You are here

Article Text

Article menu
Download PDFPDF
‘Call of the ILD’
P151 The role of the endothelial glycocalyx in fibrotic interstitial lung disease
  1. G Dixon1,2,3,4,
  2. JCL Rodrigues4,5,
  3. K Tsaneva-Atanasova6,7,8,
  4. CJ Scotton1,
  5. MA Gibbons3,
  6. SL Barratt2
  1. 1Department of Clinical and Biomedical Sciences, University of Exeter, Exeter, UK
  2. 2Bristol Interstitial Lung Disease Service, North Bristol NHS Trust, Bristol, UK
  3. 3South West Peninsula ILD Network, Royal Devon University Healthcare NHS Foundation Trust, Exeter, UK
  4. 4Royal United Hospitals Bath NHS Foundation Trust, Bath, UK
  5. 5Department of Health, University of Bath, Bath, UK
  6. 6Department of Mathematics and Statistics, Faculty of Environment, Science and Economy, University of Exeter, Exeter, UK
  7. 7EPSRC Hub for Quantitative Modelling in Healthcare, University of Exeter, Exeter, UK
  8. 8Living Systems Institute, University of Exeter, Exeter, UK

Abstract

Background and Aims The interstitial lung diseases are a heterogenous group of conditions with varying degrees of inflammation and fibrosis of the lungs. Disruption of the endothelial glycocalyx (EG) and subsequent vascular remodelling has been implicated in the pathogenesis of organ fibrosis but its role in the pathogenesis of pulmonary fibrosis is unknown. We aimed to assess the acceptability of EG assessment using sublingual video-microscopy and compare EG health between patients with fibrotic-ILD and healthy controls.

Methods Patients with fibrotic-ILD and age and sex matched healthy controls were recruited to a prospective observational study (PREDICT-ILD NCT05609201). Participants with diabetes, renal disease (eGFR<60) or connective tissue disease were excluded. EG assessment was performed using sublingual side-stream darkfield video-microscopy (GlycoCheckTM). GlycoCheckTM measures perfused boundary region (PBR) in vessels 5–25μm in width, a surrogate for EG width. Acceptability was measured using a modified theoretical framework of acceptability questionnaire. Participants in the fibrotic-ILD arms underwent pulmonary function testing on the same day as EG assessment.

Results 18 patients with IPF, 18 patients with non-IPF fibrotic-ILD (11 fibrotic hypersensitivity pneumonitis, 3 unclassifiable-ILD, 3 fibrotic non-specific interstitial pneumonia and 1 asbestosis) and 16 healthy controls were recruited. There was no significant difference in age or gender between groups. There was no significant different in% predicted FVC or% predicted DLCO between IPF and non-IPF fibrotic-ILD arms (76.5% vs 68.7%, p=0.197 and 50.9% vs 47.5%, p=0.534 respectively).

EG measurement was not possible in 2 participants in the non-IPF fibrotic ILD arm due to breathing pattern and tongue movement. There was no statistically significant difference between groups in intervention comfort, burden, self-efficacy and overall acceptability (p=0.169–0.987).

Mean PBR 5–25μm was higher in the IPF group vs controls 2.12μm vs 1.99μm (p=0.019) (figure 1). There was no difference between the non-IPF fibrotic-ILD group and IPF patients (p=0.492) or controls (p=0.216). The IPF group demonstrated significant correlation between% predicted FVC and PBR (5–25) r=-0.478 p=0.045.

Conclusions Sublingual video-microscopy is an acceptable test in patients with fibrotic-ILD. Baseline results suggest there may be a decrease in sublingual endothelial glycocalyx thickness in patients with IPF compared to healthy controls.

Abstract P151 Figure 1
Abstract P151 Figure 1

Mean perfused boundary region (5–25μm) between patients with non-IPF fibrotic-ILD, IPF and healthy controls. IPF = Idiopathic pulmonary fibrosis. PBR = Perfused Boundary Region

https://doi.org/10.1136/thorax-2024-BTSabstracts.312

Statistics from Altmetric.com

    Request Permissions

    If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.