[Eosinophilic granulocyte-associated diseases. Current aspects of pathogenesis and therapy].
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Diagnosis, Differential↗
Biomedical subjects
U Costabel
Publications and source records attributed to U Costabel.
[Bilateral lung infiltration with therapy-resistant fever].
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Biopsy↗
Morphology and density features of eosinophil leukocytes in eosinophilic pneumonia. A case report.
We compared the morphological characteristics and density properties of eosinophil leukocytes obtained from the blood and bronchoalveolar lavage fluid of a 29-year-old patient with chronic eosinophil pneumonia during exacerbation. The lavage eosinophils were significantly increased in size when compared with blood cells (surface area: 208 +/- 12 microns 2 versus 161 +/- 13 microns 2). Moreover, eosinophils contained slightly more granules (23.4 versus 20.7 per cell surface area), but no difference was found when the number was corrected for cell size. Electron microscopy revealed a loss of granule contents in eosinophils from both blood and bronchoalveolar lavage. Finally, 61% of the lavage eosinophils were hypodense (with a density less than 1.085 g/ml), whereas 96.3% of the blood cells were normodense. In conclusion, our data demonstrate that in chronic eosinophil pneumonia, eosinophils obtained from bronchoalveolar lavage and blood show differences in both their morphology and density, suggesting that eosinophils during migration into the lung may become activated.
Adult↗
BOOP and COP.
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Bronchiolitis Obliterans↗
Local immune components in chronic obstructive pulmonary disease.
Bronchoalveolar lavage (BAL) may have a potential role in contributing to a more precise definition of COPD disorders, but at present little is known about the cellular and biochemical changes that occur in BAL in the different stages of COPD. On the contrary, BAL features due to smoking habits, a well-known risk factor for COPD, have been widely investigated. We submitted to BAL 15 normal nonsmokers, 15 asymptomatic smokers and 11 smokers affected by chronic bronchitis. In this latter group BAL fluid recovery was significantly reduced and cellularity increased, but less prominently than in asymptomatic smokers. The CD4/CD8 ratio was significantly decreased in smokers with and without bronchitis, the CD8 percentage being positively correlated with the smoking history. NK cells were decreased in patients with chronic bronchitis. BAL neutrophils were increased in both smoker groups and a correlation was seen with smoking history and degree of airflow obstruction. Neutrophils are markedly involved in the oxidation of BAL proteins, as we could determine with the evaluation of the methionine sulphoxide/methionine ratio in BAL fluids. This finding may be relevant to better understand COPD pathogenesis and progression.
Adult↗
Expression of alveolar macrophage adhesion molecules in pulmonary sarcoidosis.
Beta-2-integrins belong to a family of leukocyte surface glycoproteins that are essential for immune functions of bronchoalveolar cells. The expression of three alpha chains designed as CD11a, CD11b, CD11c, a common beta chain CD18, and of a ligand for several integrins CD54 (ICAM-1) was studied on alveolar macrophages of patients with active and inactive sarcoidosis and in control subjects. The percentage of macrophages expressing CD11b (CR3) was significantly increased in patients with active sarcoidosis compared with patients who had inactive disease and control subjects. The adhesion molecule CD54 (ICAM-1) was detected on a higher percentage of alveolar macrophages in patients with active rather than inactive sarcoidosis and in control subjects. Since integrin-mediated adhesion seems to be important in macrophage-lymphocyte interactions during the immune response, higher expression of both CD11b and CD54 on sarcoid alveolar macrophages may be related to several immune abnormalities reported in pulmonary sarcoidosis.
Adult↗
The role of integrins in the immune response.
The integrin is one of at least three different families of adhesion molecules. Integrins are heterodimeric cell surface receptors, important for adhesion, migration and cellular interactions of immune cells. There are at least 6 subgroups of integrins, each defined by a common beta submit (beta 1-beta 6) which shares multiple alpha subunits. Among them are the receptors for fibronectin, laminin, vitronectin, as well as the very late activation antigens (VLA 1-6) and the C11/CD18 complex. The role of these molecules in the immune response is discussed with special focus on the beta 2 integrins (CD11/CD8) and their ligand ICAM-1 (CD549).
Animals↗
Effect of storage time of pleural effusions on immunocytochemical cell surface analysis of tumor cells.
