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Biomedical subjects

G Bertorelli

Publications and source records attributed to G Bertorelli.

36 records · Page 2Linked to original sources
PubMed1990

Eosinophilic alveolitis in immunologic interstitial lung disorders.

To analyze the role of eosinophils in alveolitis due to immunological interstitial lung disorders, 568 bronchoalveolar lavage (BAL) from 537 patients affected by 13 types of interstitial lung disease involving immunologic mechanisms were considered. An arbitrary cut-off of 4% of eosinophils in BAL was assumed. In five (idiopathic pulmonary fibrosis (IPF), allergic bronchopulmonary aspergillosis (ABPA), amiodarone-induced pneumonitis (AIP), chronic eosinophilic pneumonia (CEP), Churg-Strauss syndrome (CSS)) out of the thirteen groups we took into consideration, the level of eosinophils was greater than 4%. In CEP and CSS in particular, the arbitrary cut-off of 4% was greatly exceeded (28.9% +/- 27.4, p less than 0.01 and 33.6% +/- 14.5, p less than 0.01, respectively). In the same two groups the increase of eosinophils in BAL was isolated with a direct correlation to the number of eosinophils in blood. By contrast, the increase of eosinophils in BAL of IPF, AIP and ABPA was of lesser extent (4.7% +/- 5.7 p less than 0.01, 5.0% +/- 3.0 p less than 0.01 and 6.1% +/- 10.4 p less than 0.01, respectively) and was accompanied by an increase of neutrophils in IPF, of lymphocytes in AIP and both in ABPA. These patterns are generally defined as "mixed alveolitis." On the basis of these data we conclude that the term "eosinophilic alveolitis" should be reserved for CEP and CSS.

Adult↗
PubMed1990

Inflammatory markers in bronchoalveolar lavage and in bronchial biopsy in asthma during remission.

Bronchoalveolar lavage and BB were performed in 13 asthmatic and six healthy subjects to characterize cellular markers of inflammation in BAL and BB; to compare cellular profile of BAL with cell infiltration in BB; to examine the relationship between bronchial responsiveness and markers of inflammation in BAL and BB. Eosinophils and mast cells were increased in BAL in asthmatic subjects; eosinophils were positively correlated with neutrophils and mast cells. Epithelial shedding was present in nine asthmatic and five control subjects. Intraepithelial cells and cells in submucosa were increased in asthmatic subjects. Eosinophils and intraepithelial mast cells were higher. Thickened basement membrane was associated with more marked cell infiltration in submucosa. Ciliated cells in BAL relate to intraepithelial cells; cells in BAL broadly reflect cell infiltration of submucosa. In the asthmatic group, the degree of bronchial responsiveness correlated with ciliated cells in BAL and with intra-epithelial cells in BB. Marked airway inflammation is associated with stable asthma; inflammatory changes within bronchial epithelium may be linked to the development of bronchial hyperresponsiveness.

Adolescent↗
PubMed1988

Bronchoalveolar lavage in chronic eosinophilic pneumonia. Analysis of six cases in comparison with other interstitial lung diseases.

We describe 6 patients with chronic eosinophilic pneumonia (CEP) investigated clinically and by bronchoalveolar lavage (BAL). The BAL findings of these 6 patients were compared with those of 293 patients with other interstitial lung diseases (ILD): 184 with sarcoidosis, 63 with hypersensitivity pneumonitis, 46 with idiopathic pulmonary fibrosis (IPF). In patients with CEP, BAL analysis was characterized by a markedly increased number of eosinophils (mean +/- 1 SD: 54.2 +/- 26.4 of effector cells; in control subjects, eosinophils were less than 1% of effector cells). In patients with other ILD, BAL fluid analysis showed a significant increase in the percentage of eosinophils only in the group of IPF, but in IPF the increased number of eosinophils is linked with a significant increase in the percentage of neutrophils. These findings indicate that besides the classic patterns of lymphocytosis or polymorphonuclear leukocytosis, a predominantly eosinophilic pattern may also be present in the BAL fluid. Moreover, BAL may contribute to understanding the pathogenesis of lung tissue damage in CEP.

