Use of discriminant analysis in assessing pulmonary function worsening in patients with sarcoidosis by a panel of inflam
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Inflammation Research
ORIGINAL RESEARCH PAPER
Use of discriminant analysis in assessing pulmonary function worsening in patients with sarcoidosis by a panel of inflammatory biomarkers Gregorino Paone • Alvaro Leone • Sandro Batzella • Vittoria Conti • Francesco Belli • Laura De Marchis • Alice Mannocci • Giovanni Schmid Claudio Terzano
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Received: 29 October 2011 / Revised: 23 November 2012 / Accepted: 10 December 2012 / Published online: 23 December 2012 Ó Springer Basel 2012
Abstract Objectives and design To date, no sufficiently sensitive and specific single marker has been found to predict the clinical course of sarcoidosis. We designed a cohort study to investigate whether a panel of biomarkers measured in bronchoalveolar lavage (BAL) and peripheral blood could
Responsible Editor: John Di Battista. G. Schmid and C. Terzano contributed equally to the work. G. Paone (&) Department of Cardiovascular, Respiratory, Nephrologic and Geriatric Sciences, ‘Sapienza’ University of Rome, S. Camillo-Forlanini Hospital, Via Portuense 332, 00149 Rome, Italy e-mail: [email protected] A. Leone Pathology Unit, S. Camillo-Forlanini Hospital, Rome, Italy S. Batzella F. Belli Department of Respiratory Diseases, S. Camillo-Forlanini Hospital, Rome, Italy V. Conti C. Terzano Eleonora Lorillard Spencer Cenci Foundation, ‘Sapienza’ University of Rome, Rome, Italy L. De Marchis Department of Radiology, Oncology, and Pathology, ‘Sapienza’ University of Rome, Rome, Italy A. Mannocci Department of Public Health and Infectious Diseases, ‘Sapienza’ University of Rome, Rome, Italy G. Schmid IRCCS Fondazione Don Carlo Gnocchi-Onlus, Rome, Italy
help predict pulmonary function worsening during the clinical course of sarcoidosis. Methods We analyzed 30 individuals with histologically proven sarcoidosis. At baseline, participants underwent pulmonary function tests (PFTs), fiberoptic bronchoscopy and radiological investigations. BAL and blood cellular profiles were obtained from all individuals and six proinflammatory molecules were quantified in BAL and serum. PFTs were performed at follow-up visits over a 2-year period. Using discriminant function analysis, a canonical variable was generated to optimize the accuracy of selected variables in predicting pulmonary function worsening and was validated on a subset of nine consecutive individuals with sarcoidosis. Results A combination of 6 markers from BAL was able to predict pulmonary function worsening in 96 % of patients [95 % confidence interval (CI) 84.4–99.81]. We validated the generated formula on a group of nine patients with sarcoidosis, obtaining 77.8 % correct classification (95 % CI 45.3–93.7). Conclusions Our results show that a combinational approach could contribute to identifying individuals likely to experience pulmonary function worsening, thus helping to decide the correct therapeutic strategies. Keywords Biomarker Discriminant analysis Disease severity Pulmonary function worsening Sarcoidosis
Introduction Sarcoidosis is a chronic multi-systemic disorder of un
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