Objective: Role of chemokines in the pathogenesis of pulmonary fibrosis (PF) due to sulfur mustard (SM) gas inhalation.
Patients: 18 veterans with SM gas-induced PF, 15 patients with IPF and 18 normal as controls.
Intervention: Chest roentgenograms, PFTs, the percentage DLCO, high-resolution CT scans of the chest, and analyses of BAL fluids for chemokines (MCP-1, MIP-1 alpha, and MIP-1 beta) were performed in all cases.
Results: There were significant differences in chemokines (MCP-1, MIP-1 alpha, and MIP-1 beta) levels of BAL fluid between patients with PF and healthy controls (p<0.0006). MCP-1 and MIP-1 alpha levels in BAL fluid correlate only with the percentage and the absolute number lymphocytes of the BAL fluid in patients with PF due to SM gas inhalation (p=0.0006/p=0.03; p=0.04/p=0.02; respectively). The BAL fluid level of MIP-alpha in SM gas-induced PF was significantly correlated with the number of lymphocytes (r=-0.56, p=0.01), neutrophils (r=-0.50, p=0.03) and eosinophils (r=-0.49, p=0.03). A significant negative correlation was observed between the percentage of Dlco and MCP-1 and MIP-1 alpha levels in BAL fluid in patients with PF (r=-0.65, p=0.003; r=-0.48, p=0.04; respectively).
Conclusion: Neutrophils alveolitis, presence of eosinophils, and higher concentrations of interleukin MCP-1, MIP-1 alpha, and MIP-1 beta in BAL fluid are associated with the development of fibrosis in SM victims.