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. 2023 Nov;28(11):1043-1052.
doi: 10.1111/resp.14582. Epub 2023 Aug 29.

Analysis of tissue lipidomics and computed tomography pulmonary fat attenuation volume (CTPFAV ) in idiopathic pulmonary fibrosis

Marissa O'Callaghan  1   2 , John Duignan  3 , Elizabeth J Tarling  4 , Darragh K Waters  3 , Megan McStay  3 , Orla O'Carroll  1 , James P Bridges  5 , Elizabeth F Redente  6 , Alessandro N Franciosi  1   2 , Emmet E McGrath  1   2 , Marcus W Butler  1   2 , Jonathan D Dodd  2   3 , Aurelie Fabre  2   7 , David J Murphy  2   3 , Michael P Keane  1   2 , Cormac McCarthy  1   2
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Free article

Analysis of tissue lipidomics and computed tomography pulmonary fat attenuation volume (CTPFAV ) in idiopathic pulmonary fibrosis

Marissa O'Callaghan et al. Respirology. 2023 Nov.
Free article

Abstract

Background and objective: There is increasing interest in the role of lipids in processes that modulate lung fibrosis with evidence of lipid deposition in idiopathic pulmonary fibrosis (IPF) histological specimens. The aim of this study was to identify measurable markers of pulmonary lipid that may have utility as IPF biomarkers.

Study design and methods: IPF and control lung biopsy specimens were analysed using a unbiased lipidomic approach. Pulmonary fat attenuation volume (PFAV) was assessed on chest CT images (CTPFAV ) with 3D semi-automated lung density software. Aerated lung was semi-automatically segmented and CTPFAV calculated using a Hounsfield-unit (-40 to -200HU) threshold range expressed as a percentage of total lung volume. CTPFAV was compared to pulmonary function, serum lipids and qualitative CT fibrosis scores.

Results: There was a significant increase in total lipid content on histological analysis of IPF lung tissue (23.16 nmol/mg) compared to controls (18.66 mol/mg, p = 0.0317). The median CTPFAV in IPF was higher than controls (1.34% vs. 0.72%, p < 0.001) and CTPFAV correlated significantly with DLCO% predicted (R2 = 0.356, p < 0.0001) and FVC% predicted (R2 = 0.407, p < 0.0001) in patients with IPF. CTPFAV correlated with CT features of fibrosis; higher CTPFAV was associated with >10% reticulation (1.6% vs. 0.94%, p = 0.0017) and >10% honeycombing (1.87% vs. 1.12%, p = 0.0003). CTPFAV showed no correlation with serum lipids.

Conclusion: CTPFAV is an easily quantifiable non-invasive measure of pulmonary lipids. In this pilot study, CTPFAV correlates with pulmonary function and radiological features of IPF and could function as a potential biomarker for IPF disease severity assessment.

Keywords: idiopathic pulmonary fibrosis; interstitial lung disease; lipidomics; pulmonary fat; quantitative CT.

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References

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