title: Removal of bronchoalveolar cells augments the late eosinophilic response to segmental allergen challenge.
abstract: BACKGROUND
  In patients with quiescent asthma, macrophages are the most prevalent cells recovered by bronchoalveolar lavage (BAL). Through activation via their FcepsilonRII receptors or by acting as antigen-presenting cells, macrophages could, in theory, promote the late airway response to allergen.
  
  
  OBJECTIVE
  In order to investigate the importance of macrophages and other airway luminal cells in inducing the late airway response, a novel washout experiment was designed.
  
  
  METHODS
  Five patients with ragweed-allergic asthma underwent bronchoscopy and segmental bronchial challenge with either normal saline or short ragweed extract in two segments of one lung. In a third segment of the opposite lung, 12 successive BALs (25 mL each) were performed, followed by challenge with an identical dose of short ragweed (washed-challenged segment). After 24 h, all three challenged segments underwent BAL.
  
  
  RESULTS
  Initially, in the washed-challenged segment, over 80% (mean 80.4%, range 68-88%) of the recoverable airway dwelling cells were removed. Unexpectedly, 24 h later these same washed-challenged segments contained more eosinophils in the BAL than the challenged segments from the opposite lung (P = 0.033).
  
  
  CONCLUSIONS
  Removing the majority of airway luminal cells followed by allergen bronchoprovocation increased the number of eosinophils recovered 24 h after challenge. Our results suggest that in quiescent allergic asthma, the airway luminal cells are protective and attenuate the late eosinophilic response to allergen challenge.
authors.affiliation: Division of Allergic Diseases/Department of Internal Medicine, Mayo Clinic and Foundation, Rochester, Minnesota, USA. lhunt330@Bellsouth.net
authors.forename: L W
authors.initials: LW
authors.lastname: Hunt
authors.forename: G J
authors.initials: GJ
authors.lastname: Gleich
authors.forename: H
authors.initials: H
authors.lastname: Kita
authors.forename: D A
authors.initials: DA
authors.lastname: Weiler
authors.forename: D R
authors.initials: DR
authors.lastname: Schroeder
authors.forename: Z
authors.initials: Z
authors.lastname: Vuk-Pavlovic
authors.forename: S
authors.initials: S
authors.lastname: Sur
mesh_terms: D000328:Adult; D000941:Antigens / Q000276:immunology*; D001249:Asthma / Q000276:immunology* / Q000473:pathology; D001985:Bronchial Provocation Tests; D001992:Bronchoalveolar Lavage Fluid / Q000166:cytology / Q000276:immunology*; D002455:Cell Division; D004804:Eosinophils / Q000276:immunology* / Q000473:pathology; D005260:Female; D006801:Humans; D007958:Leukocyte Count; D008168:Lung / Q000276:immunology; D008264:Macrophages / Q000502:physiology; D008297:Male; D008875:Middle Aged; D010940:Plant Proteins / Q000276:immunology; D011058:Pollen / Q000276:immunology; D013997:Time Factors
chemical_list: D000941:Antigens; D010940:Plant Proteins