Adult↗
PubMed1988

Evaluation of some immunological parameters in interstitial lung disease by discriminant analysis.

In 37 subjects affected by interstitial lung diseases (19 patients with pulmonary sarcoidosis, 11 with hypersensitivity pneumonitis, 7 with idiopathic pulmonary fibrosis), we have compared by discriminant analysis (Statistical Package for the Social Sciences, version 8.3) 17 biological parameters derived from bronchoalveolar lavage analysis, gallium-67 scanning and lung biopsy. The aim of the study was to analyze the parameters of these three groups by forming one or more linear combinations of the discriminant variables. In particular, we tried to define the ability of such parameters to define these interstitial lung diseases and the relative importance of the data examined. The functions obtained are highly discriminant, so that the three groups are well distinguished among themselves; it means that the variables employed discriminate among the diseases studied. Among the variables considered, differential cell count, immune complex determination, gallium-67 lung scanning have the most important discriminant capacity. Discriminant analysis emphasizes that the three diseases are mediated by different immune mechanisms and underlines the role of each mechanism in determining the disease.

Adult↗
PubMed1988

The intensity of sarcoidosis alveolitis is related to albumin and IgG levels in BAL.

To define whether the levels of immunoglobulins and albumin in bronchoalveolar lavage (BAL) fluid are related to the intensity of sarcoidosis alveolitis, 49 patients affected with pulmonary sarcoidosis were studied. To distinguish between high- and low-intensity alveolitis, two parameters were used: the percentage of T lymphocytes and the CD4+/CD8+ ratio in BAL fluid. The results showed an increase of albumin and of the IgG/albumin ratio (p less than 0.05) in patients with high-intensity alveolitis as assessed by both criteria. Moreover, an increase (p less than 0.05) of albumin concentration related to T lymphocyte alveolitis was found. We conclude that: albumin is a reliable index of inflammation; the increase of the IgG/albumin ratio is the expression of local production of IgG as well as of inflammation; the evaluation of albumin and of the IgG/albumin ratio should be useful because they both correlate with the intensity of the alveolitis: the former express inflammatory damage and the latter, immunological activity.

Adult↗
PubMed1988

Study of immune complexes in bronchoalveolar lavage fluids.

Immune complexes (IC) were investigated in the bronchoalveolar lavage fluid (BAL) of 5 patients with hypersensitivity pneumonitis (HP), 11 with idiopathic pulmonary fibrosis (IPF) and 16 with sarcoidosis (S) by three different methods: C1Q-BA, KgB, AKgB-MA. Using AKgB-MA, it is possible to identify the class of antibodies forming the IC. IC were present in all cases of HP, in 8/11 (73%) of IPF and in 10/16 (62%) of S. However, the three tests showed discordant results for the three different diseases: C1Q-BA and KgB-SP were both positive in 40%, AKgB-MA in 80% of HP cases; C1Q-BA in 73%, KgB-SP in 9% and AKgB-MA in 46% of IPF cases; C1Q-BA in 31%, KgB-SP in 12% and AKgB-MA in 31% of S cases. In all of the diseases, the IC were mostly composed of IgG; moreover, in HP IgA was also frequently present. The determination of IC in different fractions obtained from BAL ultracentrifugation, confirmed the simultaneous presence of IC of different molecular weights and antibody composition. Lung transbronchial biopsy with immunofluorescence showed immunoglobulin, prevalently IgG, and C, in all HP cases, the majority of IPF cases and 50% of S cases. This confirms the importance of IC in the pathogenesis and/or evolution of some pulmonary diseases.

Adult↗
PubMed1986

Clinical physiological data on the bronchodilator effect of Duovent versus salbutamol in chronic obstructive lung disease.

