Bronchoalveolar lavage cell pattern from healthy human lung
Bronchoalveolar lavage cell pattern from healthy human lung
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DOI：
10.1111/j.1365-2249.2011.04529.x
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发表时间：
2012-03-01
影响因子：
4.6
通讯作者：
van Velzen-Blad, H.
中科院分区：
文献类型：
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作者：
Heron, M.;Grutters, J. C.;van Velzen-Blad, H.
支气管肺泡灌洗（BAL）是间质性肺疾病（ILD）的重要诊断手段。我们进行了一项研究，以获得BAL液中差异细胞模式的参考区间，特别注意灌洗液的来源，例如支气管/肺泡，特应性和吸烟状态以及健康人的年龄。我们对55名已知有特应性状态的健康受试者（年龄：18-64岁，非吸烟者/吸烟者：34/21）进行支气管肺泡灌洗，并测定BAL液和血液中的分类细胞计数和淋巴细胞亚群。此外，在非吸烟健康个体的亚组中，我们测量了血液和BAL液淋巴细胞上调节性T细胞标志物叉头盒蛋白3（FoxP 3）的表达以及一组全面的活化标志物。来自肺泡灌洗液部分的差异细胞计数与计算的合并部分显著不同（n = 11）。与此相反，特应性和非特应性受试者之间的边际差异。有趣的是，BALF液CD 4（+）/CD 8（+）比值与年龄密切相关（r2 = 0.50，P < 0.0001）。我们认为支气管和肺泡部分是从根本上不同的隔室灌洗液，并建议在ILD的诊断检查中分析肺泡部分。此外，我们的数据表明，年龄校正的BAL液CD 4（+）/CD 8（+）比值应用于间质性肺疾病患者的临床评价。
Bronchoalveolar lavage (BAL) is widely accepted as a key diagnostic procedure in interstitial lung diseases (ILD). We performed a study to obtain reference intervals of differential cell patterns in BAL fluid with special attention to the origin of lavage fluid, e.g. bronchial/alveolar, to atopy and smoking status and to age of the healthy people. We performed bronchoalveolar lavage in 55 healthy subjects with known atopy status (age: 18-64 years, non-smokers/smokers: 34/21) and determined differential cell counts and lymphocyte subsets in BAL fluid and blood. Moreover, in a subgroup of non-smoking healthy individuals we measured the expression of the regulatory T cell marker forkhead box protein 3 (FoxP3) on blood and BAL fluid lymphocytes in addition to a comprehensive set of activation markers. Differential cell counts from the alveolar lavage fraction differed significantly from calculated pooled fractions (n = 11). In contrast, marginal differences were found between atopic and non-atopic subjects. Interestingly, the BAL fluid CD4(+)/CD8(+) ratio correlated strongly with age (r2 = 0.50, P < 0.0001). We consider the bronchial and alveolar fraction to be lavage fluid from fundamentally different compartments and recommend analysis of the alveolar fraction in diagnostic work-up of ILD. In addition, our data suggest that age corrected BAL fluid CD4(+)/CD8(+) ratios should be used in the clinical evaluation of patients with interstitial lung diseases.