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Kulkarni T, Valentine VG, Fei F, et al. Correlates of survival after autoantibody reduction therapy for acute IPF exacerbations. PLoS One. 2021;16(11):e0260345doi: 10.1371/journal.pone.0260345.
Kulkarni, T., Valentine, V. G., Fei, F., Tran-Nguyen, T. K., Quesada-Arias, L. D., Mkorombindo, T., Pham, H. P., Simmons, S. C., Dsouza, K. G., Luckhardt, T., & Duncan, S. R. (2021). Correlates of survival after autoantibody reduction therapy for acute IPF exacerbations. PloS one, 16(11), e0260345. https://doi.org/10.1371/journal.pone.0260345
Kulkarni, Tejaswini, et al. "Correlates of survival after autoantibody reduction therapy for acute IPF exacerbations." PloS one vol. 16,11 (2021): e0260345. doi: https://doi.org/10.1371/journal.pone.0260345
Kulkarni T, Valentine VG, Fei F, Tran-Nguyen TK, Quesada-Arias LD, Mkorombindo T, Pham HP, Simmons SC, Dsouza KG, Luckhardt T, Duncan SR. Correlates of survival after autoantibody reduction therapy for acute IPF exacerbations. PLoS One. 2021 Nov 23;16(11):e0260345. doi: 10.1371/journal.pone.0260345. eCollection 2021. PMID: 34813613; PMCID: PMC8610261.
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PLoS One. 2021 Nov 23;16(11):e0260345. doi: 10.1371/journal.pone.0260345. eCollection 2021.

Correlates of survival after autoantibody reduction therapy for acute IPF exacerbations.

PloS one

Tejaswini Kulkarni, Vincent G Valentine, Fei Fei, Thi K Tran-Nguyen, Luisa D Quesada-Arias, Takudzwa Mkorombindo, Huy P Pham, Sierra C Simmons, Kevin G Dsouza, Tracy Luckhardt, Steven R Duncan

Affiliations

  1. Department of Medicine, University of Alabama at Birmingham, Birmingham, AL, United States of America.
  2. Department of Pathology, University of Alabama at Birmingham, Birmingham, AL, United States of America.
  3. Department of Medicine, Brigham and Women's Hospital, Boston, MA, United States of America.
  4. Department of Pathology, University of Southern California, Los Angeles, CA, United States of America.
  5. Department of Pathology, Michigan Pathology Specialists, Spectrum Health Hospitals, Grand Rapids, MI, United States of America.

PMID: 34813613 PMCID: PMC8610261 DOI: 10.1371/journal.pone.0260345

Abstract

BACKGROUND: No medical treatment has proven efficacy for acute exacerbations of idiopathic pulmonary fibrosis (AE-IPF), and this syndrome has a very high mortality. Based on data indicating humoral autoimmune processes are involved in IPF pathogenesis, we treated AE-IPF patients with an autoantibody reduction regimen of therapeutic plasma exchange, rituximab, and intravenous immunoglobulin. This study aimed to identify clinical and autoantibody determinants associated with survival after autoantibody reduction in AE-IPF.

METHODS: Twenty-four(24) AE-IPF patients received the autoantibody reduction regimen. Plasma anti-epithelial autoantibody titers were determined by HEp-2 indirect immunofluorescence assays in 22 patients.

RESULTS: Mean age of the patients was 70 + 7 years old, and 70% were male. Beneficial clinical responses that occurred early during therapy were a favorable prognostic indicator: supplemental O2 flows needed to maintain resting SaO2>92% significantly decreased and/or walk distances increased among all 10 patients who survived for at least one year. Plasma anti-HEp-2 autoantibody titers were ~-three-fold greater in survivors compared to non-survivors (p<0.02). Anti-HEp-2 titers >1:160 were present in 75% of the evaluable one-year survivors, compared to 29% of non-survivors, and 10 of 12 patients (83%) with anti-HEP-2 titers <1:160 died during the observation period (Hazard Ratio = 3.3, 95% Confidence Interval = 1.02-10.6, p = 0.047).

