May 22, 2013 New research from Brigham and Women's Hospital (BWH) finds that a genetic risk factor for pulmonary fibrosis, an uncommon but deadly lung disease, may be effective in identifying individuals at risk for this disease.
These findings will be presented at the American Thoracic Society International Conference and publish online simultaneously at the New England Journal of Medicine on May 22 and will appear in the July 4, 2013 print edition.
"While this variant of the MUC5B gene is fairly common, pulmonary fibrosis is not. Our findings suggest that pulmonary fibrosis may be a part of a much more common, but likely less severe, syndrome and could potentially be predicted on the basis of the MUC5B genetic variant," said Gary M. Hunninghake, MD, MPH, a physician researcher in the pulmonary and critical care division at BWH and co-corresponding author of the research paper. "While too early to tell how important this variant may be in clinical practice, this finding could open new research avenues into this disease."
Researchers looked at a common variant of the gene for mucin-5B, a protein that is a component of the mucous produced by the bronchial tubes associated with associated with pulmonary fibrosis. Their goal was to determine whether this common gene variant was also associated with interstitial lung disease in the general population. To do this, researchers reviewed CT scans of more than 2,600 adults who did not have a clinical diagnosis of pulmonary fibrosis. Researchers found imaging evidence of interstitial lung abnormalities (lung inflammation and scarring) in about 9 percent of those over age 50. In this age group, these abnormal findings were significantly more common among the 19 percent of people with the MUC5B genetic variant. While these abnormalities do not necessarily indicate a disease that will progress, the presence of these abnormalities was associated with more shortness of breath and cough as well as smaller lung sizes and ability to transfer oxygen.
"Our findings provide important insights into the pulmonary effects of a common genetic variant in the general population, and they also suggest that the clinical condition pulmonary fibrosis may be part of the broader spectrum of abnormalities that includes more subtle and asymptomatic findings," said George O'Connor, MD, professor of medicine at Boston University School of Medicine, director of lung research at the Framingham Heart Study, and a senior collaborator in this study.
Future research efforts will focus on identifying which people with imaging abnormalities are at greatest risk for progression to pulmonary fibrosis, and reciprocally, why some people "at-risk" for pulmonary fibrosis do not develop a clinical disease. The authors believe that this work may eventually pave the way for efforts aimed at preventing pulmonary fibrosis.
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- Gary M. Hunninghake, Hiroto Hatabu, Yuka Okajima, Wei Gao, Josée Dupuis, Jeanne C. Latourelle, Mizuki Nishino, Tetsuro Araki, Oscar E. Zazueta, Sila Kurugol, James C. Ross, Raúl San José Estépar, Elissa Murphy, Mark P. Steele, James E. Loyd, Marvin I. Schwarz, Tasha E. Fingerlin, Ivan O. Rosas, George R. Washko, George T. O'Connor, David A. Schwartz. MUC5BPromoter Polymorphism and Interstitial Lung Abnormalities. New England Journal of Medicine, 2013; : 130521110015008 DOI: 10.1056/NEJMoa1216076
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