Helano Neiva de Castro, Mara Rúbia Fernandes de Figueiredo, Norma Selma Santos, Teresa Neuma Albuquerque Gomes Nogueira, Maria da Penha Uchoa, Marcelo Alcântara Holanda

J Bras Pneumol.2005;31(4):360-364

Original Article

PET/CT and inflammatory mediators in systemic sclerosis-associated interstitial lung disease

PET/TC e mediadores inflamatórios na doença pulmonar intersticial associada à esclerose sistêmica

Andréa L Bastos1, Gilda A Ferreira2, Marcelo Mamede1, Eliane V Mancuzo3, Mauro M Teixeira4, Flávia P S T Santos5, Cid S Ferreira6, Ricardo A Correa3

J Bras Pneumol.2022;48(4):e20210329

Objective: To investigate the correlation of HRCT findings with pulmonary metabolic activity in the corresponding regions using 18F-FDG PET/CT and inflammatory markers in patients with systemic sclerosis (SSc)-associated interstitial lung disease (ILD). Methods: This was a cross-sectional study involving 23 adult patients with SSc-associated ILD without other connective tissue diseases. The study also involved 18F-FDG PET/CT, HRCT, determination of serum chemokine levels, clinical data, and pulmonary function testing. Results: In this cohort of patients with long-term disease (disease duration, 11.8 ± 8.7 years), a nonspecific interstitial pneumonia pattern was found in 19 (82.6%). Honeycombing areas had higher median standardized uptake values (1.95; p = 0.85). Serum levels of soluble tumor necrosis factor receptor 1, soluble tumor necrosis factor receptor 2, C-C motif chemokine ligand 2 (CCL2), and C-X-C motif chemokine ligand 10 were higher in SSc patients than in controls. Serum levels of CCL2-a marker of fibroblast activity-were correlated with pure ground-glass opacity (GGO) areas on HRCT scans (p = 0.007). 18F-FDG PET/CT showed significant metabolic activity for all HRCT patterns. The correlation between serum CCL2 levels and GGO on HRCT scans suggests a central role of fibroblasts in these areas, adding new information towards the understanding of the mechanisms surrounding cellular and molecular elements and their expression on HRCT scans in patients with SSc-associated ILD. Conclusions: 18F-FDG PET/CT appears to be unable to differentiate the intensity of metabolic activity across HRCT patterns in chronic SSc patients. The association between CCL2 and GGO might be related to fibroblast activity in these areas; however, upregulated CCL2 expression in the lung tissue of SSc patients should be investigated in order to gain a better understanding of this association.

Keywords: Tomography; Lung diseases, interstitial; Scleroderma, systemic; Cytokines.

Letters to the Editor

Diffuse pulmonary lymphangiomatosis

Linfangiomatose pulmonar difusa

Igor Biscotto1,a, Rosana Souza Rodrigues1,2,b, Danielle Nunes Forny1,c, Miriam Menna Barreto1,d, Edson Marchiori1,e

J Bras Pneumol.2019;45(5):e20180412

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