CONCLUSIONS: Autoantibody reduction therapy is associated with rapid reduction of supplemental oxygen requirements and/or improved ability to ambulate in many AE-IPF patients. Facile anti-epithelial autoantibody assays may help identify those most likely to benefit from these treatments.

Conflict of interest statement

I have read the journal’s policy and the authors of this manuscript have the following competing interests: SRD reports personal fees from Novartis and aTyr Pharma, outside the submitted work. TK repo

References

  1. N Engl J Med. 2012 Nov 22;367(21):2015-25 - PubMed
  2. Lung. 2000;178(3):171-9 - PubMed
  3. Sci Transl Med. 2013 Oct 9;5(206):206ra139 - PubMed
  4. Pediatr Nephrol. 2010 Oct;25(10):2035-45; quiz 2045-8 - PubMed
  5. Blood Transfus. 2007 Jul;5(3):164-74 - PubMed
  6. Am J Respir Crit Care Med. 2007 Oct 1;176(7):636-43 - PubMed
  7. Am J Respir Crit Care Med. 2014 Apr 15;189(8):966-74 - PubMed
  8. J Med Invest. 2001 Aug;48(3-4):181-9 - PubMed
  9. PLoS One. 2016 May 09;11(5):e0154516 - PubMed
  10. Ther Apher. 2001 Jun;5(3):186-92 - PubMed
  11. J Autoimmun. 2015 Jan;56:1-11 - PubMed
  12. Eur Respir J. 2015 Oct;46(4):976-87 - PubMed
  13. Eur Respir J. 2012 Sep;40(3):641-8 - PubMed
  14. PLoS One. 2011 Feb 23;6(2):e14715 - PubMed
  15. Immunol Cell Biol. 2017 Aug;95(7):577-583 - PubMed
  16. J Immunol. 2017 Sep 1;199(5):1596-1605 - PubMed
  17. Respiration. 2007;74(2):159-69 - PubMed
  18. Eur Respir J. 2011 Feb;37(2):356-63 - PubMed
  19. Arthritis Rheum. 2002 Aug;47(4):434-44 - PubMed
  20. Am J Respir Crit Care Med. 2016 Aug 1;194(3):265-75 - PubMed
  21. J Clin Apher. 1995;10(4):210-7 - PubMed
  22. PLoS One. 2010 Jan 29;5(1):e8959 - PubMed
  23. N Engl J Med. 1978 Feb 16;298(7):353-7 - PubMed
  24. Arthritis Rheum. 2008 Aug;58(8):2257-67 - PubMed
  25. Circulation. 2009 Nov 17;120(20):2012-24 - PubMed
  26. Hum Immunol. 2006 Apr-May;67(4-5):284-97 - PubMed
  27. Am J Respir Crit Care Med. 2011 Mar 15;183(6):788-824 - PubMed
  28. J Pathol. 2001 Sep;195(2):251-6 - PubMed
  29. Am J Respir Crit Care Med. 2011 Mar 15;183(6):759-66 - PubMed
  30. Am J Respir Crit Care Med. 2015 Jul 15;192(2):e3-19 - PubMed
  31. Arthritis Rheum. 2006 May;54(5):1390-400 - PubMed
  32. Am J Respir Crit Care Med. 2011 May 1;183(9):1231-7 - PubMed
  33. Respir Med. 2008 Oct;102(10):1355-9 - PubMed
  34. Mayo Clin Proc. 1979 Nov;54(11):714-20 - PubMed
  35. J Immunol. 2008 Jul 1;181(1):756-67 - PubMed
  36. Respiration. 1988;54 Suppl 1:36-41 - PubMed
  37. J Immunol. 2013 Sep 1;191(5):2089-95 - PubMed
  38. Arthritis Res Ther. 2010;12(2):R48 - PubMed
  39. Am J Respir Crit Care Med. 2017 Nov 15;196(10):1298-1310 - PubMed
  40. J Immunol. 2007 Aug 15;179(4):2592-9 - PubMed
  41. Am J Respir Crit Care Med. 2013 Apr 1;187(7):768-75 - PubMed
  42. PLoS One. 2015 Jun 17;10(6):e0127771 - PubMed

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