We studied the bronchodilator effect of a combination of fenoterol (100 micrograms) and ipratropium bromide (40 micrograms) (Duovent) versus salbutamol and placebo in 16 patients with chronic obstructive lung disease (COLD). FEV1 and the side-effects (palpitations, tremors, excitation) were measured at 0, 30, 60, 120, 240, 360 and 420 min after administration. The drugs were administered in aerosol form following a randomization schedule. The bronchodilator effect of Duovent was greater than that of salbutamol; moreover, Duovent had a lasting efficacy and few side-effects. Duovent is thus a useful drug therapeutically.

Albuterol↗
PubMed1984

Pulmonary involvement in Sjögren's syndrome.

In this study we tried to value the frequency and the characteristics of the physiological abnormalities affecting the lungs in Sjögren's syndrome (SS). We studied 18 female nonsmokers (average age 53 years). The diagnosis has been made on the presence of at least two of the following abnormalities: keratoconjunctivitis sicca (Schirmer's test), xerostomia (scanning of the salivary glands, lip biopsy) and collagen vascular disease. We made the following tests: clinical examination, chest roentgenogram, spirometry, TGV, RAW and SAW valuation, study of the flow-volume curves, diffusion capacity test, bronchoalveolar lavage, bronchial biopsy. The physiological results have demonstrated the presence of a restrictive syndrome affecting above all the small airways (MEF25-32.7%) and a decrease of the diffusion capacity (DLCO-25%). There is, moreover, a constant lymphocytic infiltration of the bronchial mucosa and of the lung's interstitium. In conclusion the pulmonary involvement in SS seems to be constant, unpredictable and of remarkable clinical-physiological importance.

Adult↗
PubMedDate not supplied

Short-term treatment with a low dose of inhaled fluticasone propionate decreases the number of CD1a+ dendritic cells in asthmatic airways.

The activation of T-lymphocytes through the recognition of specific allergens is a crucial event in the development of allergic inflammation. Dendritic cells (DC) are potent accessory cells that play an important role in initiating bronchial immune responses by activation of T-lymphocytes. We investigated the distribution of CD1a+ DC in the bronchial biopsies from asthmatic patients, and evaluated the effects of a short course of low dose inhaled fluticasone propionate treatment. Twenty-three mild to moderate stable asthmatic patients and eight normal subjects were included in the study. Bronchoscopy with bronchial biopsies were performed in each subject. Eighteen of the 23 asthmatics underwent a second bronchoscopy after 6 weeks of low dose inhaled fluticasone propionate treatment (250 mcg bd) in a placebo-controlled double-blind study. Biopsies were embedded into glycolmethacrylate resin and analysed by immunohistochemistry methods using specific monoclonal antibodies against CD1a, which is a widely recognized marker for DC. In asthmatics, CD1a+ DC number was significantly higher in bronchial epithelium (P < 0.001) and in lamina propria (P < 0.001) when compared with normal controls. In addition, we observed that a short course of low dose inhaled fluticasone propionate treatment decreased the number of CD1a+ DC in both the bronchial epithelium (P < 0.05) and lamina propria (P < 0.01). The increased number of CD1a+ DC support the hypothesis that DC play an important role in the modulation of the immune response in chronic asthma. Short-term low dose fluticasone propionate treatment induces down-regulation of the CD1a+ DC number.

Administration, Inhalation↗
PubMedDate not supplied

Bronchoalveolar lavage analysis of interstitial lung disease in CREST syndrome.

The bronchoalveolar lavage (BAL) technique was used to characterize inflammatory cells in the lower respiratory tract of seven nonsmoking patients with CREST syndrome and interstitial pulmonary fibrosis. Differential cell counts in the BAL fluid showed a significant increase of neutrophils (p less than 0.05) and eosinophils (p less than 0.01) in comparison to normal subjects. In three patients there was also an increase of lymphocytes. No correlation was found between BAL and duration of scleroderma and/or lung function tests. The BAL findings in these scleroderma patients resemble those of idiopathic interstitial fibrosis suggesting that a similar inflammatory process occurs within the lower respiratory tract.

Aged↗