A. Adamson et al., Proliferation, c-myc, and cyclin D1 expression in diffuse alveolar damage:Potential roles in pathogenesis and implications for prognosis, HUMAN PATH, 30(9), 1999, pp. 1050-1057
Citations number
76
Categorie Soggetti
Research/Laboratory Medicine & Medical Tecnology","Medical Research Diagnosis & Treatment
In this study, we compared expression of DNA topoisomerase II alpha, a mark
er of cellular proliferation, c-myc, and cyclin D1 in lung biopsy specimens
showing diffuse alveolar damage (DAD) with control lung tissues. We subseq
uently correlated DNA topoisomerase Do, c-myc, and cyclin D1 expression wit
h survival. We hypothesized that poor outcome may correlate with a higher p
roliferation index, and that c-myc and cyclin D1 activation are potentially
important regulators of both proliferation and apoptosis in DAD. Immunohis
tochemical stains for c-myc, cyclin D1, and DNA topoisomerase II alpha were
performed on 10 cases of DAD (15 cases for DNA topoisomerase Do) and 10 co
ntrol lungs. A proliferation index for each case was calculated by dividing
the number of nuclei expressing DNA topoisomerase II alpha by the total nu
mber of nuclei counted. The percentages of alveolar pneumocytes and interst
itial cells staining positively for c-myc and cyclin D1were estimated. The
average proliferation index (DNA topoisomerase II alpha index) in DAD (0.16
+/- 0.06, n = 15) was significantly greater than in control lungs (0.00 +/
- 0.01, n = 10) (P < .0001). The average proliferation index of patients wi
th DAD who died of respiratory failure (0.18 +/- 0.05, n = 9) was significa
ntly greater than the average proliferation index of patients whose respira
tory disease resolved or stabilized (0.11 +/- 0.05, n = 5) (P < .03). Expre
ssion of c-myc in alveolar pneumocytes and interstitial cells was more inte
nse and slightly more widespread in cases of DAD compared with control lung
s. In 9 of 10 cases of DAD, cyclin D1 expression was present in up to 30% o
f alveolar pneumocytes and up to 10% of interstitial cells. No staining for
cyclin D1 was present in control lungs. These results show that the prolif
eration index in DAD potentially correlates with patient survival. Furtherm
ore, enhanced expression of c-myc and cyclin D1 may contribute to dysregula
tion of cellular proliferation and apoptosis observed in DAD. HUM PATHOL 30
:1050-1057.