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Autoimmune PAP

Nebulized GM-CSF offers promising alternative for autoimmune pulmonary alveolar proteinosis treatment

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Nebulized granulocyte-macrophage colony-stimulating factor (GM-CSF) appears to be a promising non-invasive treatment for autoimmune pulmonary alveolar proteinosis (aPAP), showing significant improvements in symptoms, lung function, and gas exchange compared to standard whole lung lavage, according to a study.

The review, which analyzed data from 6 studies and 3 for meta-analysis, focused on various outcomes including symptoms, functional capacity, and lung function. Results indicate that patients receiving nebulized GM-CSF experienced significant improvements across several measures:

  • St George’s Respiratory Questionnaire (SGRQ) score: An average reduction of 8.09 points, indicating decreased symptoms and improved quality of life.
  • 6-Minute Walk Test (6MWT): An average increase of 21.72 meters, suggesting improved functional capacity.
  • Diffusing Capacity of the Lung for Carbon Monoxide (DLCO): An average increase of 5.09%, reflecting enhanced gas exchange.
  • Arterial-Alveolar Oxygen Gradient: A reduction of 4.36 mmHg, demonstrating better oxygenation efficiency.

No serious adverse events related to the treatment were reported, and the study found minimal statistical heterogeneity.

These findings underscore the need for further comparison between nebulized GM-CSF and whole lung lavage, considering patient preferences and clinical outcomes.

Reference
Munsif M, Sweeney D, Leong TL, et al. Nebulised granulocyte-macrophage colony-stimulating factor (GM-CSF) in autoimmune pulmonary alveolar proteinosis: a systematic review and meta-analysis. Eur Respir Rev. 2023;32(170):230080. doi: 10.1183/16000617.0080-2023. PMID: 37993127; PMCID: PMC10663936.

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