[en] PURPOSE: To assess, in lung cancer patients, the effects of thoracic radiotherapy (RT) on the concentrations of transforming growth factor-beta(1) (TGF-beta(1)) and interleukin-6 (IL-6) in the bronchoalveolar lavage (BAL) fluid. METHODS AND MATERIALS: Eleven patients with lung cancer requiring RT as part of their treatment were studied. BAL was performed bilaterally before, during, and 1, 3, and 6 months after RT. Before each BAL session, the patient's status was assessed clinically using pulmonary function tests and an adapted late effects on normal tissue-subjective, objective, management, analytic (LENT-SOMA) scale, including subjective and objective alterations. The National Cancer Institute Common Toxicity Criteria were used to grade pneumonitis. The TGF-beta(1) and IL-6 levels in the BAL fluid were determined using the Easia kit. RESULTS: The TGF-beta(1) and IL-6 concentrations in the BAL fluid recovered from the irradiated areas were significantly increased by thoracic RT. The increase in TGF-beta(1) levels tended to be greater in the group of patients who developed severe pneumonitis. In the BAL fluid from the nonirradiated areas, the TGF-beta(1) and IL-6 concentrations remained unchanged. CONCLUSION: The observed increase in TGF-beta(1) and IL-6 concentrations in the BAL fluid recovered from the irradiated lung areas demonstrated that these cytokines may contribute to the process leading to a radiation response in human lung tissue.
Bosquee, Lionel; Centre Hospitalier Universitaire de Liège - CHU
Cataldo, Didier ; Université de Liège - ULiège > Département des sciences cliniques > Labo de biologie des tumeurs et du développement - Département des sciences biomédicales et précliniques
Corhay, Jean-Louis ; Université de Liège - ULiège > Département des sciences cliniques > Département des sciences cliniques
Gustin, Michel
Seidel, Laurence ; Université de Liège - ULiège > Département des sciences de la santé publique > Informatique médicale et biostatistique
Thiry, Albert ; Université de Liège - ULiège > Anatomie pathologique
Ghaye, Benoît ; Centre Hospitalier Universitaire de Liège - CHU > Imagerie médicale
Nizet, Michel
Albert, Adelin ; Université de Liège - ULiège > Département des sciences de la santé publique > Informatique médicale et biostatistique
Deneufbourg, Jean-Marie ; Université de Liège - ULiège > Département des sciences cliniques > Radiothérapie
Bartsch, Pierre ; Université de Liège - ULiège > Pneumologie-Allergologie
Nusgens, Betty ; Université de Liège - ULiège > Département des sciences biomédicales et précliniques > Laboratoire de Biologie des Tissus Conjonctifs
Landis S.H., Murray T., Bolden S., et al. Cancer statistics 1999. CA Cancer J Clin. 49:1999;8-31.
Martel M.K., Ten Haken R.K., Hazuka M.B., et al. Dose-volume histogram and 3-D treatment planning evaluation of patients with pneumonitis. Int J Radiat Oncol Biol Phys. 28:1994;575-581.
Roach M. III, Gandara D.R., Yuo H.S., et al. Radiation pneumonitis following combined modality therapy for lung cancer Analysis of prognostic factors . J Clin Oncol. 13:1995;2606-2612.
Dosoretz D.E., Galmarini D., Rubenstein J.H., et al. Local control in medically inoperable lung cancer An analysis of its importance in outcome and factors determining the probability of tumor eradication . Int J Radiat Oncol Biol Phys. 27:1993;507-516.
Rubin P., Johnston C.J., Williams J.P., et al. A perpetual cascade of cytokines postirradiation leads to pulmonary fibrosis. Int J Radiat Oncol Biol Phys. 33:1995;99-109.
Anscher M.S., Marks L.B., Shafman T.D., et al. Using plasma transforming growth factor beta-1 during radiotherapy to select patients for dose escalation. J Clin Oncol. 19:2001;3758-3765.
Chen Y., Rubin P., Williams J., et al. Circulating IL-6 as a predictor of radiation pneumonitis. Int J Radiat Oncol Biol Phys. 49:2001;641-648.
Chen Y., Williams J., Ding I., et al. Radiation pneumonitis and early circulatory cytokine markers. Semin Radiat Oncol. 12:2002;26-33.
van Snick J. Interleukin-6 An overview . Annu Rev Immunol. 8:1990;253-278.
Hirano T. Interleukin-6 and its relation to inflammation and disease. Clin Immunol Immunopathol. 62:1992;S60-65.
Kelley J. State of the art Cytokines of the lung . Am Rev Respir Dis. 141:1990;765-788.
