To explore the difference of iron status, nutrition status, and serum cytokine levels between two types of mycobacterium avium complex (MAC) lung disease including fibrocavitary lung disease and nodular bronchiectatic disease.
The cross-sectional study was conducted at Niigata University Hospital, Japan, from April 2013 to March 2015, and comprised cases of pulmonary MAC disease. Iron status was explored by measuring hemoglobin (Hb), erythrocyte mean cell volume (MCV), serum concentrations of iron (Fe), unsaturated iron binding capacity (UIBC) / total iron binding capacity (TIBC), ferritin, and hepcidin. Nutritional status was determined by serum levels of albumin (Alb) and prealbumin (pre-Alb). Furthermore, serum concentrations of 38 cytokines were measured by using Luminex bead-based assays. The measured serum cytokines and several clinical factors were compared between the two forms of MAC lung disease.
There were 23 patients among whom 18 (78.3%) were females with an overall mean age of 67.5 ± 13.8 years. Anemia was more frequent in fibrocavitary lung disease (38%) than in nodular bronchiectatic disease (25%). Univariate analysis revealed that serum levels of CRP, SAA, Fe, UIBC , G-CSF, Interleukin (IL) -5, Interferon-Inducible Protein (IP) - 10, and VEGF were significantly elevated (p<0.05 each) in patients with fibrocavitary lung disease, and correlated inversely with Alb (p = 0.004) and pre-Alb (p = 0.002), compared to the group with nodular bronchiectatic disease.
Patients with fibrocavitary MAC lung disease tend to have elevated inflammatory markers, poor nutritional status and deterioration of iron status, and long-term management is necessary. Serum IP-10 levels were significantly increased in the cavitary form, and it might reflect the severity of pulmonary MAC disease as well as pulmonary tuberculosis.
T. Sakagami, None
T. Koya, None
Y. Tanabe, None
H. Kagamu, None
T. Takada, None
T. Kikuchi, None