title: Immunological characterization of bronchoalveolar lavage fluid in patients with acute pulmonary coccidioidomycosis.
abstract: BACKGROUND
  The specific cellular immunological characteristics of bronchoalveolar lavage (BAL) fluid in acute pulmonary coccidioidomycosis have not been defined.
  
  
  METHODS
  BAL fluid from patients living in a coccidioidomycosis-endemic region of Arizona who were undergoing bronchoscopy because of pulmonary infiltrates was analyzed. Mononuclear cells from BAL fluid and peripheral blood mononuclear cells (PBMCs) were incubated with the coccidioidal antigen T27K in vitro, and cellular immunological assays were performed.
  
  
  RESULTS
  Forty-six patients were studied. Twelve received a diagnosis of acute pulmonary coccidioidomycosis, 17 received other diagnoses, and 17 had no diagnosis established. There was an increased proportion of polyfunctional CD8(+) T cells after antigen stimulation from subjects with coccidioidomycosis as compared to those with another diagnosis (P = .025). In cells collected from BAL fluid and in PBMCs, the concentrations of interferon γ, tumor necrosis factor α, and interleukin 17 (IL-17) were all significantly increased in samples from those with acute pulmonary coccidioidomycosis, compared with the other 2 groups (for all, P<.05).
  
  
  CONCLUSIONS
  When incubated in vitro with a coccidioidal antigen preparation, cells from both BAL fluid and peripheral blood obtained from patients with pulmonary coccidioidomycosis demonstrated specific cellular immune responses, including expression of IL-17.
authors.affiliation: Research Services, Southern Arizona Veterans Affairs Health Care System, USA.
authors.forename: Lance A
authors.initials: LA
authors.lastname: Nesbit
authors.forename: Kenneth S
authors.initials: KS
authors.lastname: Knox
authors.forename: Chinh T
authors.initials: CT
authors.lastname: Nguyen
authors.forename: Justin
authors.initials: J
authors.lastname: Roesch
authors.forename: L Joseph
authors.initials: LJ
authors.lastname: Wheat
authors.forename: Suzanne M
authors.initials: SM
authors.lastname: Johnson
authors.forename: Demosthenes
authors.initials: D
authors.lastname: Pappagianis
authors.forename: Suzette
authors.initials: S
authors.lastname: Chavez
authors.forename: Neil M
authors.initials: NM
authors.lastname: Ampel
mesh_terms: D000328:Adult; D000368:Aged; D000946:Antigens, Fungal / Q000276:immunology; D001130:Arizona / Q000453:epidemiology; D001769:Blood / Q000276:immunology; D001992:Bronchoalveolar Lavage Fluid / Q000276:immunology*; D003047:Coccidioidomycosis / Q000453:epidemiology / Q000276:immunology*; D019353:Endemic Diseases; D005260:Female; D006801:Humans; D007371:Interferon-gamma / Q000378:metabolism; D020381:Interleukin-17 / Q000378:metabolism; D007963:Leukocytes, Mononuclear / Q000276:immunology; D008172:Lung Diseases, Fungal / Q000276:immunology*; D008297:Male; D008875:Middle Aged; D014409:Tumor Necrosis Factor-alpha / Q000378:metabolism
chemical_list: D000946:Antigens, Fungal; D020381:Interleukin-17; D014409:Tumor Necrosis Factor-alpha; D007371:Interferon-gamma
keywords: bronchoalveolar lavage; cellular immunity; coccidioidomycosis; human