Elias J.A., Lentz V., Cummings P.J. Transforming growth factor-β regulation of IL-6 production by unstimulated and IL-1 stimulated human fibroblasts. J Immunol. 146:1991;3437-3443.
Cromwell O., Hamid Q., Corrigan C.J., et al. Expression and generation of interleukin-8, IL-6 and granulocyte-macrophage colony-stimulating factor by bronchial epithelial cells and enhancement by IL-1 β and tumour necrosis factor-α Immunology. 77:1992;330-337.
Crestani B., Cornillet P., Dehoux M., et al. Alveolar type II epithelial cells produce interleukin-6 in vitro and in vivo Regulation by alveolar macrophage secretory products . J Clin Invest. 94:1994;731-740.
Crestani B., Seta N., De Bandt M., et al. Interleukin 6 secretion by monocytes and alveolar macrophages in systemic sclerosis with lung involvement. Am J Respir Crit Care Med. 149:1994;1260-1265.
Wong C.K., Ho C.Y., Ko F.W., et al. Proinflammatory cytokines (IL-17, IL-6, IL-18 and IL-12) and Th cytokines (IFN-γ, IL-4, IL-10 and IL-13) in patients with allergic asthma. Clin Exp Immunol. 125:2001;177-183.
Hsieh C.C., Tang R.B., Tsai C.H., et al. Serum interleukin-6 and tumor necrosis factor-α concentrations in children with mycoplasma pneumonia. J Microbiol Immunol Infect. 34:2001;109-112.
Wedzicha J.A., Seemungal T.A.R., MacCallum P.K., et al. Acute exacerbations of chronic obstructive pulmonary disease are accompanied by elevations of plasma fibrinogen and serum IL-6 levels. Thromb Haemost. 84:2000;210-215.
Headley A.S., Tolley E., Meduri G.U. Infections and the inflammatory response in acute respiratory distress syndrome. Chest. 111:1997;1306-1321.
Dobyns E.L., Eells P.L., Griebel J.L., et al. Elevated plasma endothelin-1 and cytokine levels in children with severe acute respiratory distress syndrome. J Pediatr. 135:1999;246-249.
Yanagawa H., Sone S., Takahashi Y., et al. Serum levels of interleukin 6 in patients with lung cancer. Br J Cancer. 71:1995;1095-1098.
Tyburski J.G., Dente C., Wilson R.F., et al. Differences in arterial and mixed venous IL-6 levels The lungs as a source of cytokine storm in sepsis . Surgery. 130:2001;748-752.
Schutte H., Lohmeyer J., Rosseau S., et al. Bronchoalveolar and systemic cytokine profiles in patients with ARDS, severe pneumonia and cardiogenic pulmonary oedema. Eur Respir J. 9:1996;1858-1867.
Maus U., Rosseau S., Knies U., et al. Expression of pro-inflammatory cytokines by flow-sorted alveolar macrophages in severe pneumonia. Eur Respir J. 11:1998;534-541.
Park C.S., Chung S.W., Ki S.Y., et al. Increased levels of interleukin-6 are associated with lymphocytosis in bronchoalveolar lavage fluids of idiopathic nonspecific interstitial pneumonia. Am J Respir Crit Care Med. 162:2000;1162-1168.
Park W.Y., Goodman R.B., Steinberg K.P., et al. Cytokine balance in the lungs of patients with acute respiratory distress syndrome. Am J Respir Crit Care Med. 164:2001;1896-1903.
Magnan A., Mege J.L., Escallier J.C., et al. Balance between alveolar macrophage IL-6 and TGF-β in lung-transplant recipients. Am J Respir Crit Care Med. 153:1996;1431-1436.
Dowlati A., Levitan N., Remick S.C. Evaluation of interleukin-6 in bronchoalveolar lavage fluid and serum of patients with lung cancer. J Lab Clin Med. 134:1999;405-409.
Chyczewska E., Mroz R.M., Kowal E. TNF-alpha, IL-1 and IL-6 concentration in bronchoalveolar lavage fluid (BALF) of non-small cell lung cancer (NSCLC). Rocz Akad Med Bialymst. 42:(Suppl. 1):1997;123-135.
Song W., Zhao J., Li Z. Interleukin-6 in bronchoalveolar lavage fluid from patients with COPD. Chin Med J. 114:2001;1140-1142.
Scholma J., Slebos D.J., Boezen H.M., et al. Eosinophilic granulocytes and interleukin-6 level in bronchoalveolar lavage fluid are associated with the development of obliterative bronchiolitis after lung transplantation. Am J Respir Crit Care Med. 162:2000;2221-2225.
