Chest
Volume 85, Issue 4, April 1984, Pages 514-518
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T-Lymphocytosis in Bronchoalveolar Lavage Fluid of Hypersensitivity Pneumonitis: Changes in Profile of T-cell Subsets during the Course of Disease

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Materials and Methods

Eight untreated patients with hypersensitivity pneumonitis (four men and four women, mean age 47 years, range 42 to 53) were investigated. The diagnosis was based on history, clinical and radiologic features, and the functional pattern of interstitial lung disease. All patients had precipitins against the relevant antigens. Four were parakeet fanciers, two were pigeon breeders, one had farmer's lung, and one humidifer's lung. Four patients were studied less than two days after the last antigen

Results

Table 1 shows the general characteristics of BAL fluid. Total cell counts were significantly increased in all disease groups compared to control subjects. The proportion of BAL lymphocytes was elevated in both diseases (hypersensitivity pneumonitis: 68 ± 16 percent of total cells recovered, sarcoidosis 54 ± 22; difference not significant). Immunoglobulin levels in BAL fluid were highest in the group of patients with hypersensitivity pneumonitis and recent exposure (Table 2).

The results of the

Discussion

This study shows that, in contrast to pulmonary sarcoidosis, suppressor cells are the predominant cell type in the BAL of antigen-exposed patients with hypersensitivity pneumonitis. When exposure to antigens has been avoided for more than five days, the inversed OKT 4 / OKT 8 ratio (below 1.0) is raised by a relative increase of helper cells and a fall of suppressor cells. This was demonstrated by repeated BAL in three patients. It is supported by the observation that patients who were

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  • Cited by (107)

    • Imaging of Hypersensitivity Pneumonitis

      2016, Radiologic Clinics of North America
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      The HP study showed that the presence of serum precipitins has utility as a predictor of HP, with an odds ratio of 5.3, but numerous studies have demonstrated positive precipitins in asymptomatic patients who have had incidental or ongoing exposure to common HP-inciting antigens. For instance, 54% of asymptomatic dairy farmers assessed in 1 study tested positive for precipitins to Micropolyspora faeni antigens.15,31,60–62 Testing for precipitins is widely regarded as only a confirmatory test.

    • CCL18 in serum, BAL fluid and alveolar macrophage culture supernatant in interstitial lung diseases

      2013, Respiratory Medicine
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      Both HP and pulmonary sarcoidosis present as Th1-predominant lung disorders [20,21] characterized by local accumulation of activated T-lymphocytes [20,22], albeit T-cell subpopulations are different. In BALF, the predominant T-cell subset in HP is CD8+ while that in sarcoidosis is CD4+ [23]. This study aimed to compare CCL18 levels in serum, BALF and alveolar macrophage (AM) culture supernatant between various ILDs characterized by fibrosis or inflammation.

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    Manuscript received August l2; revision accepted October 12.

    Presented in part at the meeting of the SEPCR working group “Lung Cell: Structure and Function,” Cefalù, Palermo, Italy, October 5, 1982.

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