title: [Modifications of the cytoimmunological pattern of bronchoalveolar lavage (BAL) material caused by cigarette smoking in selected lower air-way diseases].
abstract: BACKGROUND
  In the last years we have used flow cytometry as an auxiliary diagnostic tool in alveolar lymphocyte (i.e. originating from BAL) phenotyping in more than 500 persons suspected for lower airways pathology.
  
  
  METHODS
  In the study we compared the results of 1) BAL lymphocyte typing by flow cytometry, 2) cytological examination, respectively, in nonsmoking/smoking (NS/S) patients with lung sarcoidosis, n = 56/31, extrinsic allergic alveolitis (EAA), n = 9/5, silicosis, n = 15/18, idiopathic pulmonary fibrosis (IPF), n = 20/7, and pulmonary tuberculosis (TBC), n = 7/6. The results were related to the volume of BAL fluid recovery (higher value reflects the dominance of lower airways content versus bronchial content).
  
  
  RESULTS
  In smoking patients, in comparison with respective NS, significantly higher total BAL cell numer (except TBC), higher macrophage percentage, lower lymphocyte percentage and lower CD4/CD8 ratio (except EAA) was found. CD4/CD8 results: 8.26 +/- 0.52 (NS) vs 4.29 +/- 0.65 (S) in sarcoidosis (p < 0.001), 1.18 +/- 0.44 (NS) vs 0.99 +/- 0.43 (S) in IPF (p < 0.05), 1.79 +/- 0.22 (NS) vs 0.73 +/- 0.11 (S) in silicosis (p < 0.001) and 1.64 +/- 0.57 vs 0.88 +/- 0.1 in TBC (p < 0.05). Additionally, cigarette smoking modified BAL pattern: 1. in sarcoidosis and silicosis lower CD4+ cell and higher CD8+ cell percentage; 2. in IPF increase in neutrophil percentage; 3. in TBC higher neutrophil and eosinophil percentage. Both in NS and S, BAL fluid recovery rate is significantly positively correlated with CD4/CD8 ratio and total BAL CD3+ cell number and negatively with BAL CD8+ cell percentage.
  
  
  CONCLUSIONS
  Interpreting of BAL material cytoimmunology pattern should take into account data on cigarette smoking and BAL fluid recovery rate. The results obtained in the study may reflect more severe disease course in IPF and TBC.
authors.affiliation: Katedra Genoterapii, Collegium Medicum UMK, Bydgoszcz. mpkopins@hotmail.com
authors.forename: Piotr
authors.initials: P
authors.lastname: Kopiński
authors.forename: Jerzy
authors.initials: J
authors.lastname: Szczeklik
authors.forename: Barbara
authors.initials: B
authors.lastname: Balicka-Slusarczyk
authors.forename: Grazyna
authors.initials: G
authors.lastname: Pinis
authors.forename: Grzegorz
authors.initials: G
authors.lastname: Przybylski
authors.forename: Ewelina
authors.initials: E
authors.lastname: Półgesek
authors.forename: Tomasz
authors.initials: T
authors.lastname: Wandtke
authors.forename: Marzena
authors.initials: M
authors.lastname: Wojciechowska
authors.forename: Andrzej
authors.initials: A
authors.lastname: Marszałek
mesh_terms: D000542:Alveolitis, Extrinsic Allergic / Q000209:etiology / Q000473:pathology*; D001992:Bronchoalveolar Lavage Fluid / Q000166:cytology*; D016516:CD4-CD8 Ratio; D005434:Flow Cytometry; D016591:Histocytological Preparation Techniques; D006801:Humans; D018655:Lymphocyte Count; D008264:Macrophages / Q000166:cytology; D011658:Pulmonary Fibrosis / Q000209:etiology / Q000473:pathology*; D012507:Sarcoidosis / Q000473:pathology*; D012829:Silicosis / Q000209:etiology / Q000473:pathology*; D012907:Smoking / Q000009:adverse effects / Q000473:pathology*; D014397:Tuberculosis, Pulmonary / Q000209:etiology / Q000473:pathology*