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Soluble Transforming Growth Factor-α Is Present in the Pulmonary Edema Fluid of Patients With Acute Lung Injury

Asha N. Chesnutt; Farrah Kheradmand; Hans G. Folkesson; Michael Alberts; Michael A. Matthay
Author and Funding Information

From the Departments of Medicine and Anesthesia, Cardiovascular Research Institute, University of California, San Francisco


1997 by the American College of Chest Physicians


Chest. 1997;111(3):652-656. doi:10.1378/chest.111.3.652
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Abstract

Recent in vivo and in vitro experimental evidence indicates that transforming growth factoralpha (TGF-α) is an important growth factor in the process of recovery and remodeling that occurs after acute lung injury. However, there are very little clinical data on TGF-α in patients with acute lung injury. Therefore, the purpose of this study was to determine if TGF-α is present in biologically significant concentrations in the pulmonary edema fluid from patients with acute lung injury, and to determine if the presence of TGF-α is specific for acute lung injury by including control patients with hydrostatic edema. Using an enzyme-linked immunosorbent assay, plasma and pulmonary edema fluid TGF-α levels were measured in 43 patients (34 with increased permeability edema, nine with hydrostatic edema). TGF-α was detected in 24 of 34 patients (71%) with increased permeability pulmonary edema (range, 0.035 to 2.57 ng/mL) compared with only two of nine patients with hydrostatic edema (p<0.05). TGF-α was not detected in any plasma samples. These concentrations of TGF-α in pulmonary edema fluid have potent in vivo and in vitro effects on alveolar epithelial sodium transport and alveolar epithelial cell motility. In conclusion, biologically relevant concentrations of soluble TGF-α are present in the pulmonary edema fluid on day 1 of patients with acute lung injury, a remarkable finding with important implications for the repair and resolution of acute lung injury, particularly since TGF-α was detected so early in the course of acute lung injury.


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