A team of researchers identified macrophage activation and other cellular events that may contribute to exacerbations in idiopathic pulmonary fibrosis.

From the initial IPF sample, 12 patients were found to have acute exacerbations (AE), while 16 developed the condition after 12 months. Using a data analysis method called ELISA, the researchers observed that compared to controls, those patients who suffered from AE, had higher levels of BAL neutrophils. Moreover, there was an increase in pro-inflammatory cytokines CXCL1 and IL-8 combined with an increase in the M2 cytokines by BAL-cells. During AE, the researchers observed in BAL cells an increase in CCL18 and neutrophils. Additionally, the researchers found that this increase in CCL18 production by BAL cells was a predictor for AE.