Pentamidine aerosol increases the number of alveolar macrophages in HIV-infected patients.
In order to determine the possible effect of aerosolized pentamidine on the cellular composition of the bronchoalveolar lavage fluid in HIV-infected patients, differential counts of 22 consecutive patients who had been rebronchoscopied after 3-19 months were reviewed. Eleven patients were started on pentamidine prophylaxis subsequent to their first presentation. Eleven patients had never taken pentamidine or had discontinued the prophylactic regimen. Compared to first bronchoscopy, the bronchoalveolar lavage (BAL) from patients on regular prophylaxis revealed a significant increase in absolute alveolar macrophage (AM) counts at second presentation (20.8 +/- 11.2 to 50.3 +/- 39.4 x 10(5) cells/100 ml BAL; P less than 0.01). The AM counts of those without pentamidine remained essentially unchanged. Lymphocytes, including CD4 and CD8 subtypes, and neutrophils did not change over time in either group. The results of this retrospective analysis suggest that, in addition to its antimicrobial action, pentamidine may modulate local lung defence mechanisms, particularly by increasing the absolute number of AM.
3rd Medical Department, University of Cologne, Germany.
K
K
Wassermann
E
E
Schell-Frederick
G
G
Eckert
M
M
Don
G
G
Pothoff
H H
HH
Hilger
D000280:Administration, Inhalation; D000328:Adult; D000336:Aerosols; D001992:Bronchoalveolar Lavage Fluid / Q000473:pathology*; D001999:Bronchoscopy; D002452:Cell Count / Q000187:drug effects; D006678:HIV / Q000276:immunology; D015658:HIV Infections / Q000150:complications* / Q000276:immunology; D006801:Humans; D008171:Lung Diseases / Q000188:drug therapy*; D016676:Macrophages, Alveolar / Q000187:drug effects*; D008297:Male; D008875:Middle Aged; D010419:Pentamidine / Q000008:administration & dosage / Q000627:therapeutic use*; D011020:Pneumonia, Pneumocystis / Q000188:drug therapy; D012008:Recurrence; D012189:Retrospective Studies
D000336:Aerosols; D010419:Pentamidine