CD8+ T lymphocytes in bronchoalveolar lavage in idiopathic pulmonary fibrosis.
BACKGROUND
Recently it was shown that in Idiopathic Pulmonary Fibrosis (IPF) tissue infiltrating CD8+ T lymphocytes (TLs) are associated with breathlessness and physiological indices of disease severity, as well as that CD8+ TLs recovered by bronchoalveolar lavage (BAL) relate to those infiltrating lung tissue. Since BAL is a far less invasive technique than tissue biopsy to study mechanisms in IPF we further investigated the usefulness offered by this means by studying the relationship between BAL macrophages, neutrophils, eosinophils, CD3+, CD4+, CD8+, CD8+/38+ TLs and CD4+/CD8+ ratio with breathlessness and physiological indices.


METHODS
27 IPF patients, 63 +/- 9 years of age were examined. Cell counts were expressed as percentages of total cells and TLs were evaluated by flow cytometry. FEV1, FVC, TLC, RV, DLCO, PaO2, and PaCO2 were measured in all. Breathlessness was assessed by the Medical Research Council (MRC) chronic dyspnoea scale.


RESULTS
CD8+ TLs correlated positively (rs = 0.46, p = 0.02), while CD4+/CD8+ ratio negatively (rs = -0.54, p = 0.006) with the MRC grade. CD8+ TLs correlated negatively with RV (rs = -0.50, p = 0.017). CD8+/38+ TLs were negatively related to the FEV1 and FVC (rs = -0.53, p = 0.03 and rs = -0.59, p = 0.02, respectively). Neutrophils correlated positively with the MRC grade (rs = 0.42, p = 0.03), and negatively with the DLCO (rs = -0.54, p = 0.005), PaO2 (rs = -0.44, p = 0.03), and PaCO2 (rs = -0.52, p = 0.01).


CONCLUSIONS
BAL CD8+ TLs associations with physiological and clinical indices seem to indicate their implication in IPF pathogenesis, confirming our previous tissue study.
Papiris
Spyros A
SA
2nd Pulmonary Department, National and Kapodistrian University of Athens, Attikon University Hospital, Athens, Greece. papiris@otenet.gr
Kollintza
Androniki
A
Karatza
Marilena
M
Manali
Effrosyni D
ED
Sotiropoulou
Christina
C
Milic-Emili
Joseph
J
Roussos
Charis
C
Daniil
Zoe
Z