Objective To detect the changes of soluble receptor for advanced glycation end products (sRAGE), fibrosis-related factors in alveolar lavage fluid (BALF), and lung function of patients with silicosis in different stages, analyze the relationship of sRGAE with fibrosis-related factors and lung function, and discuss the possible role and significance of sRGAE in the progression of silicosis.
Methods Sixty-one patients who underwent bronchoalveolar lavage in the Chinese Coal Worker Beidaihe Nursing Home from May to October 2016 were selected as study subjects, including 7 silicosis observation subjects, whose chest X-ray films showed uncertain silicosis-like changes, and 18 stage Ⅰ, 15 stage Ⅱ, and 21 stage Ⅲ silicosis patients. General data such as age, working age, blood pressure, body mass index (BMI), and age of first exposure to dust were collected. Pulmonary function related indicators such as forced vital capacity (FVC), forced expiratory volume in one second (FEV1), peak expiratory flow (PEF), peak expiratory flow at 25% of vital capacity (PEF25), forced expiratory flow at 50% of vital capacity (PEF50), ratio of forced expiratory volume in one second to forced vital capacity (FEV1/FVC), deep inspiratory capacity (IC), and maximum vital capacity (VCmax) were measured with PB840 pulmonary function tester. The levels of sRAGE, tumor necrosis factor α (TNF-α), and transforming growth factor β1 (TGF-β1) in BALF were detected with enzyme-linked immunosorbent assay (ELISA) kits. Correlations of sRAGE with indicators such as age, working age, age of first exposure to dust, blood pressure, BMI, lung function indicators, TNF-α, and TGF-β1 were assessed by Pearson product moment correlation.
Results There were no differences in age, working age, blood pressure, and BMI between the observation group and the patients with silicosis, but the age of first exposure to dust in the patients with silicosis at stage Ⅲ(29.19±7.64) years was higher than that of the observation group(26.86±7.01) years (P < 0.05). The lung function of the silicosis subjects decreased with the increase of silicosis stages, and VCmax, IC, PEF, PEF25, PEF50, PEF75, FEV1, FEV1/FVC were all lower in the patients with silicosis at stage Ⅲ than in the observation group (Ps < 0.05). The level of sRAGE of the silicosis stage Ⅲ group(1 060.91±472.75) pg/mL was lower than those of the silicosis stage Ⅱ group(1 490.36±688.56) pg/mL and the observation group(1 450.37±530.98) pg/mL (Ps < 0.05). The expression of TNF-α of the silicosis stage Ⅲ group(2.42±0.94) pg/mL was higher than those of the observation group(1.16±1.03) pg/mL and the silicosis stage Ⅰ group(1.51±0.97) pg/mL (Ps < 0.05). No significant difference was found in TGF-β1 level among the groups. The level of sRAGE was positively correlated with FEV1, FVC, and BMI, while negatively with the age of first exposure to dust, with correlation coefficients of 0.295, 0.265, 0.404, and -0.267 respectively (Ps < 0.05).
Conclusion The level of sRAGE is associated with FEV1, FVC, BMI, and the age of first exposure to dust. Reduced sRAGE may play an important role in the late progression of silicotic fibrosis.
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