Pulmonary function tests of Mycobacterium avium-intracellulare infection: correlation with bronchoalveolar lavage fluid findings.
BACKGROUND
The pulmonary Mycobacterium avium-intracellulare (MAI) infection in patients with neither predisposing lung disease nor immunodeficiency is recognized to occur predominantly in older or middle-aged and thin females, and has characteristic chest computed tomography (CT) findings with multiple nodules and bronchiectasis.


OBJECTIVE
To investigate the pathophysiology with and individual of MAI infection with neither predisposing lung disease nor immunodeficiency. The bronchoalveolar lavage (BAL) fluid (BALF) was recovered directly from the affected segments identified by the chest CT.


METHODS
We performed a pulmonary function test (PFT) and BAL in 15 patients (all females) with MAI infection and 5 normal female volunteers.


RESULTS
The residual volume and the slope of phase III (DeltaN(2)) were significantly increased and V(25) was significantly decreased in the 15 patients compared with the normal control subjects. The patients' BALF showed significant increases in neutrophils and activated CD4 lymphocytes, proinflammatory cytokines, and neutrophil elastase (NE) compared to those in the controls. We analyzed the PFT and BALF findings, and observed a significant correlation between the DeltaN(2) and interleukin (IL)-8 concentration (r = 0.65, p < 0.01), IL-8/albumin ratio (r = 0.51, p < 0.05) and NE/albumin ratio (r = 0.57, p < 0.05) in the BALF and DeltaN(2), respectively.


CONCLUSIONS
These findings suggest that small airway dysfunction in MAI infection without predisposing lung disease is related to the inflammation probably related to the neutrophil.
Yamazaki
Y
Y
Department of Medicine, Shinshu University School of Medicine, Matsumoto, Japan.
Kubo
K
K
Fujimoto
K
K
Matsuzawa
Y
Y
Sekiguchi
M
M
Honda
T
T
D000368:Aged; D001992:Bronchoalveolar Lavage Fluid / Q000737:chemistry; D018791:CD4 Lymphocyte Count; D005260:Female; D006801:Humans; D008875:Middle Aged; D015270:Mycobacterium avium-intracellulare Infection / Q000503:physiopathology*; D009504:Neutrophils; D012129:Respiratory Function Tests