Bronchoscopic microsampling to analyze the epithelial lining fluid of patients with pulmonary Mycobacterium avium complex disease.
BACKGROUND
A new bronchoscopic microsampling (BMS) probe has recently been developed, which allows the minimally invasivecollection of epithelial lining fluid (ELF) simultaneously from multiple sites. While the number of immunocompetent patients with pulmonary Mycobacterium avium complex(MAC) disease is growing, the precise pathogenesis of the disease remains to be clarified.


OBJECTIVE
This study aimed to measure biochemical markers in the ELF of patients with pulmonary MAC disease using BMS.


METHODS
We studied 8 healthy volunteers (controls) and 8 patients with pulmonary MAC disease. In the patients, ELF was collected from visibly abnormal (involved) and normal (uninvolved) sites using high-resolution computed tomography (HRCT).


RESULTS
The concentration of IFN-gamma (means +/- SEM) was significantly higher in patient ELF sampled from involved (26.62 +/- 9.66 pg/ml) than from uninvolved sites (5.33 +/- 1.44 pg/ml; p < 0.05) or from normal controls (<1.56 pg/ml; p < 0.05). In most patients, there was no difference in IFN-gamma concentrations between the involved and uninvolved sites. The concentration of KL-6 in ELF was significantly higher in the involved (793 +/- 108 U/ml) than in the uninvolved sites (192 +/- 43 U/ml;p < 0.05) or in normal controls (186 +/- 38 U/ml;p < 0.05).


CONCLUSIONS
The specific inflammatory reaction caused by MAC infection might not be limited to sites that were visibly abnormal on HRCT. Although further improvement has to be considered, BMS may help to increase the understanding of the pathogenesis of various respiratory disorders.
Nishimura
Tomoyasu
T
Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, Tokyo, Japan.
Hasegawa
Naoki
N
Watanabe
Masazumi
M
Takebayashi
Toru
T
Tasaka
Sadatomo
S
Ishizaka
Akitoshi
A
D000328:Adult; D015415:Biomarkers / Q000378:metabolism; D001992:Bronchoalveolar Lavage Fluid / Q000737:chemistry*; D001999:Bronchoscopy; D016022:Case-Control Studies; D004848:Epithelium / Q000378:metabolism*; D005260:Female; D006801:Humans; D007371:Interferon-gamma / Q000378:metabolism; D008168:Lung / Q000000981:diagnostic imaging; D008297:Male; D008875:Middle Aged; D018396:Mucin-1 / Q000378:metabolism; D015269:Mycobacterium avium Complex; D015270:Mycobacterium avium-intracellulare Infection / Q000378:metabolism*; D014057:Tomography, X-Ray Computed; D042461:Vascular Endothelial Growth Factor A / Q000378:metabolism; D055815:Young Adult
D015415:Biomarkers; C060192:MUC1 protein, human; D018396:Mucin-1; C467484:VEGFA protein, human; D042461:Vascular Endothelial Growth Factor A; D007371:Interferon-gamma