Hosoi Y., Miyachi H., Matsumoto Y., et al. Induction of Interleukin-1β and interleukin-6 mRNA by low doses of ionizing radiation in macrophages. Int J Cancer (Radiat Oncol Invest). 96:2001;270-276.
Broekelmann T.J., Limper A.H., Colby T.V., et al. Transforming growth factor β1 is present at sites of extracellular matrix gene expression in human pulmonary fibrosis. Proc Natl Acad Sci USA. 88:1991;6642-6646.
El-Gamel A., Sim E., Hasleton P., et al. Transforming growth factor beta (TGF-β) and obliterative bronchiolitis following pulmonary transplantation. J Heart Lung Transplant. 18:1999;828-837.
Jagirdar J., Begin R., Dufresne A., et al. Transforming growth factor-β (TGF-β) in silicosis. Am J Respir Crit Care Med. 154:1996;1076-1081.
Khalil N., O'Connor R.N., Flanders K.C., et al. TGF-β1, but not TGF-β2 or TGF-β3, is differentially present in epithelial cells of advanced pulmonary fibrosis An immuno-histochemical study . Am J Respir Cell Mol Biol. 14:1996;131-138.
Khalil N., O'Connor R.N., Unruh H.W., et al. Increased production and immunohistochemical localization of transforming growth factor-β in idiopathic pulmonary fibrosis. Am J Respir Cell Mol Biol. 5:1991;155-162.
Anscher M.S., Kong F.M., Jirtle R.L. The relevance of transforming growth factor β1 in pulmonary injury after radiation therapy. Lung Cancer. 19:1998;109-120.
Fu X.L., Huang H., Bentel G., et al. Predicting the risk of symptomatic radiation-induced lung injury using both the physical and biologic parameters V30 and transforming growth factor β Int J Radiat Oncol Biol Phys. 50:2001;899-908.
Anscher M.S., Kong F.M., Andrews K., et al. Plasma transforming growth factor β1 as a predictor of radiation pneumonitis. Int J Radiat Oncol Biol Phys. 41:1998;1029-1035.
Anscher M.S., Kong F.M., Murase T., et al. Short communication Normal tissue injury after cancer therapy is a local response exacerbated by an endocrine effect of TGF-β Br J Radiol. 68:1995;331-333.
Barthelemy-Brichant N., David J.L., Bosquée L., et al. Increased TGF-β1 plasma level in patients with lung cancer Potential mechanisms . Eur J Clin Invest. 32:2002;193-198.
Rube C.E., Uthe D., Schmid K.W., et al. Dose-dependent induction of transforming growth factor β (TGF-β) in the lung tissue of fibrosis-prone mice after thoracic irradiation. Int J Radiat Oncol Biol Phys. 47:2000;1033-1042.
Finkelstein J.N., Johnston C.J., Baggs R., et al. Early alterations in extracellular matrix and transforming growth factor β gene expression in mouse lung indicative of late radiation fibrosis. Int J Radiat Oncol Biol Phys. 28:1994;621-631.
Yi E.S., Bedoya A., Lee H., et al. Radiation-induced lung injury in vivo Expression of transforming growth factor-beta precedes fibrosis . Inflammation. 20:1996;339-352.
Hakenjos L., Bamberg M., Rodemann H.P. TGF-beta1-mediated alterations of rat lung fibroblast differentiation resulting in the radiation-induced fibrotic phenotype. Int J Radiat Biol. 76:2000;503-509.
von Pfeil A., Hakenjos L., Herskind C., et al. Irradiated homozygous TGF-β1 knockout fibroblasts show enhanced clonogenic survival as compared with TGF-β1 wild-type fibroblasts. Int J Radiat Biol. 78:2002;331-339.
Johnston C.J., Piedboeuf B., Baggs R., et al. Differences in correlation of mRNA gene expression in mice sensitive and resistant to radiation-induced pulmonary fibrosis. Radiat Res. 142:1995;197-203.
Franko A.J., Sharplin J., Ghahary A., et al. Immunohistochemical localization of transforming growth β and tumor necrosis factor α in the lungs of fibrosis-prone and "non-fibrosing" mice during the latent period and early phase after irradiation. Radiat Res. 147:1997;245-256.
Kong F.M., Washington M.K., Jirtle R.L., et al. Plasma transforming growth factor-β1 reflects disease status in patients with lung cancer after radiotherapy A possible tumor marker . Lung Cancer. 16:1996;47-59.
Kong F.M., Jirtle R.L., Huang D.H., et al. Plasma transforming growth factor-β1 level before radiotherapy correlates with long term outcome of patients with lung carcinoma. Cancer. 86:1999;1712-1719.