Skip to main content
Top
Published in: Diagnostic Pathology 1/2011

Open Access 01-12-2011 | Research

Medical Research Council dyspnea scale does not relate to fibroblast foci profusion in IPF

Authors: Christina Triantafillidou, Effrosyni D Manali, Christina Magkou, Christina Sotiropoulou, Likurgos F Kolilekas, Konstantinos Kagouridis, Dimitra Rontogianni, Spyros A Papiris

Published in: Diagnostic Pathology | Issue 1/2011

Login to get access

Abstract

Background

In Idiopathic pulmonary fibrosis (IPF) irreversibly progressive fibrosing parenchymal damage, leads to defects in mechanics and gas exchange, manifesting with disabling exertional dyspnea. Previous studies have shown a relationship between fibroblast foci (FF) profusion and severity and survival and a relationship between dyspnea grade and severity and outcome. We hypothesized a relationship between Medical Research Council (MRC) dyspnea scale with FF, and a relationship between FF and functional parameters and survival.

Methods

We retrospectively reviewed 24 histologically documented IPF patients. Profusion of FF was semiquantitatively evaluated by two scores, Brompton and Michigan. Survival analysis was performed by fitting Cox regression models to examine the relationship of the two scores with survival and the non-parametric Spearman correlation coefficient was calculated to describe the relationships of FF scores with dyspnea scores and functional parameters.

Results

No statistically significant correlation between FF scores and the MRC scores was observed (p = 0.96 and p = 0.508 respectively). No significant correlation between FF scores and survival (p = 0.438 and p = 0.861 respectively) or any functional parameter was observed.

