Rev Respir Dis 146:701–706PubMedCrossRef

28.

Marshall RP, Bellingan G, Webb S, Puddicombe A, Goldsack N, McAnulty RJ, Laurent GJ (2000) Fibroproliferation occurs early in the acute respiratory distress syndrome and impacts on outcome. Am J Respir Crit Care Med 162:1783–1788PubMedCrossRef

29.

Demoule A, Decailliot F, Jonson B, Christov C, Maitre B, Touqui L, Brochard L, Delclaux C (2006) Relationship between pressure-volume curve and markers for collagen turn-over in early acute respiratory distress syndrome. Intensive Care Med 32:413–420PubMedCrossRef

30.

Meduri GU, Tolley EA, Chinn A, Stentz F, Postlethwaite A (1998) Procollagen types I and III aminoterminal propeptide levels during acute respiratory distress syndrome and in response to methylprednisolone treatment. Am J Respir Crit Care Med 158:1432–1441PubMedCrossRef

31.

Meduri GU, Golden E, Freire AX, Taylor E, Zaman M, Carson SJ, Gibson M, Umberger R (2007) Methylprednisolone infusion in early severe ARDS: results of a randomized controlled trial. Chest 131:954–963PubMedCrossRef

32.

Azoulay E, Mokart D, Lambert J, Lemiale V, Rabbat A, Kouatchet A, Vincent F, Gruson D, Bruneel F, Epinette-Branche G, Lafabrie A, Hamidfar-Roy R, Cracco C, Renard B, Tonnelier JM, Blot F, Chevret S, Schlemmer B (2010) Diagnostic strategy for hematology and oncology patients with acute respiratory failure: randomized controlled trial. Am J Respir Crit Care Med 182:1038–1046PubMedCrossRef

33.

Berger P, Papazian L, Drancourt M, La Scola B, Auffray JP, Raoult D (2006) Ameba-associated microorganisms and diagnosis of nosocomial pneumonia. Emerg Infect Dis 12:248–255PubMedCentralPubMedCrossRef

34.

Vincent JL, Moreno R, Takala J, Willatts S, De Mendonca A, Bruining H, Reinhart CK, Suter PM, Thijs LG (1996) The SOFA (Sepsis-related Organ Failure Assessment) score to describe organ dysfunction/failure. On behalf of the Working Group on Sepsis-Related Problems of the European Society of Intensive Care Medicine. Intensive Care Med 22:707–710PubMedCrossRef

35.

Le Gall JR, Lemeshow S, Saulnier F (1993) A new Simplified Acute Physiology Score (SAPS II) based on a European/North American multicenter study. JAMA 270:2957–2963PubMedCrossRef

36.

Murray JF, Matthay MA, Luce JM, Flick MR (1988) An expanded definition of the adult respiratory distress syndrome. Am Rev Respir Dis 138:720–723PubMedCrossRef

Title: Type III procollagen is a reliable marker of ARDS-associated lung fibroproliferation
Authors: Jean-Marie Forel
Christophe Guervilly
Sami Hraiech
François Voillet
Guillemette Thomas
Claude Somma
Véronique Secq
Catherine Farnarier
Marie-Josée Payan
Stéphanie-Yannis Donati
Gilles Perrin
Delphine Trousse
Stéphanie Dizier
Laurent Chiche
Karine Baumstarck
Antoine Roch
Laurent Papazian
Publication date: 01-01-2015
Publisher: Springer Berlin Heidelberg
Published in: Intensive Care Medicine / Issue 1/2015
Print ISSN: 0342-4642
Electronic ISSN: 1432-1238
DOI: https://doi.org/10.1007/s00134-014-3524-0

At a glance: The STEP trials

Springer Medicine

Type III procollagen is a reliable marker of ARDS-associated lung fibroproliferation

Abstract

Purpose

Methods

Results

Conclusions

At a glance: The STEP trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

Please log in to get access to this content

Other articles of this Issue 1/2015

Comment on Debaty et al.: Impact of intra-arrest therapeutic hypothermia in outcomes of prehospital cardiac arrest: a randomized controlled trial

Ventilator-associated pneumonia: present understanding and ongoing debates

Treatment of Ebola virus disease

What’s new in ethics of cardio-pulmonary resuscitation research: too little time and too many rules?

Teaching medical students to talk about death and dying in the ICU: feasibility of a peer-tutored workshop

Biology and pathology of fibroproliferation following the acute respiratory distress syndrome