title: Bronchoalveolar lavage in infants with recurrent lower respiratory symptoms.
abstract: BACKGROUND
  Few data are available about the inflammatory cytokine profile of bronchoalveolar lavage (BAL) from young children with frequent wheeze. The first aim was to investigate the BAL cellular and cytokine profiles in infants with recurrent lower respiratory symptoms in whom bronchoscopy was indicated for clinical symptom evaluation. The second aim was to relate the BAL results with the histological findings of the endobronchial carina biopsies.
  
  
  METHODS
  Thirty-nine infants (median age 0.9 years) underwent lung function testing by whole-body plethysmography prior to the bronchoscopy. The BAL differential cell counts and cytokine levels were quantified. These findings were compared with the histological findings of the endobronchial carina biopsies.
  
  
  RESULTS
  The differential cytology reflected mainly that described for healthy infants with lymphocyte counts at the upper range level. A positive association between BAL CD8+ lymphocytes and neutrophils and endobronchial reticular basement membrane was found. Detectable levels of pro-inflammatory cytokine proteins IL-1β, IL-17A, IL-18, IL-23, and IL-33 were found, whereas levels of Th2-type cytokine proteins were low. Frequent wheeze was the only clinical characteristic significantly related to detectable combined pro-inflammatory cytokine profile. Lung function did not correlate with any cytokine.
  
  
  CONCLUSIONS
  A positive association between BAL CD8+ lymphocytes and neutrophils and endobronchial reticular basement thickness was found. Detectable production of pro-inflammatory cytokines associated positively with frequent wheeze.
authors.affiliation: Department of Allergy, Helsinki University Central Hospital, PO Box 160, Helsinki, FI 00029 Finland.
authors.forename: Kristiina
authors.initials: K
authors.lastname: Malmström
authors.affiliation: Institute of Occupational Health, Helsinki, Finland.
authors.forename: Maili
authors.initials: M
authors.lastname: Lehto
authors.affiliation: Institute of Occupational Health, Helsinki, Finland.
authors.forename: Marja-Leena
authors.initials: ML
authors.lastname: Majuri
authors.affiliation: Department of Pathology, Fimlab Laboratories, Tampere University Central Hospital, and University of Tampere, Tampere, Finland.
authors.forename: Timo
authors.initials: T
authors.lastname: Paavonen
authors.affiliation: Department of Public Health, University of Helsinki, Helsinki, Finland.
authors.forename: Seppo
authors.initials: S
authors.lastname: Sarna
authors.affiliation: Department of Allergy, Helsinki University Central Hospital, PO Box 160, Helsinki, FI 00029 Finland.
authors.forename: Anna S
authors.initials: AS
authors.lastname: Pelkonen
authors.affiliation: Department of Allergy, Helsinki University Central Hospital, PO Box 160, Helsinki, FI 00029 Finland.
authors.forename: L Pekka
authors.initials: LP
authors.lastname: Malmberg
authors.affiliation: Hospital for Children and Adolescents, Helsinki University Central Hospital, Helsinki, Finland.
authors.forename: Harry
authors.initials: H
authors.lastname: Lindahl
authors.affiliation: Hospital for Children and Adolescents, Helsinki University Central Hospital, Helsinki, Finland.
authors.forename: Merja
authors.initials: M
authors.lastname: Kajosaari
authors.affiliation: Department of Respiratory Pediatrics, Imperial College London, London, UK.
authors.forename: Sejal
authors.initials: S
authors.lastname: Saglani
authors.affiliation: Institute of Occupational Health, Helsinki, Finland.
authors.forename: Harri
authors.initials: H
authors.lastname: Alenius
authors.affiliation: Department of Allergy, Helsinki University Central Hospital, PO Box 160, Helsinki, FI 00029 Finland.
authors.forename: Mika J
authors.initials: MJ
authors.lastname: Mäkelä
keywords: Bronchoalveolar lavage; Infant; Pro-inflammatory cytokines; Pulmonary function; Wheeze