Conclusions

The lack of relationship between the MRC dyspnea scale and the FF might relate to the fact that dyspnea in IPF better reflects the overall of lung damage and its related consequences on mechanics and gas exchange whereas FF, one of its histological hallmarks, may not reflect its entire histology derangement also constrained by the geographically limited sampled tissue. This might be also valid for the observed lack of association between FF and survival or functional parameters.
Appendix
Available only for authorised users
Literature
1.
go back to reference Wells AU, the BTS Group, a subgroup of the British Thoracic Society Standards of Care Committee, in collaboration with the Thoracic Society of Australia and New Zealand and the Irish Thoracic Society: Interstitial lung disease guideline. Thorax. 2008, 63 (Suppl 5): 1-58. 10.1136/thx.2008.101691.CrossRef Wells AU, the BTS Group, a subgroup of the British Thoracic Society Standards of Care Committee, in collaboration with the Thoracic Society of Australia and New Zealand and the Irish Thoracic Society: Interstitial lung disease guideline. Thorax. 2008, 63 (Suppl 5): 1-58. 10.1136/thx.2008.101691.CrossRef
2.
go back to reference Katzenstein AL, Mukhopadhyay S, Myers JL: Diagnosis of usual interstitial pneumonia and distinction from other fibrosing interstitial lung diseases. Hum Pathol. 2008, 39: 1275-1294. 10.1016/j.humpath.2008.05.009.CrossRefPubMed Katzenstein AL, Mukhopadhyay S, Myers JL: Diagnosis of usual interstitial pneumonia and distinction from other fibrosing interstitial lung diseases. Hum Pathol. 2008, 39: 1275-1294. 10.1016/j.humpath.2008.05.009.CrossRefPubMed
3.
go back to reference Raghu G, Mageto YN, Lockhart D, Schmidt RA, Wood DE, Godwin JD: The accuracy of the clinical diagnosis of new-onset idiopathic pulmonary fibrosis and other interstitial lung disease: a prospective study. Chest. 1999, 116: 1168-1174. 10.1378/chest.116.5.1168.CrossRefPubMed Raghu G, Mageto YN, Lockhart D, Schmidt RA, Wood DE, Godwin JD: The accuracy of the clinical diagnosis of new-onset idiopathic pulmonary fibrosis and other interstitial lung disease: a prospective study. Chest. 1999, 116: 1168-1174. 10.1378/chest.116.5.1168.CrossRefPubMed
4.
go back to reference Souza CA, Muller NL, Flint J, Wright JL, Churg A: Idiopathic pulmonary fibrosis: spectrum of high-resolution CT findings. Am J Roentgenol. 2005, 185: 1531-1539. 10.2214/AJR.04.1599.CrossRef Souza CA, Muller NL, Flint J, Wright JL, Churg A: Idiopathic pulmonary fibrosis: spectrum of high-resolution CT findings. Am J Roentgenol. 2005, 185: 1531-1539. 10.2214/AJR.04.1599.CrossRef
5.
go back to reference Fell CD, Martinez FJ, Liu LX, Murray S, Han MK, Kazerooni EA, Gross BH, Myers J, Travis WD, Colby TV, Toews GB, Flaherty KR: Clinical Predictors of a Diagnosis of Idiopathic Pulmonary Fibrosis. Am J Respir Crit Care Med. 2010, 181: 832-837. 10.1164/rccm.200906-0959OC.PubMedCentralCrossRefPubMed Fell CD, Martinez FJ, Liu LX, Murray S, Han MK, Kazerooni EA, Gross BH, Myers J, Travis WD, Colby TV, Toews GB, Flaherty KR: Clinical Predictors of a Diagnosis of Idiopathic Pulmonary Fibrosis. Am J Respir Crit Care Med. 2010, 181: 832-837. 10.1164/rccm.200906-0959OC.PubMedCentralCrossRefPubMed
6.
go back to reference Gay SE, Kazerooni EA, Toews GB, Lynch JP, Gross BH, Cascade PN, Spizarny DL, Flint A, Schork MA, Whyte RI, Popovich J, Hyzy R, Martinez FJ: Idiopathic pulmonary fibrosis: predicting response to therapy and survival. Am J Respir Crit Care Med. 1998, 157: 1063-1072.CrossRefPubMed Gay SE, Kazerooni EA, Toews GB, Lynch JP, Gross BH, Cascade PN, Spizarny DL, Flint A, Schork MA, Whyte RI, Popovich J, Hyzy R, Martinez FJ: Idiopathic pulmonary fibrosis: predicting response to therapy and survival. Am J Respir Crit Care Med. 1998, 157: 1063-1072.CrossRefPubMed
7.
