Serum type III procollagen peptide: indicator for pulmonary fibrosis: II. Application in 80 asbestos insulation workers

Our plain-English summary of Serum type III procollagen peptide: indicator for pulmonary fibrosis: II. Application in 80 asbestos insulation workers, by I. Okazaki, K. Maruyama, Y. Kobayashi, et al (American Journal of Industrial Medicine, 1987).

The study

• Authors: I. Okazaki, K. Maruyama, Y. Kobayashi, R. Lilis, Y. Suzuki
• Journal: American Journal of Industrial Medicine
• Published: 1987;11(4):439-46
• Cited by: 9 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

An assay for type III procollagen peptide (P-III-P) was applied to serum from 80 asbestos insulation workers in order to evaluate its relationship with pulmonary and pleural fibrosis. The serum peptide levels of 16 control workers were 7.8 +/- 2.0 ng/ml (mean +/- SD). An association between the serum values of P-III-P and the profusion of small irregular opacities on chest X-rays was noted. The levels in the group with moderate interstitial pulmonary fibrosis [profusion category 2(2/1, 2/2, and 2/3)] and with marked interstitial pulmonary fibrosis [profusion category 3(3/3)] were 9.9 +/- 2.3 ng/ml (n = 5) and thus tended to be higher than those of 16 control workers (p less than 0.1). On the other hand, there was not correlation between serum peptide levels and pleural lesions nor between the former and duration of asbestos exposure. From the results of the investigation [part I of which is reported elsewhere (Okazaki et al, 1986)] this assay may be useful for detecting individuals with a more marked tendency for progression of interstitial pulmonary fibrosis due to asbestos exposure in insulation work.

In plain English

The authors measured type III procollagen peptide (P-III-P), a blood marker of collagen production, in serum from 80 asbestos insulation workers. The workers came from a larger Mount Sinai School of Medicine study in the United States. Workers with abnormal liver tests were excluded. Sixteen workers with no small opacities and no pleural fibrosis on X-ray served as controls, averaging 7.8 ng/ml (standard deviation 2.0). The five workers with moderate or marked lung scarring on X-ray (profusion categories 2 and 3) averaged 9.9 ng/ml. The 75 workers in categories 0 and 1 averaged 8.2 ng/ml. This difference was not statistically significant; compared with the controls the level only tended to be higher (p less than 0.1). Levels did not differ markedly by duration of exposure. No significant relationship with pleural changes was found, although levels tended to be higher with more extensive pleural fibrosis. The authors noted that levels were not high even with relatively marked lung fibrosis. They concluded the test may help detect workers with more rapidly progressing pulmonary fibrosis. The study had no comparison group of people without asbestos insulation work.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: Cross-sectional laboratory study comparing serum P-III-P levels with chest X-ray findings, age and exposure duration in a group of workers
• Who was studied: 80 asbestos insulation workers, selected at random from a large United States study run by the Mount Sinai School of Medicine. Workers with abnormal liver function tests or a disease thought to affect collagen metabolism were excluded. 16 workers with no small opacities (profusion 0) and no pleural fibrosis formed the control subgroup.
• Exposure: Asbestos insulation work. Exposure was described by duration from onset of exposure and actual duration of exposure. No fiber types are named.
• Main results:
  • The 16 control workers (no small opacities and no pleural fibrosis) had serum P-III-P of 7.8 plus or minus 2.0 ng/ml (mean plus or minus SD).
  • Workers in their 60s (9.0 plus or minus 2.2 ng/ml; n=13) and 70s (9.2 plus or minus 2.1 ng/ml; n=9) had higher mean levels than other age groups (8.0 plus or minus 2.3 ng/ml; n=58). The difference was not statistically significant.
  • No marked differences in serum P-III-P were found between groups with different durations of exposure.
  • Workers in profusion groups 2 and 3 had 9.9 plus or minus 2.3 ng/ml (n=5), compared with 8.2 plus or minus 2.3 ng/ml in groups 0 and 1 (n=75). The difference did not reach statistical significance.
  • Compared with the 16 control workers, levels in profusion groups 2 and 3 tended to be higher (p less than 0.1).
  • No significant relationships were found between serum P-III-P and pleural changes (pleural fibrosis, pleural calcification, diaphragmatic plaques). In the discussion, the authors wrote that cases with pleural thickening or calcification did not show increased levels.
  • There was a tendency toward higher levels in workers with more extensive pleural fibrosis (extent 2) than in those with less extensive pleural changes (extent 1).
  • Serum levels were not high even in workers with relatively marked parenchymal fibrosis.
• The authors' conclusion: The authors concluded that, because levels tended to be higher with higher profusion categories, the assay may be useful for detecting individuals with more rapidly progressing pulmonary fibrosis and could be useful in surveys of asbestos-exposed workers.
• Limitations the authors state:
  • No control workers without a history of asbestos insulation work were included. The control subgroup consisted of insulation workers without X-ray abnormalities.
  • The authors noted that when pulmonary fibrosis progresses slowly, as it usually does in asbestos insulation workers, serum P-III-P may not be high.

Topics

The National Library of Medicine indexes this study under subjects our site covers: Asbestosis.

Medical terms in this study, explained in our Lexicon: Pulmonary Fibrosis, Insulator, Fibrosis, Chest X-Ray, Interstitial, Asbestos Exposure.

Related studies

• Carboxyterminal propeptide of type I procollagen in ELF: elevation in asbestosis, but not in pleural plaque disease — L. Lammi, L. Ryhänen, et al. (1999)
• Asbestosis: interstitial pulmonary fibrosis and pleural fibrosis in a cohort of asbestos insulation workers: influence of cigarette smoking — R. Lilis, I.J. Selikoff, et al. (1986)
• Pulmonary fibrosis in asbestos insulation workers with lung cancer: a radiological and histopathological evaluation — H.M. Kipen, R. Lilis, et al. (1987)
• Pulmonary fibrosis in asbestos insulation workers with lung cancer — Y. Suzuki, H. Kipen, et al. (1987)
• Pulmonary fibrosis in asbestos insulation workers with lung cancer — W. Weiss (1989)
• Relationship of fiber surface iron and active oxygen species to expression of procollagen, PDGF-A, and TGF-beta(1) in tracheal explants exposed to amosite asbestos — J. Dai, A. Churg (2001)

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