Determinants of bronchoalveolar lavage cellularity in idiopathic pulmonary fibrosis.
Schwartz-DA; Helmers-RA; Dayton-CS; Merchant-RK; Hunninghake-GW
J Appl Physiol 1991; 71(5):1688-1693
Bronchoalveolar lavage (BAL) cells from patients with idiopathic pulmonary fibrosis (IPF) were compared to those from nonsmoking and smoking normal volunteers to identify determinants of BAL cellularity in IPF. The study subjects included 83 patients with IPF, 111 nonsmoking volunteers, and 19 smoking volunteers. IPF subjects had an overall increase in the total cells per milliliter of BAL fluid. However, smoking volunteers had even higher concentrations than patients with IPF. IPF patents had a higher concentration of alveolar macrophages than nonsmoking volunteers and a higher concentration of both neutrophils and eosinophils than normal volunteers with no attention given to smoking status. Current smokers had a marked increase in the macrophage content of lavage fluid. A marginal relationship was noted between the concentration of BAL macrophages and both pack years of smoking and two measures of lung function. No clear association was manifested between the BAL macrophages and either the type of immunosuppressive therapy or other specific measures of lung function. The authors conclude that cigarette smoking influences the inflammatory changes in the alveoli and possibly the airways of patients with IPF. The authors suggest that smoking may contribute to the development and/or progression of this disease.
NIOSH-Grant; Pulmonary-system-disorders; Cigarette-smoking; Alveolar-cells; Lung-function; Pulmonary-function-tests; Immune-reaction; Humans
Internal Medicine University of Iowa Pulmonary Disease Division Iowa City, IA 52242
Pulmonary System Disorders
Journal of Applied Physiology
University of Iowa, Iowa City, Iowa