title: Cytokines in bronchoalveolar lavage fluid in patients with high altitude pulmonary oedema at moderate altitude in Japan.
abstract: BACKGROUND
  The precise mechanism of high altitude pulmonary oedema (HAPE) remains unclear. The purpose of this study was to evaluate the role of cytokines and P-selectin in the development of HAPE which occurred at moderate altitude in Japan.
  
  
  METHODS
  The following cellular and biochemical markers and chemotactic cytokines were measured in the bronchoalveolar (BAL) fluid from four patients with HAPE at 2857-3180 m in the Japanese Alps: total proteins, albumin, lactate dehydrogenase (LDH), and interleukin (IL)-1 alpha, IL-1 beta, IL-1 receptor antagonist (ra), IL-6, IL-8, IL-10, tumour necrosis factor (TNF)-alpha, and the soluble form of P-selectin.
  
  
  RESULTS
  At admission there were significant increases in the levels of total cells, especially macrophages and neutrophils, total protein, albumin and LDH when compared with 13 healthy individuals. Furthermore, the levels of IL-1 beta, IL-6, IL-8, and TNF-alpha were also considerably increased but returned quickly to the normal ranges or were not detected after recovery. The levels of IL-1 alpha, IL-10, and P-selectin did not change.
  
  
  CONCLUSIONS
  These results suggest that an inflammatory process almost identical with acute respiratory distress syndrome (ARDS) may occur in HAPE, but that these changes are transient and are not associated with any increase in P-selectin levels in the BAL fluid.
authors.affiliation: First Department of Medicine, Shinshu University, School of Medicine, Matsumoto, Japan.
authors.forename: K
authors.initials: K
authors.lastname: Kubo
authors.forename: M
authors.initials: M
authors.lastname: Hanaoka
authors.forename: S
authors.initials: S
authors.lastname: Yamaguchi
authors.forename: T
authors.initials: T
authors.lastname: Hayano
authors.forename: M
authors.initials: M
authors.lastname: Hayasaka
authors.forename: T
authors.initials: T
authors.lastname: Koizumi
authors.forename: K
authors.initials: K
authors.lastname: Fujimoto
authors.forename: T
authors.initials: T
authors.lastname: Kobayashi
authors.forename: T
authors.initials: T
authors.lastname: Honda
mesh_terms: D000328:Adult; D000418:Albumins / Q000032:analysis; D000532:Altitude Sickness / Q000276:immunology*; D001992:Bronchoalveolar Lavage Fluid / Q000737:chemistry* / Q000166:cytology; D018925:Chemokines / Q000032:analysis*; D006801:Humans; D007107:Immune System / Q000166:cytology; D007770:L-Lactate Dehydrogenase / Q000032:analysis; D008297:Male; D019007:P-Selectin / Q000032:analysis; D011506:Proteins / Q000032:analysis; D011654:Pulmonary Edema / Q000276:immunology*
chemical_list: D000418:Albumins; D018925:Chemokines; D019007:P-Selectin; D011506:Proteins; D007770:L-Lactate Dehydrogenase