To determine how long tumor cells can be stored without losing their immunocytochemical reactivity, five malignant pleural effusions in EDTA-coated tubes were analyzed after different storage times at either 4 degrees C or room temperature. Only minor differences were observed between the cells from the two storage conditions. Though there was a considerable decrease in the number of tumor cells attached to the slides from day 0 to 1, the number of tumor cells was still sufficient to allow their clear detection with the monoclonal antibody HEA-125 even on day 4 of storage in all cases. Therefore, for routine purposes, pleural fluids in EDTA-coated tubes can be stored for at least one day prior to immunocytochemical staining if the cells are gently handled during preparation. Pleural fluid is a richly nutritious medium not only for keeping cells alive but also for preserving their immunoreactivity.
Antigens, Neoplasm↗
Therapeutic applications of bronchoalveolar lavage.
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Asthma↗
Effect of smoking on bronchoalveolar lavage constituents.
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Bronchoalveolar Lavage Fluid↗
Bronchiolitis obliterans organizing pneumonia (BOOP): the cytological and immunocytological profile of bronchoalveolar lavage.
The cytological and immunocytological profile of bronchoalveolar lavage (BAL) was studied in 10 patients with idiopathic bronchiolitis obliterans organizing pneumonia (BOOP) and compared with the data in idiopathic pulmonary fibrosis (IPF) (n = 22), chronic eosinophilic pneumonia (CEP) (n = 9), and extrinsic allergic alveolitis (EAA) (n = 24). Lymphocyte subsets were enumerated using an immunoperoxidase slide assay. The BAL pattern in BOOP patients was characterized by several features: 1) colorful cell differentials with an increase in all cell types, most markedly in lymphocytes, and more moderately in neutrophils, eosinophils and mast cells, as well as the presence of foamy macrophages and, occasionally, of plasma cells; 2) decreased CD4/CD8 ratio; 3) normal percentage of CD57+ cells; and 4) increase in activated T-cells in terms of human leucocyte antigen-DR (HLA-DR) expression, and occasionally also interleukin-2 receptor (CD25) expression. The findings were most similar to those in EAA except for the CD25 expression, which was always normal, and the CD57+ cells, which were increased in EAA. The increase in lymphocytes discriminated best between BOOP and IPF. The eosinophils were significantly higher in CEP than in BOOP with little overlap. In conclusion, BAL may be of value to distinguish between BOOP and other interstitial lung disease.
Alveolitis, Extrinsic Allergic↗
Increased oxidized methionine residues in BAL fluid proteins in acute or chronic bronchitis.
Phagocytic cells such as alveolar macrophages (AM) or polymorphonuclear neutrophils (PMN) in the bronchoalveolar tract are a potential source of the oxygen-derived free radicals which are presumed to be involved in lung tissue damage. Previous results have shown that the methionine sulphoxide (MET(O)) content of bronchoalveolar lavage fluid (BALF) protein is a reliable parameter to indicate oxidative processes in idiopathic pulmonary fibrosis (IPF). We measured the molar ratio between MET(O) and methionine (MET) in the BALF protein from healthy nonsmokers (control group), healthy smokers and patients with acute or chronic bronchitis (AB or CB). The MET(O)/MET ratio of the nonsmoking group (n = 11) was 0.046 +/- 0.008 (mean +/- SEM). Healthy smokers (n = 8) had similar values (0.042 +/- 0.008), even though they had strongly increased AM counts in BALF. Patients with AB (n = 12) showed an increased MET(O)/MET ratio (0.191 +/- 0.031) and had high PMN but normal AM counts in BALF. Patients with CB (n = 13) showed an increase in the MET(O)/MET ratio (0.086 +/- 0.010) and moderately increased PMN and markedly increased AM counts. Taking all results together, the MET(O)/MET ratio correlated positively with the relative PMN number (r = 0.70; p less than 0.0002) and inversely with the relative AM number (r = 0.67; p less than 0.0002). In the group with CB, the MET(O)/MET ratio correlated inversely with forced expiratory volume in one second (FEV1) % pred. (r = -0.77) and FEV1/inspiratory vital capacity (IVC) % pred. (r = -0.89).(ABSTRACT TRUNCATED AT 250 WORDS)
Bronchitis↗
Malignant lymphoma in pleural effusions: an immunocytochemical cell surface analysis.
