Serum B-cell activating factor and lung ultrasound B-lines in connective tissue disease related interstitial lung disease.

Objective: To investigate the role of serum B-cell activating factor (BAFF) and lung ultrasound (LUS) B-lines in connective tissue disease related interstitial lung disease (CTD-ILD), and their association with different ILD patterns on high resolution computed tomography (HRCT) of chest. Methods: We measured the levels of BAFF and KL-6 by ELISA in the sera of 63 CTD-ILD patients [26 with fibrotic ILD (F-ILD), 37 with non-fibrotic ILD (NF-ILD)], 30 CTD patients without ILD, and 26 healthy controls. All patients underwent chest HRCT and LUS examination. Results: Serum BAFF levels were significantly higher in CTD patients compared to healthy subjects (617.6 ± 288.1 pg/ml vs. 269.0 ± 60.4 pg/ml, p < 0.01). BAFF concentrations were significantly different between ILD group and non-ILD group (698.3 ± 627.4 pg/ml vs. 448.3 ± 188.6 pg/ml, p < 0.01). In patients with ILD, BAFF concentrations were significantly correlated with B-lines number (r = 0.37, 95% CI 0.13-0.56, p < 0.01), KL-6 level (r = 0.26, 95% CI 0.01-0.48, p < 0.05), and Warrick score (r = 0.33, 95% CI 0.09-0.53, p < 0.01), although all correlations were only low to moderate. B-lines number correlated with Warrick score (r = 0.65, 95% CI 0.48-0.78, p < 0.01), and KL-6 levels (r = 0.43, 95% CI 0.21-0.61, p < 0.01). Patients with F-ILD had higher serum BAFF concentrations (957.5 ± 811.0 pg/ml vs. 516.1 ± 357.5 pg/ml, p < 0.05), KL-6 levels (750.7 ± 759.0 U/ml vs. 432.5 ± 277.5 U/ml, p < 0.05), B-lines numbers (174.1 ± 82 vs. 52.3 ± 57.5, p < 0.01), and Warrick score (19.9 ± 4.6 vs. 13.6 ± 3.4, p < 0.01) vs. NF-ILD patients. The best cut-off values to separate F-ILD from NF-ILD using ROC curves were 408 pg/ml for BAFF (AUC = 0.73, p < 0.01), 367 U/ml for KL-6 (AUC = 0.72, p < 0.05), 122 for B-lines number (AUC = 0.89, p < 0.01), and 14 for Warrick score (AUC = 0.87, p < 0.01) respectively. Conclusion: Serum BAFF levels and LUS B-lines number could be useful supportive biomarkers for detecting and evaluating the severity and/or subsets of CTD-ILD. If corroborated, combining imaging, serological, and sonographic biomarkers might be beneficial and comprehensive in management of CTD-ILD.

The role of lung ultrasound B-lines and serum KL-6 in the screening and follow-up of rheumatoid arthritis patients for an identification of interstitial lung disease: review of the literature, proposal for a preliminary algorithm, and clinical application to cases.

Screening and follow-up of interstitial lung disease associated with rheumatoid arthritis (RA-ILD) is a challenge in clinical practice. In fact, the majority of RA-ILD patients are asymptomatic and optimal tools for early screening and regular follow-up are lacking. Furthermore, some patients may remain oligosymptomatic despite significant radiological abnormalities. In RA-ILD, usual interstitial pneumonia (UIP) is the most frequent radiological and pathological pattern, associated with a poor prognosis and a high risk to develop acute exacerbations and infections. If RA-ILD can be identified early, there may be an opportunity for an early treatment and close follow-up that might delay ILD progression and improve the long-term outcome.In connective tissue disease-associated interstitial lung disease (CTD-ILD), lung ultrasound (LUS) with the assessment of B-lines and serum Krebs von den Lungen-6 antigen (KL-6) has been recognized as sensitive biomarkers for the early detection of ILD. B-line number and serum KL-6 level were found to correlate with high-resolution computed tomography (HRCT), pulmonary function tests (PFTs), and other clinical parameters in systemic sclerosis-associated ILD (SSc-ILD). Recently, the significant correlation between B-lines and KL-6, two non-ionizing and non-invasive biomarkers, was demonstrated. Hence, the combined use of LUS and KL-6 to screen and follow up ILD in RA patients might be useful in clinical practice in addition to existing tools. Herein, we review relevant literature to support this concept, propose a preliminary screening algorithm, and present 2 cases where the algorithm was used.

[UP-PCR diversity analysis of Fusarium population isolated from greenhouse melon soils].

A total of 112 Fusarium isolates were obtained from 36 soil samples collected from the greenhouse melon fields of Liaoning Province, among which, 11 species were identified by traditional morphological classification and rDNA sequence analysis. Universally Primed PCR (UP-PCR) was conducted to analyze the 25 strains of test Fusarium isolates and 3 strains of positive control Fusarium isolates. The results indicated that a total of 73 bands appeared after amplification by using 6 primers, and 66 bands (90.4%) were polymorphic. The isolates were clustered into eight groups at the similarity of 0.736 by cluster analysis, among which, 14 isolates were clustered into one group. It was concluded that UP-PCR could present the genetic relationship and difference among Fusarium strains, being able to be used as an assistant method for Fusarium classification.

[Population of entophytic bacteria in maize roots and its dynamic analysis].

In 2001-2002, 14 maize cultivars in Liaoning Province were used for the analysis of their entophytic bacteria population. The entophytic bacteria strains with a higher frequency in maize roots were Bacillus spp., Enterobacter spp., Serratia spp., Pseudomonas spp., Xanthomonas spp., Clavibacter spp., Bacillus spp., Enterobacter spp. and Serratia spp. Comparatively, Bacillus spp. was the most prevalent entophytic bacterium, including 8 species, B. subtilis, B. megaterium, B. cereus, B. licheniformis, B. anthracis, B. mycoides, B. pumilus and B. circulans, and with an average isolation frequency of 75.5% at seedling stage and 77.6% at adult stage. There existed significant differences in the population and dynamics of endophytic bacteria among maize cultivars and growth periods, and a significant correlation was found between maize genetic background and entophytic bacteria population.