Interstitial Score and Concentrations of IL-4Rα, PAR-2, and MMP-7 in Bronchoalveolar Lavage Fluid Could Be Useful Markers for Distinguishing Idiopathic Interstitial Pneumonias

Idiopathic interstitial pneumonia (IIP) entails a variable group of lung diseases of unknown etiology. Idiopathic pulmonary fibrosis, nonspecific interstitial pneumonia, interstitial lung diseases related to connective tissue disease (CTD-ILD), and hypersensitivity pneumonitis (HP) can manifest with similar clinical, radiological, and histopathological features. In a differential diagnosis, biomarkers can play a significant role. We assume that levels of specific cyto- or chemokines or their receptors can signal pathogenetic processes in the lungs. Eighty patients with different types of idiopathic interstitial pneumonia were enrolled in this study. Cell counts and concentrations of tumor necrosis factor (TNF)-α, interleukin-4 receptor α, proteinase-activated receptor (PAR)-2, matrix metalloproteinase (MMP)-7, and B cell-activating factor were measured in bronchoalveolar lavage fluid using commercial ELISA kits. High resolution computer tomography results were evaluated using alveolar and interstitial (IS) score scales. Levels of TNF-α were significantly higher in HP compared to fibrosing IIP (p < 0.0001) and CTD-ILD (p = 0.0381). Concentrations of IL-4Rα, PAR-2, and MMP-7 were positively correlated with IS (p = 0.0009; p = 0.0256; p = 0.0015, respectively). Since TNF-α plays a major role in inflammation, our results suggest that HP is predominantly an inflammatory disease. From the positive correlation with IS we believe that IL-4Rα, PAR-2, and MMP-7 could serve as fibroproliferative biomarkers in differential diagnosis of IIP.

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Detection and quantification of human herpesvirus 6 genomes using bronchoalveolar lavage fluid in immunocompromised patients with interstitial pneumonia

International Journal of Molecular Medicine ◽

10.3892/ijmm.8.4.379 ◽

2001 ◽

Author(s):

Akira Nagate ◽

Junko Ohyashiki ◽

Ikuma Kasuga ◽

Kazushige Minemura ◽

Kenji Abe ◽

...

Keyword(s):

Bronchoalveolar Lavage ◽

Interstitial Pneumonia ◽

Bronchoalveolar Lavage Fluid ◽

Human Herpesvirus ◽

Lavage Fluid ◽

Immunocompromised Patients ◽

Human Herpesvirus 6 ◽

Herpesvirus 6 ◽

Detection And Quantification

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Bronchoalveolar Lavage Fluid and Serum Canine Surfactant Protein A Concentrations in Dogs with Chronic Cough by Bronchial and Interstitial Lung Diseases

Journal of Veterinary Medical Science ◽

10.1292/jvms.13-0428 ◽

2014 ◽

Vol 76 (4) ◽

pp. 593-596 ◽

Cited By ~ 1

Author(s):

Yoshiki YAMAYA ◽

Kazuyuki SUZUKI ◽

Toshihiro WATARI ◽

Ryuji ASANO

Keyword(s):

Bronchoalveolar Lavage ◽

Chronic Cough ◽

Lung Diseases ◽

Bronchoalveolar Lavage Fluid ◽

Protein A ◽

Lavage Fluid ◽

Surfactant Protein ◽

Interstitial Lung Diseases ◽

Surfactant Protein A

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Concordance of Bronchoalveolar Lavage Cytology with Transbronchial Lung Biopsies in Non-neoplastic Pulmonary Diseases

JOURNAL FOR CLINICAL AND DIAGNOSTIC RESEARCH ◽

10.7860/jcdr/2021/48003.14971 ◽

2021 ◽

Author(s):

Nischita Jayaraj ◽

Kusuma Venkatesh

Keyword(s):

Bronchoalveolar Lavage ◽

Interstitial Pneumonia ◽

Lung Diseases ◽

Correct Diagnosis ◽

Usual Interstitial Pneumonia ◽

Granulomatous Inflammation ◽

Pulmonary Diseases ◽

Differential Count ◽

Flexible Bronchoscope ◽

Cell Counts

Introduction: In many pulmonary diseases, despite radiological & clinical investigations, laboratory tests and function studies, the diagnosis becomes difficult. Bronchoalveolar Lavage (BAL) is a minimally invasive method in which cells are collected from bronchial and alveolar spaces for cytology. This is facilitated by using a flexible bronchoscope with which a biopsy is taken following BAL. Bronchoscopy with BAL when used appropriately can offer correct diagnosis which in turn aids in proper management of the patient. Aim: To find the concordance of BAL findings with the histopathological features of Transbronchial Lung Biopsy (TBLB) in non-neoplastic lung diseases. Materials and Methods: It was a retrospective study conducted in Kempegowda Institute of Medical Sciences, Bengaluru, Karnataka. A total of 40 patients presenting with clinico-radiological findings, suggesting a non-neoplastic lung disease in the year 2019, undergoing bronchoscopy with BAL and concurrent TBLB were chosen. The BAL fluid was processed and differential count of cells was done to classify according to the American Thoracic Society Guidelines. Concordance was checked between the diagnoses made on TBLB and BAL analysis. Results: In the present study, a total of 40 cases were included of which 13 (32.5%) cases showed neutrophilic, 16 (40%) cases showed lymphocytic, 5 (12.5%) cases showed eosinophilic and 6 (15%) cases showed normal cellular distribution on BAL cytology. Diagnoses on studying TBLB included nine cases of Nonspecific Interstitial Pneumonia, seven cases of Usual Interstitial Pneumonia, six cases of Bronchiolitis Obliterans Organising Pneumonia, three cases of Bronchiolitis, two cases each of pulmonary tuberculosis and granulomatous inflammation. There was one case each of actinomycosis, sarcoidosis, lung abscess and mucor mycosis. Normal histology was noted in seven cases. The sensitivity of BAL fluid analysis was found to be 84.84% and the concordance was 80%. The Kappa value obtained was 0.71 indicating good agreement/concordance between BAL cytology and TBLB. Conclusion: The data from the current study suggest that differential cell counts in BAL provide diagnostic information of fundamental importance in frequently occurring non-neoplastic lung diseases in the community.

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