title: T-cell dominated inflammatory reactions in the bronchi of asthmatics are not reflected in matched bronchoalveolar lavage specimens.
abstract: Samples of bronchoalveolar lavage (BAL) and endobronchial biopsies were obtained from five patients with clinically diagnosed asthma (ATS criteria). A comparison was made of the presence and distribution of immunocompetent lymphocytes and macrophages within each sample. Significantly raised numbers of T lymphocytes, CD45RO+ lymphocytes, RFD1+ macrophage-like cells and RFD7+ macrophages were seen in the bronchial biopsies. In contrast four out of five of the BAL specimens showed a normal differential cell count, the one exception being a patient exhibiting a degree of lymphocytosis. Further, immunocytological investigation demonstrated a normal distribution of T-cell subsets and macrophage subsets in asthmatic BAL with the exception that in four out of five of these patients a raised number of macrophage-like cells exhibiting phenotypic markers of monocytes was observed. Correlation between BAL and biopsy data was seen in the number of CD45RO+ T-cells present. No other parameters exhibited a significant correlation. Raised expression of HLA-DR was recorded in all asthmatic biopsies, yet lavage cells from the same patients failed to exhibit any increase of HLA-DR density over normal. It is concluded that the immune-associated inflammation present in endobronchial biopsies of clinically stable asthmatics is not reflected in bronchoalveolar lavage samples taken from the same patients.
authors.affiliation: Dept of Immunology, Royal Free Hospital School of Medicine, London, England.
authors.forename: L W
authors.initials: LW
authors.lastname: Poulter
authors.forename: A
authors.initials: A
authors.lastname: Norris
authors.forename: C
authors.initials: C
authors.lastname: Power
authors.forename: A
authors.initials: A
authors.lastname: Condez
authors.forename: B
authors.initials: B
authors.lastname: Schmekel
authors.forename: C
authors.initials: C
authors.lastname: Burke
mesh_terms: D000210:Acute-Phase Reaction; D000293:Adolescent; D000328:Adult; D001249:Asthma / Q000276:immunology / Q000473:pathology*; D001980:Bronchi / Q000276:immunology / Q000473:pathology*; D001992:Bronchoalveolar Lavage Fluid / Q000276:immunology / Q000473:pathology*; D002452:Cell Count; D005260:Female; D006684:HLA-DR Antigens / Q000032:analysis; D006801:Humans; D007124:Immunoenzyme Techniques; D008264:Macrophages / Q000276:immunology; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D013601:T-Lymphocytes
chemical_list: D006684:HLA-DR Antigens