title: Bronchoscopic microsampling to analyze the epithelial lining fluid of patients with pulmonary Mycobacterium avium complex disease.
abstract: 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.
authors.affiliation: Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, Tokyo, Japan.
authors.forename: Tomoyasu
authors.initials: T
authors.lastname: Nishimura
authors.forename: Naoki
authors.initials: N
authors.lastname: Hasegawa
authors.forename: Masazumi
authors.initials: M
authors.lastname: Watanabe
authors.forename: Toru
authors.initials: T
authors.lastname: Takebayashi
authors.forename: Sadatomo
authors.initials: S
authors.lastname: Tasaka
authors.forename: Akitoshi
authors.initials: A
authors.lastname: Ishizaka
mesh_terms: 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
chemical_list: D015415:Biomarkers; C060192:MUC1 protein, human; D018396:Mucin-1; C467484:VEGFA protein, human; D042461:Vascular Endothelial Growth Factor A; D007371:Interferon-gamma