Nine malignant pleural effusions due to lymphoma were immunocytochemically analyzed with the peroxidase-antiperoxidase adhesive slide assay for detection of cell surface antigens using a broad panel of monoclonal antibodies. The study population included one case of hairy-cell leukemia; four cases of B cell non-Hodgkin's lymphoma (B-NHL), low malignant grade; two cases of B-NHL, high malignant grade; one case of Hodgkin's disease; and one case of plasmacytoma. In the cases of B cell lymphoma, high percentages of B cells with monoclonal staining for kappa were found. In hairy-cell leukemia, the hairy cells reacted with the monoclonal antibodies CD20, CD25, HLA-DR, CD45, and HLA-1. In Hodgkin's disease, the Hodgkin cells reacted with CD15, CD20, CD25, CD30, Tü9, and OKT9. The plasmacytoma case showed tumor cells negative for CD20, HLA-DR, and CD45; partially positive for CD38; positive for HLA-1; monoclonally positive for lambda; and negative for heavy-chain immunoglobulins. The analysis of nonmalignant lymphocyte subpopulations revealed CD4/CD8 ratios similar to those in effusions of other etiologies. The percentages of natural killer cells (Leu-7-positive and CD16-positive) were small and also similar to percentages in effusions of other etiologies. We conclude that immunocytochemical analysis of pleural effusions allows a clear recognition of B lymphoma cells and also of Hodgkin and hairy cells and that the distribution of nonmalignant lymphocyte subsets is indistinguishable from those found in other malignant and nonmalignant effusions.
Aged↗
Increased levels of oxidized methionine residues in bronchoalveolar lavage fluid proteins from patients with idiopathic pulmonary fibrosis.
Phagocytic cells are believed to play a crucial role in the development of inflammatory lung diseases. We assumed that the oxidation of methionine (met) to methionine sulfoxide [met(O)] by oxygen-derived free radicals released from phagocytes is one parameter to identify the oxidative mechanisms of lung injury. To test this hypothesis we determined the molar ratio of met(O)/met in the soluble protein fraction of bronchoalveolar lavage (BAL) fluids from healthy nonsmokers and from nonsmoking patients with idiopathic pulmonary fibrosis (IPF) or sarcoidosis. The met(O)/met ratio of the healthy nonsmoker group (n = 11) was 0.046 +/- 0.008 (mean +/- SEM). In contrast, the met(O)/met ratio of the nonsmoking IPF group (n = 11) was significantly increased to 0.223 +/- 0.053 (p less than 0.0002). The BAL fluids of this group showed strongly increased numbers of neutrophils but normal numbers of alveolar macrophages (AM). In the sarcoidosis group (n = 10) the met(O)/met ratio (0.048 +/- 0.010) was not significantly different from control values. A close relationship was found between the met(O)/met ratios and the relative as well as the absolute neutrophil counts (r = 0.86; p less than 0.0002; n = 22). In contrast, no significant correlation was found between the met(O)/met ratios and the absolute AM counts (r = 0.22; p = 0.32; n = 22). We conclude that mechanisms of oxidative lung injury in IPF can be characterized by oxidation of met and that this oxidation may be mediated by neutrophils.
Adult↗
Bronchoalveolar lavage cell data in alveolar proteinosis.
In bronchoalveolar lavage fluid (BAL) from nine patients with alveolar proteinosis (AP), total and differential cell count and T-lymphocyte phenotyping were done and compared with those in 12 healthy volunteers comparable as to age and tobacco consumption. Although total cell count was not significantly different from that in control subjects, the most prominent feature in patients was an increase in the number of CD4 and CD8 T-lymphocytes within the alveoli. Conversely, the macrophage population was significantly reduced. The ratio of CD4/CD8 T-lymphocytes tended to be high, but this increase did not reach statistical significance. The pathophysiologic mechanism and the meaning of these alveolar cell changes in AP remain to be elucidated.
Adult↗
[Asbestos content in bronchoalveolar lavage fluid].
The concentration and size distribution of bronchoalveolar lavage (BAL) asbestos fibers (AF) longer than 2 microns was determined by analytical transmission electron microscopy (TEM). The concentration of asbestos bodies (AB) was measured by TEM and light microscopy (LM). The study group consisted of 110 patients. 27 patients had no occupational asbestos exposure, 44 patients had occupational exposure to asbestos but no asbestos related disease and 39 patients had asbestos related diseases, either asbestosis (n = 34) or malignant mesothelioma of the pleura (n = 5) following long time asbestos exposure at the working place. Occupational asbestos exposure was reflected by increased asbestos fiber concentration in the BAL samples. Mean fiber concentration and size was different between the groups, but the scatter was large.
Asbestos↗
[Alveolitis and pulmonary fibrosis: more current pathogenic and clinical aspects].
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Alveolitis, Extrinsic Allergic↗