Study on Phenotypic Characterization of Combined Pulmonary Fibrosis and Emphysema

A new disease including concomitant upper-lobe emphysema and lower-lobe fibrosis in radiology has been defined as (combined pulmonary fibrosis and emphysema, CPFE). CPFE has distinct clinical characteristics with the emphysema and the pulmonary fibrosis, including gender, age, clinical manifestation, pulmonary function tests and prognosis.

Normally Th1/Th2 is balanced. However, patients with emphysema had a significantly higher expression of Th1. On the other hand, higher expression of Th2 is involved in the development of pulmonary fibrosis. The expressions of Th1 and Th2 were proved to play a central role in pathogenesis of emphysema and pulmonary fibrosis, while are still unknown in patients of combined pulmonary fibrosis and emphysema. The study would observe the Th1/Th2 expression, pulmonary function tests , fractional exhaled nitric oxide （FENO）and other features in CPFE patients.

Inclusion criteria

• IPF-alone group: 10 patients meeting the IPF diagnosis criteria without emphysema.
• CPFE group: 15 patients with CT presentation of concomitant upper-lobe emphysema and lower-lobe fibrosis.
• Emphysema-alone group: 15 patients with their CT diagnosis of emphysema without fibrosis.
• Control: 20 healthy sex- and age-matched volunteers including nonsmokers and smokers. None of the healthy volunteers with a history of respiratory diseases.

Exclusion criteria

• Age > 90 or < 50
• Treated with corticosteroids or other immunomodulatory drugs
• Some known causes of interstitial lung disease such as collagen vascular disease, drug-induced lung disease, occupational disease.
• An exacerbation in 4 weeks
• Subjects had a history of allergic diseases.