go back to reference Papiris SA, Daniil ZD, Malagari K, Kapotsis GE, Sotiropoulou C, Milic-Emili J, Roussos C: The Medical Research Council dyspnea scale in the estimation of disease severity in idiopathic pulmonary fibrosis. Respir Med. 2005, 99: 755-761. 10.1016/j.rmed.2004.10.018.CrossRefPubMed Papiris SA, Daniil ZD, Malagari K, Kapotsis GE, Sotiropoulou C, Milic-Emili J, Roussos C: The Medical Research Council dyspnea scale in the estimation of disease severity in idiopathic pulmonary fibrosis. Respir Med. 2005, 99: 755-761. 10.1016/j.rmed.2004.10.018.CrossRefPubMed
8.
go back to reference Manali ED, Stathopoulos G, Kollintza A, Kalomenidis I, Milic-Emili J, Sotiropoulou C, Daniil Z, Roussos C, Papiris SA: Medical Research Council chronic dyspnea score predicts the survival of patients with idiopathic pulmonary fibrosis. Respir Med. 2008, 102: 586-592. 10.1016/j.rmed.2007.11.008.CrossRefPubMed Manali ED, Stathopoulos G, Kollintza A, Kalomenidis I, Milic-Emili J, Sotiropoulou C, Daniil Z, Roussos C, Papiris SA: Medical Research Council chronic dyspnea score predicts the survival of patients with idiopathic pulmonary fibrosis. Respir Med. 2008, 102: 586-592. 10.1016/j.rmed.2007.11.008.CrossRefPubMed
9.
go back to reference Nishiyama Ο, Taniguchi Η, Kondoh Υ, Kimura T, Kato K, Kataoka K, Ogawa T, Watanabe F, Arizono S: A simple assessment of dyspnea as a prognostic indicator in idiopathic pulmonary fibrosis. Eur Respir J. 2010 Nishiyama Ο, Taniguchi Η, Kondoh Υ, Kimura T, Kato K, Kataoka K, Ogawa T, Watanabe F, Arizono S: A simple assessment of dyspnea as a prognostic indicator in idiopathic pulmonary fibrosis. Eur Respir J. 2010
10.
go back to reference Baddini Martinez JA, Martinez TY, Lovetro Galhardo FP, de Castro Pereira CA: Dyspnea scales as a measure of health-related quality of life in patients with idiopathic pulmonary fibrosis. Med Sci Monit. 2002, 8: CR405-410.PubMed Baddini Martinez JA, Martinez TY, Lovetro Galhardo FP, de Castro Pereira CA: Dyspnea scales as a measure of health-related quality of life in patients with idiopathic pulmonary fibrosis. Med Sci Monit. 2002, 8: CR405-410.PubMed
11.
go back to reference King TE, Tooze JA, Schwarz MI, Brown KR, Cherniack RM: Predicting survival in idiopathic pulmonary fibrosis: scoring system and survival model. Am J Respir Crit Care Med. 2001, 164: 1171-1181.CrossRefPubMed King TE, Tooze JA, Schwarz MI, Brown KR, Cherniack RM: Predicting survival in idiopathic pulmonary fibrosis: scoring system and survival model. Am J Respir Crit Care Med. 2001, 164: 1171-1181.CrossRefPubMed
12.
go back to reference Flaherty KR, Mumford JA, Murray S, Kazerooni EA, Gross BH, Colby TV, Travis WD, Flint A, Toews GB, Lynch JP, Martinez FJ: Prognostic implications of physiologic and radiographic changes in idiopathic pulmonary fibrosis. Am J Respir Crit Care Med. 2003, 168: 543-548. 10.1164/rccm.200209-1112OC.CrossRefPubMed Flaherty KR, Mumford JA, Murray S, Kazerooni EA, Gross BH, Colby TV, Travis WD, Flint A, Toews GB, Lynch JP, Martinez FJ: Prognostic implications of physiologic and radiographic changes in idiopathic pulmonary fibrosis. Am J Respir Crit Care Med. 2003, 168: 543-548. 10.1164/rccm.200209-1112OC.CrossRefPubMed
13.
go back to reference Collard HR, King TE, Bartelson BB, Vourlekis JS, Schwarz MI, Brown KK: Changes in clinical and physiologic variables predict survival in idiopathic pulmonary fibrosis. Am J Respir Crit Care Med. 2003, 168: 538-542. 10.1164/rccm.200211-1311OC.CrossRefPubMed Collard HR, King TE, Bartelson BB, Vourlekis JS, Schwarz MI, Brown KK: Changes in clinical and physiologic variables predict survival in idiopathic pulmonary fibrosis. Am J Respir Crit Care Med. 2003, 168: 538-542. 10.1164/rccm.200211-1311OC.CrossRefPubMed
14.
