Detection of alveolar fibrocytes in idiopathic pulmonary fibrosis and systemic sclerosis.
BACKGROUND
Fibrocytes are circulating precursors for fibroblasts. Blood fibrocytes are increased in patients with idiopathic pulmonary fibrosis (IPF). The aim of this study was to determine whether alveolar fibrocytes are detected in broncho-alveolar lavage (BAL), to identify their prognostic value, and their potential association with culture of fibroblasts from BAL.


METHODS
We quantified fibrocytes in BAL from 26 patients with IPF, 9 patients with Systemic Sclerosis(SSc)-interstitial lung disease (ILD), and 11 controls. BAL cells were cultured to isolate alveolar fibroblasts.


RESULTS
Fibrocytes were detected in BAL in 14/26 IPF (54%) and 5/9 SSc patients (55%), and never in controls. Fibrocytes were in median 2.5% [0.4-19.7] and 3.0% [2.7-3.7] of BAL cells in IPF and SSc-ILD patients respectively. In IPF patients, the number of alveolar fibrocytes was correlated with the number of alveolar macrophages and was associated with a less severe disease but not with a better outcome. Fibroblasts were cultured from BAL in 12/26 IPF (46%), 5/9 SSc-ILD (65%) and never in controls. The detection of BAL fibrocytes did not predict a positive culture of fibroblasts.


CONCLUSIONS
Fibrocytes were detected in BAL fluid in about half of the patients with IPF and SSc-ILD. Their number was associated with less severe disease in IPF patients and did not associate with the capacity to grow fibroblasts from BAL fluid.
Assistance Publique-Hopitaux de Paris, Service de Pneumologie A, Centre de Compétences Maladies Rares Pulmonaires, Hôpital Bichat, Paris, France.
Raphael
R
Borie
Christophe
C
Quesnel
Sophie
S
Phin
Marie-Pierre
MP
Debray
Joelle
J
Marchal-Somme
Kiet
K
Tiev
Marcel
M
Bonay
Aurélie
A
Fabre
Paul
P
Soler
Monique
M
Dehoux
Bruno
B
Crestani
D000368:Aged; D000369:Aged, 80 and over; D018893:Bronchoalveolar Lavage; D002452:Cell Count; D005260:Female; D005347:Fibroblasts / Q000473:pathology*; D006801:Humans; D054990:Idiopathic Pulmonary Fibrosis / Q000473:pathology* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D011650:Pulmonary Alveoli / Q000473:pathology*; D012595:Scleroderma, Systemic / Q000473:pathology* / Q000628:therapy; D013997:Time Factors