LSC Abstract – Is it possible to predict the outcome of the whole lung lavage (WLL) in pulmonary alveolar proteinosis (PAP)?

Résumé fourni par la source

PAP is a rare disorder characterized by the accumulation of lipoproteinaceous material within alveolar spaces. WLL is the current standard treatment for PAP patients and although it is effective in the majority of cases, disease persistence is not unusual. To identify blood biomarkers able to predict the outcome of the WLL: total resolution/persistent improvement (positive outcome) or transient resolution/progressive deterioration (negative outcome). We collected total RNA from peripheral mononuclear cells of 8 PAP patients who underwent WLL, at the baseline and 24 months from the lavage. After the 24-month follow up, they were dichotomized in positive vs negative outcome and a microarray analysis was performed. Co-expression eigengenes module search and Gene Ontology, Reactome, KEGG, and Disease Ontology enrichment analysis was performed for differentially expressed genes (DEGs). Our preliminary data show 86 significantly DEGs, between PAP patients with a positive vs negative outcome; whereas WLL seems not to induce difference in gene expression, in the same subject, at least after two years. The gene co-expression networks analysis, selected a module comprehending 764 genes, which showed a gene significance mean p value=0.04 and a strong relationship between pairwise gene connections and gene significance. The enrichment analysis showed a common predominance of the GO biological process and Reactome pathways. This preliminary study allows to identify key pathways whose different expression could discriminate between PAP patients with a positive outcome vs negative outcome. The validation of our results will lead us to select biomarkers useful to follow up the clinical response to WLL.

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