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Original Research: Diffuse Lung Disease |

Telomere Length in Interstitial Lung DiseasesTelomere Length in Interstitial Lung Diseases

Reinier Snetselaar, MSc; Coline H. M. van Moorsel, PhD; Karin M. Kazemier, BSc; Joanne J. van der Vis, BSc; Pieter Zanen, MD, PhD; Matthijs F. M. van Oosterhout, MD, PhD; Jan C. Grutters, MD, PhD
Author and Funding Information

From the Center of Interstitial Lung Diseases, Department of Pulmonology (Mr Snetselaar; Drs van Moorsel, Zanen, and Grutters; and Mss Kazemier and van der Vis), Department of Clinical Chemistry (Ms van der Vis), and Department of Pathology (Dr van Oosterhout), St. Antonius Hospital, Nieuwegein; and the Division of Heart and Lung (Drs van Moorsel, Zanen, and Grutters and Ms Kazemier), University Medical Center Utrecht, Utrecht, The Netherlands.

CORRESPONDENCE TO: Coline H. M. van Moorsel, PhD, Center of Interstitial Lung Diseases, Department of Pulmonology, St. Antonius Hospital, Koekoekslaan 1, 3435 CM Nieuwegein, The Netherlands; e-mail: c.van.moorsel@antoniusziekenhuis.nl


Part of this study was presented at the International World Association for Sarcoidosis and Other Granulomatous Disorders (WASOG) Conference on Diffuse Parenchymal Lung Diseases, June 6-7, 2013, Paris, France, and the Pittsburgh-Munich International Lung Conference, October 23-24, 2014, Pittsburgh, PA.

FUNDING/SUPPORT: Funding for this study was received from the St. Antonius Research Fund and the Pender Foundation.

Reproduction of this article is prohibited without written permission from the American College of Chest Physicians. See online for more details.


Chest. 2015;148(4):1011-1018. doi:10.1378/chest.14-3078
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BACKGROUND:  Interstitial lung disease (ILD) is a heterogeneous group of rare diseases that primarily affect the pulmonary interstitium. Studies have implicated a role for telomere length (TL) maintenance in ILD, particularly in idiopathic interstitial pneumonia (IIP). Here, we measure TL in a wide spectrum of sporadic and familial cohorts of ILD and compare TL between patient cohorts and control subjects.

METHODS:  A multiplex quantitative polymerase chain reaction method was used to measure TL in 173 healthy subjects and 359 patients with various ILDs, including familial interstitial pneumonia (FIP). The FIP cohort was divided into patients carrying TERT mutations, patients carrying SFTPA2 or SFTPC mutations, and patients without a proven mutation (FIP-no mutation).

RESULTS:  TL in all cases of ILD was significantly shorter compared with those of control subjects (P range: .038 to < .0001). Furthermore, TL in patients with idiopathic pulmonary fibrosis (IPF) was significantly shorter than in patients with other IIPs (P = .002) and in patients with sarcoidosis (P < .0001). Within the FIP cohort, patients in the FIP-telomerase reverse transcriptase (TERT) group had the shortest telomeres (P < .0001), and those in the FIP-no mutation group had TL comparable to that of patients with IPF (P = .049). Remarkably, TL of patients with FIP-surfactant protein (SFTP) was significantly longer than in patients with IPF, but similar to that observed in patients with other sporadic IIPs.

CONCLUSIONS:  The results show telomere shortening across all ILD diagnoses. The difference in TL between the FIP-TERT and FIP-SFTP groups indicates the distinction between acquired and innate telomere shortening. Short TL in the IPF and FIP-no mutation groups is indicative of an innate telomere-biology defect, while a stress-induced, acquired telomere shortening might be the underlying process for the other ILD diagnoses.

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