go back to reference Latsi PI, du Bois RM, Nicholson AG, Colby TV, Bisirtzoglou D, Nikolakopoulou A, Veeraraghavan S, Hansell DM, Wells AU: Fibrotic idiopathic interstitial pneumonia: the prognostic value of longitudinal functional trends. Am J Respir Crit Care Med. 2003, 168: 531-537. 10.1164/rccm.200210-1245OC.CrossRefPubMed Latsi PI, du Bois RM, Nicholson AG, Colby TV, Bisirtzoglou D, Nikolakopoulou A, Veeraraghavan S, Hansell DM, Wells AU: Fibrotic idiopathic interstitial pneumonia: the prognostic value of longitudinal functional trends. Am J Respir Crit Care Med. 2003, 168: 531-537. 10.1164/rccm.200210-1245OC.CrossRefPubMed
15.
go back to reference Lama VN, Flaherty KR, Toews GB, Colby TV, Travis WD, Long Q, Murray S, Kazerooni EA, Gross BH, Lynch JP, Martinez FJ: Prognostic value of desaturation during a 6-minute walk test in idiopathic interstitial pneumonia. Am J Respir Crit Care Med. 2003, 168: 1084-1090. 10.1164/rccm.200302-219OC.CrossRefPubMed Lama VN, Flaherty KR, Toews GB, Colby TV, Travis WD, Long Q, Murray S, Kazerooni EA, Gross BH, Lynch JP, Martinez FJ: Prognostic value of desaturation during a 6-minute walk test in idiopathic interstitial pneumonia. Am J Respir Crit Care Med. 2003, 168: 1084-1090. 10.1164/rccm.200302-219OC.CrossRefPubMed
16.
go back to reference Lederer DJ, Arcasoy SM, Wilt JS, D'Ovidio F, Sonett JR, Kawut SM: Six-minute walk distance predicts waiting list survival in idiopathic pulmonary fibrosis. Am J Respir Crit Care Med. 2006, 174: 659-664. 10.1164/rccm.200604-520OC.PubMedCentralCrossRefPubMed Lederer DJ, Arcasoy SM, Wilt JS, D'Ovidio F, Sonett JR, Kawut SM: Six-minute walk distance predicts waiting list survival in idiopathic pulmonary fibrosis. Am J Respir Crit Care Med. 2006, 174: 659-664. 10.1164/rccm.200604-520OC.PubMedCentralCrossRefPubMed
17.
go back to reference Miki K, Maekura R, Hiraga T, Kuda Y, Kamoto T, Hirotani A, Gura T: Impairments and prognostic factors for survival in patients with idiopathic pulmonary fibrosis. Respir Med. 2003, 97: 482-490. 10.1053/rmed.2002.1469.CrossRefPubMed Miki K, Maekura R, Hiraga T, Kuda Y, Kamoto T, Hirotani A, Gura T: Impairments and prognostic factors for survival in patients with idiopathic pulmonary fibrosis. Respir Med. 2003, 97: 482-490. 10.1053/rmed.2002.1469.CrossRefPubMed
18.
go back to reference Fell CD, Liu LX, Motika C, Kazerooni EA, Gross BH, Travis WD, Colby TV, Murray S, Toews GB, Martinez FJ, Flaherty KR: The Prognostic Value of Cardiopulmonary Exercise Testing in Idiopathic Pulmonary Fibrosis. Am J Respir Crit Care Med. 2009, 179: 402-407. 10.1164/rccm.200802-241OC.PubMedCentralCrossRefPubMed Fell CD, Liu LX, Motika C, Kazerooni EA, Gross BH, Travis WD, Colby TV, Murray S, Toews GB, Martinez FJ, Flaherty KR: The Prognostic Value of Cardiopulmonary Exercise Testing in Idiopathic Pulmonary Fibrosis. Am J Respir Crit Care Med. 2009, 179: 402-407. 10.1164/rccm.200802-241OC.PubMedCentralCrossRefPubMed
19.
go back to reference Lynch DA, Godwin JD, Safrin S, Starko KM, Hormel P, Brown KK, Raghu G, King TE, Bradford WZ, Schwartz DA, Richard Webb W: High-resolution computed tomography in idiopathic pulmonary fibrosis. Diagnosis and prognosis. Am J Respir Crit Care Med. 2005, 172: 488-493. 10.1164/rccm.200412-1756OC.CrossRefPubMed Lynch DA, Godwin JD, Safrin S, Starko KM, Hormel P, Brown KK, Raghu G, King TE, Bradford WZ, Schwartz DA, Richard Webb W: High-resolution computed tomography in idiopathic pulmonary fibrosis. Diagnosis and prognosis. Am J Respir Crit Care Med. 2005, 172: 488-493. 10.1164/rccm.200412-1756OC.CrossRefPubMed
20.
go back to reference King TE, Schwarz MI, Brown K, Tooze JA, Colby TV, Waldron JA, Flint A, Thurlbeck W, Cherniack RM: Idiopathic Pulmonary Fibrosis: Relationship between Histopathologic Features and Mortality. Am J Respir Crit Care Med. 2001, 164: 1025-1032.CrossRefPubMed King TE, Schwarz MI, Brown K, Tooze JA, Colby TV, Waldron JA, Flint A, Thurlbeck W, Cherniack RM: Idiopathic Pulmonary Fibrosis: Relationship between Histopathologic Features and Mortality. Am J Respir Crit Care Med. 2001, 164: 1025-1032.CrossRefPubMed
