Autoantibodies to lipids in bronchoalveolar lavage fluid of patients with acute respiratory distress syndrome.
OBJECTIVE
To investigate the presence of autoantibodies to lipids in the bronchoalveolar lavage (BAL) fluid from adult patients with acute respiratory distress syndrome (ARDS).


METHODS
Analysis of immunoglobulin G (IgG) in BAL fluid by electrophoresis followed by immunoblotting and characterization of immunoglobulins as antilipid autoantibodies.


METHODS
Intensive care unit of a university hospital and two research university laboratories.


METHODS
Twenty-seven mechanically ventilated patients in total, including nine patients with ARDS and two control groups.


METHODS
Patients were ventilated with a mechanical ventilation mode. Six aliquots of 20-mL sterile normal saline at 37 degrees C were infused through the working channel of the bronchoscope.


METHODS
Total protein, detection of IgG by electrophoresis followed by immunoblotting, and characterization of IgG by enzyme-linked immunosorbent assay using different lipids as target antigens.


RESULTS
Antiphospholipid autoantibodies are present in BAL fluid of ARDS patients. Among the phospholipids tested, phosphatidic acid and phosphatidylserine gave the most significant activity. The IgG fraction, purified from BAL fluids by affinity chromatography, gave the same pattern of binding as that of the BAL fluid.


CONCLUSIONS
The presence of antiphospholipid autoantibodies in BAL fluid suggests involvement of autoimmune mechanisms in the pathogenesis of ARDS.
Maneta-Peyret
L
L
Laboratoire de Biogenèse Membranaire, Université Victor Segalen Bordeaux 2, Bordeaux, France.
Kitsiouli
E
E
Lekka
M
M
Nakos
G
G
Cassagne
C
C
D000328:Adult; D000368:Aged; D017152:Antibodies, Antiphospholipid / Q000032:analysis*; D001323:Autoantibodies / Q000032:analysis*; D015153:Blotting, Western; D001992:Bronchoalveolar Lavage Fluid / Q000166:cytology / Q000276:immunology; D004586:Electrophoresis; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007074:Immunoglobulin G / Q000032:analysis*; D008173:Lung Diseases, Obstructive / Q000150:complications / Q000628:therapy; D008297:Male; D008875:Middle Aged; D012016:Reference Values; D012121:Respiration, Artificial; D012128:Respiratory Distress Syndrome / Q000209:etiology / Q000276:immunology* / Q000401:mortality / Q000628:therapy; D012680:Sensitivity and Specificity; D015996:Survival Rate
D017152:Antibodies, Antiphospholipid; D001323:Autoantibodies; D007074:Immunoglobulin G