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Published online before print November 15, 2006
Eur Respir J 2006, doi:10.1183/09031936.00135205
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ORIGINAL ARTICLE

BAL fluid derived fibroblasts differ from biopsy derived fibroblasts in systemic sclerosis

A. Scheja 1*, K. Larsen 2, L. Todorova 2, E. Tufvesson 3, M. Wildt 1, A. Åkesson 1, L. Hansson 3, E. Stephen 4, G. Westergren-Thorsson 2

1 Dept of Rheumatology, Lund University Hospital, Lund, Sweden
2 Dept of Experimental Medical Science, Lund University, Lund, Sweden
3 Dept of Respiratory Medicine and Allergology, Lund University Hospital, Lund, Sweden
4 Dept of Radiology, London Chest Hospital, London, United Kingdom

* To whom correspondence should be addressed. E-mail: Agneta.Scheja{at}med.lu.se.


  Abstract

Growth of fibroblasts from bronchoalveolar lavage fluid (BALF) in patients with systemic sclerosis (SSc) has previously been described. The purpose of this study was to characterize fibroblasts from BALF and bronchial biopsies from SSc patients with alveolitis and from controls, to analyse fibroblast proliferation, migration, stress fibres and proteoglycan production.

BALF and bronchial biopsies were collected from 10 patients with SSc and alveolitis and from 15 controls.

Outgrowth of fibroblasts was observed from the BALF of 4 patients, particularly in patients with a markedly increased percentage of eosinophils in BALF, but in no member of the control group. Increased levels of granulocyte macrophage-colony stimulating factor (GM-CSF), correlating with the percentage of eosinophils in BALF, were found in the patients when compared to the controls. Fibroblasts from BALF showed an elongated, mobile phenotype and increased proteoglycan production compared to the corresponding biopsy fibroblasts.

In conclusion, we report outgrowth of fibroblasts with an altered phenotype from BALF in SSc patients with alveolitis and an increased percentage of eosinophils in the BALF. These findings indicate a possible role for eosinophil-fibroblast interaction in pulmonary fibrosis in SSc.

Keywords:  Eosinophils, fibroblasts, GM-CSF, pulmonary fibrosis, scleroderma, systemic sclerosis




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