PURPOSE: Epithelial regeneration is sometimes promoted by hepatocyte growth factor (HGF). HGF has also been shown to be mitogenic for bronchial and alveolar epitheliums. Moreover, HGF protects alveolar epithelial cells from pulmonary fibrosis. It has been reported that monocyte chemoattractant protein-1 (MCP-1) plays an important role in the resolution and repair processes of acute pneumonia via enhancing the removal of neutrophils and HGF production by alveolar macrophages. We investigated the serum levels of these cytokines and the influence of monocyte/macrophage.
METHODS: Twelve patients with treatment-responsive pneumonia were entered into the study. A complete peripheral blood cell count and differential white blood cell count were performed. Serum cytokines were also measured by enzyme-linked immuno solvent assay.
RESULTS: All cases showed symptomatic relief and a decrease of C - reactive protein following treatment with levofloxacin. After treatment, serum MCP-1 tended to increase (497.1±302.7 vs. 555.3±151.6, NS) but no relationship with either peripheral WBC counts or monocyte counts was observed. However, the serum levels of HGF significantly decreased (417.2±165.6 vs. 322.8±151.2, p<0.05).
CONCLUSION: It was reported that BALF MCP-1 and BALF HGF peaked at 36 and 72 hours, respectively, during the natural course in the mice pneumonia model. We measured the levels of cytokines before treatment and after one week's treatment, and serum HGF was found decreased exactly in the resolution phase rather than before treatment. There may be at least two reasons for this discrepancy. One is the difference in the measuring points of the cytokines, and the other is whether or not antibiotic therapy is used. The systematic elevation of HGF may lead to induce a harmful effect on vascular systems, causing a local elevation of HGF in the nearby bronchoalveolar systems in patients with pneumonia. The specific effect of antibiotics cannot be ignored.
CLINICAL IMPLICATIONS: Important parameters that should be evaluated are the timing when the beneficial elevation of HGF will occur and whether such drugs that promote MCP-1 and HGF will modify the clinical course of pneumonia.
DISCLOSURE: Kazuyuki Yamaguchi, No Financial Disclosure Information; No Product/Research Disclosure Information