21.
go back to reference Nicholson AG, Fulford LG, Colby TV, du Bois RM, Hansell DM, Wells AU: The relationship between individual histologic features and disease progression in idiopathic pulmonary fibrosis. Am J Respir Crit Care Med. 2002, 166: 173-177. 10.1164/rccm.2109039.CrossRefPubMed Nicholson AG, Fulford LG, Colby TV, du Bois RM, Hansell DM, Wells AU: The relationship between individual histologic features and disease progression in idiopathic pulmonary fibrosis. Am J Respir Crit Care Med. 2002, 166: 173-177. 10.1164/rccm.2109039.CrossRefPubMed
22.
go back to reference Flaherty KR, Colby TV, Travis WD, Toews GB, Mumford J, Murray S, Thannickal VJ, Kazerooni EA, Gross BH, Lynch JP, Martinez FJ: Fibroblastic foci in usual interstitial pneumonia: idiopathic versus collagen vascular disease. Am J Respir Crit Care Med. 2003, 167: 1410-1415. 10.1164/rccm.200204-373OC.CrossRefPubMed Flaherty KR, Colby TV, Travis WD, Toews GB, Mumford J, Murray S, Thannickal VJ, Kazerooni EA, Gross BH, Lynch JP, Martinez FJ: Fibroblastic foci in usual interstitial pneumonia: idiopathic versus collagen vascular disease. Am J Respir Crit Care Med. 2003, 167: 1410-1415. 10.1164/rccm.200204-373OC.CrossRefPubMed
23.
go back to reference Enomoto N, Suda T, Kato M, Kaida Y, Nakamura Y, Imokawa S, Ida M, Chida K: Quantitative analysis of fibroblastic foci in usual interstitial pneumonia. Chest. 2006, 130: 22-29. 10.1378/chest.130.1.22.CrossRefPubMed Enomoto N, Suda T, Kato M, Kaida Y, Nakamura Y, Imokawa S, Ida M, Chida K: Quantitative analysis of fibroblastic foci in usual interstitial pneumonia. Chest. 2006, 130: 22-29. 10.1378/chest.130.1.22.CrossRefPubMed
24.
go back to reference Tiitto L, Bloigu R, Heiskanen U, Pääkkö P, Kinnula VL, Kaarteenaho-Wiik R: Relationship between histopathological features and the course of idiopathic pulmonary fibrosis/usual interstitial pneumonia. Thorax. 2006, 61: 1091-1095. 10.1136/thx.2005.055814.PubMedCentralCrossRefPubMed Tiitto L, Bloigu R, Heiskanen U, Pääkkö P, Kinnula VL, Kaarteenaho-Wiik R: Relationship between histopathological features and the course of idiopathic pulmonary fibrosis/usual interstitial pneumonia. Thorax. 2006, 61: 1091-1095. 10.1136/thx.2005.055814.PubMedCentralCrossRefPubMed
25.
go back to reference Collard HR, Cool CD, Leslie KO, Curran-Everett D, Groshong S, Brown KK: Organizing pneumonia and lymphoplasmacytic inflammation predict treatment response in idiopathic pulmonary fibrosis. Histopathology. 2007, 50: 258-265. 10.1111/j.1365-2559.2006.02554.x.CrossRefPubMed Collard HR, Cool CD, Leslie KO, Curran-Everett D, Groshong S, Brown KK: Organizing pneumonia and lymphoplasmacytic inflammation predict treatment response in idiopathic pulmonary fibrosis. Histopathology. 2007, 50: 258-265. 10.1111/j.1365-2559.2006.02554.x.CrossRefPubMed
26.
go back to reference Hanak V, Ryu JH, de Carvalho E, Limper A, Hartman T, Decker P, Myers J: Profusion of fibroblast foci in patients with idiopathic pulmonary fibrosis does not predict outcome. Respir Med. 2008, 102: 852-856. 10.1016/j.rmed.2008.01.012.CrossRefPubMed Hanak V, Ryu JH, de Carvalho E, Limper A, Hartman T, Decker P, Myers J: Profusion of fibroblast foci in patients with idiopathic pulmonary fibrosis does not predict outcome. Respir Med. 2008, 102: 852-856. 10.1016/j.rmed.2008.01.012.CrossRefPubMed
27.
go back to reference American Thoracic Society; European Thoracic Society: Idiopathic interstitial pneumonias. Am J Respir Crit Care Med. 2002, 165: 277-304.CrossRef American Thoracic Society; European Thoracic Society: Idiopathic interstitial pneumonias. Am J Respir Crit Care Med. 2002, 165: 277-304.CrossRef
28.
