Biomedical subjects
Publications and source records attributed to W Petermann.
Alveolar macrophages obtained from 28 patients with pulmonary sarcoidosis were investigated to determine their ability spontaneously to release interleukin 1. In 14 of these patients, a significant spontaneous liberation of interleukin 1 was observed; the BAL parameters of these patients pointed to an elevated activity of the disease.
In fibrosing alveolitides that are associated with rheumatoid arthritides, the BAL fluid reveals a characteristic cell pattern. These cellular changes occur at an earlier date than do the radiological signs of pulmonary fibrosis. Together with a measurement of the CO diffusion capacity, BAL is a suitable monitoring parameter for fibrosing alveolitides in rheumatoid arthritis.
Fibrosing alveolitides are associated with a characteristic cellular pattern in the BAL fluid. In contrast, acute interstitial fibrosing pulmonary changes in patients receiving cytostatic drug treatment cannot be detected in the BAL fluid, since the direct influence of cytostatic agents on the cellular constitution of the BAL fluid predominates.
Reports on the development of tolerance have modified the use of nitrates in the treatment of coronary heart disease. Dosage limitations and nitrate-free intervals are frequently recommended to solve this problem (4, 5). In the clinical setting of acute myocardial infarction continuous application of glyceryl trinitrate (GTN) is still a widely used therapy (1). In this study we investigated whether a low-dose intravenous GTN administration leads to a rapid development of tolerance. During the observation period of 60 h, no attenuation of drug effects on the pulmonary pressures could be detected. Subsequent oral medication also showed an undiminished nitrate response.
Alveolar macrophages from 28 patients with pulmonary sarcoidosis, from 6 patients with idiopathic pulmonary fibrosis and from 8 control subjects were tested for their spontaneous interleukin-1 release. Whereas alveolar macrophages from the controls and from the patients with idiopathic pulmonary fibrosis did not show a significant release of interleukin 1, 14 of the sarcoidosis patients displayed a considerable spontaneous interleukin-1 secretion. Besides radiographic signs of an increased disease activity these patients revealed a significantly elevated number of lymphocytes and a significantly increased T4/T8-ratio in the bronchoalveolar lavage indicating an enhanced inflammatory activity of sarcoidosis. The spontaneous interleukin-1 release is possibly due to a raised number of immature alveolar macrophages in the lung of patients with sarcoidosis.
Oxidative metabolism in phagocytes such as granulocytes, monocytes, and alveolar macrophages is becoming of increasing interest in efforts to determine the pathogenetic mechanisms in diseases related to tissue damage, e.g., sarcoidosis. The release of free oxygen radicals is dependent on the activation of the oxidative metabolism and can be measured by means of chemiluminescence. Basic luminol-dependent chemiluminescence released by monocytes and alveolar macrophages from 12 patients with untreated pulmonary sarcoidosis stage II was increased (p less than 0.01) compared with 12 control subjects. A less distinct difference could be observed in the chemiluminescence response of granulocytes (P less than 0.05). After stimulation with zymosan, alveolar macrophages and monocytes (P less than 0.01) as well as granulocytes (P less than 0.05) had an enhanced luminol-dependent chemiluminescence compared with the control group. Emission of chemiluminescence by alveolar macrophages was considerably lower than that of granulocytes and monocytes. No significant correlation could be demonstrated between chemiluminescence response of granulocytes and monocytes and cellular markers of sarcoidotic activity such as lymphocytosis in bronchoalveolar lavage and T-helper/T-suppressor ratio in the lavage fluid. In contrast to that, a significant correlation (P less than 0.01) could be observed both between nonstimulated chemiluminescence and stimulated chemiluminescence and lymphocytosis and T-helper/T-suppressor ratio in bronchoalveolar lavage. Enhanced chemiluminescence may indicate inflammatory activation in pulmonary sarcoidosis.
Alveolar macrophages differ from their percursors in blood, monocytes, by expressing strong activity of the tartrate resistant variant of acid phosphatase (TAcP). A study was carried out to analyse the expression of this enzyme cytochemical marker by alveolar macrophages from bronchoalveolar lavage cells from 34 patients with sarcoidosis and 12 control subjects. Alveolar macrophages from control subjects displayed a strong and homogeneous staining pattern and only 0.1% of cells were negative after staining. Macrophages from patients with sarcoidosis showed reduced TAcP activity and up to 7% of the cells were negative. The percentage of TAcP negative macrophages was correlated with the percentage of lymphocytes and with the ratio of CD4 to CD8 lymphocytes among cells recovered by bronchoalveolar lavage. The reduced TAcP activity in alveolar macrophages from patients with sarcoidosis may be due to an increased recruitment of immature precursors from blood.
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We investigated 60 patients with severe left-sided heart failure before and after cardiac recompensation. We observed that the cardiac insufficiency had a marked effect on dynamic ventilatory parameters. The "effort independent part" of the flow-volume curve was changed significantly by means of cardiac therapy.
Oxidative metabolism correlates with the release of microbiocidal oxygen-free radicals, measured as luminol-dependent chemiluminescence. The effect of general anesthesia on the oxidative metabolism of human leukocytes was investigated. Sixteen patients undergoing a halothane-induced general anesthesia and 14 patients receiving an enflurane-induced general anesthesia participated in the study. Halothane-induced anesthesia was accompanied both by a suppression of basic chemiluminescence and by a decrease in chemiluminescence during the phagocytosis of zymosan A. This was monitored 15 min, 30 min and 60 min after starting general anesthesia and compared to the level of chemiluminescence before starting general anesthesia. Ninety minutes after finishing general anesthesia, a significant recovery of chemiluminescence was seen to exceed the level before general anesthesia. Comparable findings were observed with enflurane-induced general anesthesia, suggesting a decreased release of oxygen-free radicals during general anesthesia, and afterwards an increase exceeding the initial level.
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