The Nonthyroidal Illness Syndrome: Prognostic Value and Circulating Cytokines after Allogeneic Bone Marrow Transplantation / 대한내분비학회지

BACKGROUND: Alteration of thyroid hormone parameters are frequently observed in sick patients and commonly known as nonthyroidal illness syndrome(NTIS) or euthyroid sick syndrome(ESS). NTIS is seen in starvation, surgery, severe illness, and also bone marrow transplantation(BMT). The degree of reduction in thyroid hormone parameters correlated with the severity of NTIS and might predict the prognosis of underlying illness. Recently, particular attention is focused on the role of cytokines in developing the NTIS. This prospective study was designed to assess the relationship of serum thyroid hormone parameters and serum cytokine levels before and in the short-term follow-up after allogeneic BMT in order to predict patients outcome. METHODS: Included 80 patients that were mainly leukemia and severe aplastic anemia. Serum thyroid hormone parameters and serum cytokine levels were measured before and 7, 14, 21, 28 days and 3, and 6 months after BMT. RESULTS: Near-all patients experienced significant decrease of thyroid hormone levels and also significant increase of cytokine levels after BMT. After post-BMT 3 weeks, the serum cytokine levels were negatively correlated with the serum T3 and T4 levels, but not with the serum TSH levels. The patients treated with high-dose steroid or total-body irradiation tended to show lower levels of TSH and more delayed recovery compared to non-treated patients. The patients died after BMT represented generally lower levels of all thyroid hormone parameters than survival patients during entire follow-up period. CONCLUSION: Development of NTIS is associated with higher probability of fatal outcome after BMT and has prognostic relationship in this group of patients. Increased levels of cytokines, especially IL-6 and TNF-alpha, are often found in post-BMT NTIS patients and correlated with the changes in the levels of thyroid hormone parameters.

Clinical Process and Pulmonary Function of Workers Exposed to Dusts in Manufacturing Industries: Potential Biomarkers of Pneumoconiosis / 대한산업의학회지

Alveolitis is believed to be a primary response after dust inhalation. Activated inflammatory cells by dust and their mediators are major participants in the evolution of pneumoconiosis. Therefore evaluation of degree of alveolitis is useful for assessing disease activity and estimating of prognosis in pneumoconiosis. This study focused on the workers with pneumoconiosis who are working and worked in manufacturing industries because the occupying fraction by them among total pneumoconioses patients in our country is increasing recently. In order to identify and validate biomarkers to early diagnosis and better predict for the suceptible workers, the release of tumor necrosis factor (TNF alpha ), interleukine-8 (IL-8), platelet-derived growth factor-AA(PDGF-AA) and transforming growth factor-beta TGF beta ) from alveolar macrophages and blood monocytes, their concentration in BAL (bronchoalveolar lavage) fluid, pulmonary function test and Gallium index of lung were performed on 25 patients with pneumoconiosis who worked in manufactory industries. The results of this study were as follows ; 1. No significant differences were demonstrated between large opacity group and small opacity group, however pulmonary diffusing capacity in large opacity group was significantly lower than that in small opacity group. 2. (67)Gallium index was significantly correlated with increase of category in pnemoconiosis(r=0.83, p<0.05). 3. Numbers of total cells (r=0.583, p<0.05) and alveolar macrophages (r=0.499, p<0.05) in BAL were significantly correlated with the category of pneumoconiosis. 4. Spontaneous (r=0.474, p<0.05) and LPS (r=0.463, p<0.05) stimulated release of TNF alpha from macrophage, IL-8 (r=0.464, p<0.05) and TGF beta r=0.460, p<0.05) in BAL fluid were significantly correlated with category of pneumoconiosis. 5. Significantly positive correlation was demonstrated between spontaneous (r=0.443, p<0.05) and LPS (r=0.573, p<0.05) stimulated release of TNF alpha with the category of pneumoconiosis. 6. Release of TNF alpha from alveolar macrophages(r=0.61, p<0.05) and blood monocytes (r=0.48, p<0.05), IL-8 concentration in BAL fluid (r=0.52, p<0.05) and (67)Gallium index (r=0.53, p<0.05) were consider to sensitive biomarkers for alveolitis by dust.