Open Access Research

Medical Research Council dyspnea scale does not relate to fibroblast foci profusion in IPF

Christina Triantafillidou1, Effrosyni D Manali12, Christina Magkou3, Christina Sotiropoulou4, Likurgos F Kolilekas1, Konstantinos Kagouridis1, Dimitra Rontogianni3 and Spyros A Papiris1*

Author Affiliations

1 2nd Pulmonary Department, "Attikon" University Hospital, Athens Medical School, National and Kapodistrian University of Athens, Greece

2 "Sotiria" General Hospital, Athens Greece

3 Department of Pathology, "Evangelismos" General Hospital, Athens, Greece

4 Applied Biomedical Research & Training Center "Marianthi Simou" and 1st Department of Critical Care & Pulmonary Services, School of Medicine, National and Kapodistrian University of Athens, Greece

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Diagnostic Pathology 2011, 6:28  doi:10.1186/1746-1596-6-28

Published: 5 April 2011

Abstract

Background

In Idiopathic pulmonary fibrosis (IPF) irreversibly progressive fibrosing parenchymal damage, leads to defects in mechanics and gas exchange, manifesting with disabling exertional dyspnea. Previous studies have shown a relationship between fibroblast foci (FF) profusion and severity and survival and a relationship between dyspnea grade and severity and outcome. We hypothesized a relationship between Medical Research Council (MRC) dyspnea scale with FF, and a relationship between FF and functional parameters and survival.

Methods

We retrospectively reviewed 24 histologically documented IPF patients. Profusion of FF was semiquantitatively evaluated by two scores, Brompton and Michigan. Survival analysis was performed by fitting Cox regression models to examine the relationship of the two scores with survival and the non-parametric Spearman correlation coefficient was calculated to describe the relationships of FF scores with dyspnea scores and functional parameters.

Results

No statistically significant correlation between FF scores and the MRC scores was observed (p = 0.96 and p = 0.508 respectively). No significant correlation between FF scores and survival (p = 0.438 and p = 0.861 respectively) or any functional parameter was observed.

Conclusions

The lack of relationship between the MRC dyspnea scale and the FF might relate to the fact that dyspnea in IPF better reflects the overall of lung damage and its related consequences on mechanics and gas exchange whereas FF, one of its histological hallmarks, may not reflect its entire histology derangement also constrained by the geographically limited sampled tissue. This might be also valid for the observed lack of association between FF and survival or functional parameters.

Keywords:
dyspnea; pulmonary fibrosis; fibroblast foci