Observational studyAmerican journal of respiratory and critical care medicine2019
Prognosticating Outcomes in Interstitial Lung Disease by Mediastinal Lymph Node Assessment. An Observational Cohort Study with Independent Validation.
Observational study in American journal of respiratory and critical care medicine, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 27 papers.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
27 citing papers in PubMed, 67 citations in OpenAlex.
- Article
- Active Antigen-Specific Adaptive Immune Responses Are Shared among Patients with Progressive Fibrotic Interstitial Lung Disease.American journal of respiratory and critical care medicine · 2025Article
- To B or Not to B: Germinal Center Responses in Progressive Fibrotic Interstitial Lung Disease.American journal of respiratory and critical care medicine · 2025Article
- Frequency of imaging phenotypes of pulmonary interstitial fibrosis.SA journal of radiology · 2025Article
- Hypersensitivity Pneumonitis on Thin-Section Chest CT Scans: Diagnostic Performance of the ATS/JRS/ALAT versus ACCP Imaging Guidelines.Radiology. Cardiothoracic imaging · 2024Article
- Review
- Multidisciplinary-derived clinical score for accurate prediction of long-term mortality in fibrotic lung disease patients.European journal of medical research · 2024Article
- Expression of PD-1/PD-L1 axis in mediastinal lymph nodes and lung tissue of human and experimental lung fibrosis indicates a potential therapeutic target for idiopathic pulmonary fibrosis.Respiratory research · 2023Article
- FOXP3+ regulatory T cells are associated with the severity and prognosis of sarcoidosis.Frontiers in immunology · 2023Article
- Tomographic pleuropulmonary manifestations in rheumatoid arthritis: a pictorial essay.Jornal brasileiro de pneumologia : publicacao oficial da Sociedade Brasileira de Pneumologia e Tisilogia · 2023Article
- Dose-response relationship of pulmonary disorders by inhalation exposure to cross-linked water-soluble acrylic acid polymers in F344 rats.Particle and fibre toxicology · 2022Article
- Temporal progression of mediastinal lymphadenopathy in idiopathic pulmonary fibrosis.The European respiratory journal · 2022Article
- High-titer rheumatoid factor seropositivity predicts mediastinal lymphadenopathy and mortality in rheumatoid arthritis-related interstitial lung disease.Scientific reports · 2021Article
- Blood Transcriptomics Predicts Progression of Pulmonary Fibrosis and Associated Natural Killer Cells.American journal of respiratory and critical care medicine · 2021Article
- Mediastinal lymphadenopathy may predict 30-day mortality in patients with COVID-19.Clinical imaging · 2021Article
- Prognostic value of mediastinal lymph node enlargement in chronic interstitial lung disease.Diagnostic and interventional radiology (Ankara, Turkey) · 2021Article
- CPAP Adherence, Mortality, and Progression-Free Survival in Interstitial Lung Disease and OSA.Chest · 2020Observational
- Thoracic lymphadenopathy as possible predictor of the onset of interstitial lung disease in systemic sclerosis patients without lung involvement at baseline visit: A retrospective analysis.Journal of scleroderma and related disorders · 2020Article
- Mediastinal lymph node enlargement in idiopathic pulmonary fibrosis: relationships with disease progression and pulmonary function trends.BMC pulmonary medicine · 2020Article
- Update in Interstitial Lung Disease 2019.American journal of respiratory and critical care medicine · 2020Review
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Authors and funding
18 authors at 5 institutions in 1 country.
Funding
Abstract
rationaleMediastinal lymph node (MLN) enlargement on chest computed tomography (CT) is prevalent in patients with interstitial lung disease (ILD) and may reflect immunologic activation and subsequent cytokine-mediated immune cell trafficking.
objectivesWe aimed to determine whether MLN enlargement on chest CT predicts clinical outcomes and circulating cytokine levels in ILD.
methodsMLN measurements were obtained from chest CT scans of patients with ILD at baseline evaluation over a 10-year period. Patients with sarcoidosis and drug toxicity-related ILD were excluded. MLN diameter and location were assessed. Plasma cytokine levels were analyzed in a subset of patients. The primary outcome was transplant-free survival (TFS). Secondary outcomes included all-cause and respiratory hospitalizations, lung function, and plasma cytokine concentrations. Cox regression was used to assess mortality risk. Outcomes were assessed in three independent ILD cohorts. MEASUREMENTS AND MAIN
resultsChest CT scans were assessed in 1,094 patients (mean age, 64 yr; 52% male). MLN enlargement (≥10 mm) was present in 66% (n = 726) and strongly predicted TFS (hazard ratio [HR], 1.53; 95% confidence interval [CI], 1.12-2.10; P = 0.008) and risk of all-cause and respiratory hospitalizations (internal rate of return [IRR], 1.52; 95% CI, 1.17-1.98; P = 0.002; and IRR, 1.71; 95% CI, 1.15-2.53; P = 0.008, respectively) when compared with subjects with MLN <10 mm. Patients with MLN enlargement had lower lung function and decreased plasma concentrations of soluble CD40L (376 pg/ml vs. 505 pg/ml, P = 0.001) compared with those without MLN enlargement. Plasma IL-10 concentration >45 pg/ml predicted mortality (HR, 4.21; 95% CI, 1.21-14.68; P = 0.024). Independent analysis of external datasets confirmed these findings.
conclusionsMLN enlargement predicts TFS and hospitalization risk in ILD and is associated with decreased levels of a key circulating cytokine, soluble CD40L. Incorporating MLN and cytokine findings into current prediction models might improve ILD prognostication.
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