go back to reference Daniil Z, Kitsanta P, Kapotsis G, Mathioudaki M, Kollintza A, Karatza M, Milic-Emili J, Roussos C, Papiris SA: CD8+ T lymphocytes in lung tissue from patients with idiopathic pulmonary fibrosis. Respir Res. 2005, 6: 81-10.1186/1465-9921-6-81.PubMedCentralCrossRefPubMed Daniil Z, Kitsanta P, Kapotsis G, Mathioudaki M, Kollintza A, Karatza M, Milic-Emili J, Roussos C, Papiris SA: CD8+ T lymphocytes in lung tissue from patients with idiopathic pulmonary fibrosis. Respir Res. 2005, 6: 81-10.1186/1465-9921-6-81.PubMedCentralCrossRefPubMed
29.
go back to reference Papiris SA, Kollintza A, Karatza M, Manali ED, Sotiropoulou C, Milic-Emili J, Roussos C, Daniil Z: CD8+ lymphocytes in bronchoalveolar lavage in idiopathic pulmonary fibrosis. J Inflamm (Lond). 2007, 4: 14-10.1186/1476-9255-4-14.CrossRef Papiris SA, Kollintza A, Karatza M, Manali ED, Sotiropoulou C, Milic-Emili J, Roussos C, Daniil Z: CD8+ lymphocytes in bronchoalveolar lavage in idiopathic pulmonary fibrosis. J Inflamm (Lond). 2007, 4: 14-10.1186/1476-9255-4-14.CrossRef
30.
go back to reference Manali ED, Lyberopoulos P, Triantafillidou C, Kolilekas LF, Sotiropoulou C, Milic-Emili J, Roussos C, Papiris SA: MRC chronic Dyspnea Scale: Relationships with cardiopulmonary exercise testing and 6-minute walk test in idiopathic pulmonary fibrosis patients: a prospective study. BMC Pulmonary Medicine. 2010, 10: 32-10.1186/1471-2466-10-32.PubMedCentralCrossRefPubMed Manali ED, Lyberopoulos P, Triantafillidou C, Kolilekas LF, Sotiropoulou C, Milic-Emili J, Roussos C, Papiris SA: MRC chronic Dyspnea Scale: Relationships with cardiopulmonary exercise testing and 6-minute walk test in idiopathic pulmonary fibrosis patients: a prospective study. BMC Pulmonary Medicine. 2010, 10: 32-10.1186/1471-2466-10-32.PubMedCentralCrossRefPubMed
31.
go back to reference Noble PW: Epithelial fibroblast triggering and interactions in pulmonary fibrosis. Eur Respir Rev. 2008, 17: 123-129. 10.1183/09059180.00010904.CrossRef Noble PW: Epithelial fibroblast triggering and interactions in pulmonary fibrosis. Eur Respir Rev. 2008, 17: 123-129. 10.1183/09059180.00010904.CrossRef
32.
go back to reference Cool CD, Groshong SD, Rai PR, Henson PM, Stewart JS, Brown KK: Fibroblastic foci are not discrete sites of lung injury or repair: the fibroblast reticulum. Am J Respir Crit Care Med. 2006, 176: 654-658. 10.1164/rccm.200602-205OC.CrossRef Cool CD, Groshong SD, Rai PR, Henson PM, Stewart JS, Brown KK: Fibroblastic foci are not discrete sites of lung injury or repair: the fibroblast reticulum. Am J Respir Crit Care Med. 2006, 176: 654-658. 10.1164/rccm.200602-205OC.CrossRef
33.
go back to reference O'Donnell DE, Ora J, Webb KA, Laveneziana P, Jensen D: Mechanisms of activity related dyspnea in pulmonary diseases. Respir Physiol Neurobiol. 2009, 167: 116-132.CrossRefPubMed O'Donnell DE, Ora J, Webb KA, Laveneziana P, Jensen D: Mechanisms of activity related dyspnea in pulmonary diseases. Respir Physiol Neurobiol. 2009, 167: 116-132.CrossRefPubMed
34.
go back to reference Papiris SA, Manali ED, Kolilekas L, Kagouridis K, Triantafillidou C, Tsangaris I, Roussos C: Idiopathic Pulmonary Fibrosis Acute Exacerbations: Unravelling Ariadne's thread. Crit Care. 2010, 14: 246-10.1186/cc9241.PubMedCentralCrossRefPubMed Papiris SA, Manali ED, Kolilekas L, Kagouridis K, Triantafillidou C, Tsangaris I, Roussos C: Idiopathic Pulmonary Fibrosis Acute Exacerbations: Unravelling Ariadne's thread. Crit Care. 2010, 14: 246-10.1186/cc9241.PubMedCentralCrossRefPubMed
Metadata
Title
Medical Research Council dyspnea scale does not relate to fibroblast foci profusion in IPF
Authors
Christina Triantafillidou
Effrosyni D Manali
Christina Magkou
Christina Sotiropoulou
Likurgos F Kolilekas
Konstantinos Kagouridis
Dimitra Rontogianni
Spyros A Papiris
Publication date
01-12-2011
Publisher
BioMed Central
Published in
Diagnostic Pathology / Issue 1/2011
Electronic ISSN: 1746-1596
DOI
https://doi.org/10.1186/1746-1596-6-28

Other articles of this Issue 1/2011

Diagnostic Pathology 1/2011 Go to the issue