Changes Of Cyclic Nucleotides And Nitric Oxide In The Plasma Of Patients With Idiopathic Pulmonary Fibrosis

Objective:Idiopathic pulmonary fibrosis(IPF) is a disease with functional disturbance of epithelial cell and fibroblast. Cytokines may display a critical promote-fibrosis effect in IPF.As the incidence rate of IPF increased,IPF has been one of hot spots in the research of respiratory disease.But the etiology of this disease is unknown,and the pathogenesy of this disease is unclear,and there is no specific treatment at present,the therapy at present could not improve the life quality and lengthen survival time in the patients with IPF.Traditional theory believes that the impairment and fibrosis induced by the inflammation is the pathology feature of IPF,and believes that the inflammatory process plays a very important role.But the inflammatory reaction in the case of IPF with confirmed diagnosis is not severe,and the anti-inflammatory therapy in the most patients does not get ideal effect.With the further understanding to the pathogenesis of idiopathic pulmonary fibrosis,various new treatment strategies have been suggested. all vital phenomena in the organism depend on message transfer and regulation in or out of cell,and the process needs the messenger in or out of cell,cyclic adenosine monophosphate (cAMP) and cyclic guanosine monophosphate(cGMP) as the second messenger play important roles in regulating immunoreaction,cell proliferation and differentiation,keeping balance of relaxation and contraction of smooth muscle, homeostatic equilibrium of vessel,participating nervous activity,regulating genetic expression,and so on.nitric oxide(NO) as the messenger mediates alveolar epithelial cell and alveolar macrophage proliferation and apoptosis,takes part in the formation of pulmonary fibrosis.To detect the levels of cAMP,cGMP,cAMP/cGMP and NO in the plasma of patients with IPF,and to evaluate the significance of the changes in the pathogenesis of IPF,then to provide the rationale of the application of cAMP for curing IPF.Methods:we obtain 3ml venous blood from each patient,which was dealed with EDTA disodium anticoagulation,then extract plasma with density gradient centrifugation method,then add 0.1ml plasma into 2ml anhydrous alcohol,then centrifugate and put the supernate into tube,centrifugate the remainder with 1ml 75%alcohol,then put the two supernate together and dissolve the remainder after stoved with acetic acid buffer solution,then take 0.10ml to get the measurements by radiation immunoassay to detect cAMP, cGMP,cAMP/cGMP and the method of nitrate reductase was used to detect NO in the plasma of subjects.Pulmonary function test and HRCT were performed in patients with IPF,IPF and pulmonary infection.The total of healthy person and patients with pneumonia comed to 31,they were regarded as the control group.Results:The levels of cAMP in the plasma of the patients with IPF were(13.53±3.69)pmol/ml,The levels of cAMP in the plasma of the patients with IPF and polmonary infection were (14.32±4.09) pmol/ml,The levels of cAMP in theplasma of the patients with pneumonia were(18.80±7.13) pmol/ml,The levels of cAMP in the plasma of the healthy person were (19.24±5.32) pmol/ml.The levels of cAMP in the plasma of the patients with IPF were lower than those of healthy person. They showed no significant difference between two research groups and between two control groups.The levels of cGMP in the plasma of the patients with IPF were(2.72±1.55) pmol/ml, The levels of cGMP in the plasma of the patients with IPF and polmonary infection were(3.17±2.04) pmol/ml,The levels of cGMP in the plasma of the patients with pneumonia were (3.80±3.94) pmol/ml,The levels of cGMP in the plasma of the healthy person were(1.90±0.30) pmol/ml.The levels of cGMP in the plasma of the research group showed no significant difference as compared with those of the control group.The levels of NO in the plasma of the research group showed no significant difference as compared with those of the control group.cAMP and cAMP/cGMP in the plasma of the research group showed no correlation with chest HRCT fibrosis scores. the research group had positive correlation with pulmonary function test. Conclusion1 The level of cAMP and cAMP/cGMP in patients with IPF is lower than those of healthy person.2 Nitric oxide plays an important role at early stage of IPF.