Abstract
BACKGROUND. BAL cytoimmunological pattern, e.g. value of CD4/CD8 ratio, depends on individual patient age. We present our experience in ILD patients and healthy controls.
METHODS: BAL was performed in ILD, incl. sarcoidosis (PS), hypersensitivity pneumonitis (HP), asbestosis, silicosis, systemic sclerosis, idiopathic pulmonary fibrosis (IPF), nonspecific interstitial pneumonitis and in controls; n=198, 21, 23, 88, 12, 33,19, and 62, resp. We examined BAL routine cytology, BAL lymphocyte typing and apoptosis. Data were analyzed separately for nonsmokers (NS) and smokers.
RESULTS: The age of NS healthy individuals was negatively correlated with total BAL cell number, AL number and BAL eosinophilia. Positive correlation with CD4/CD8 ratio (+0.42, p<0.01), AL activation assessed as percentage of CD3+ HLA-DR+ cells and CD3+Fas Ligand+ cells was found. In PS we showed negative correlation with CD4/CD8 ratio (Rs= -0.26, p<0.005) and CD3+Fas Ligand+ expression. In NS HP, age was positively correlated with BAL neutrophil and eosinophil (Rs= +0.73, p<0.005) rate, in NS IPF with BAL neutrophilia and CD3+HLA-DR+ AL percentage. The relations in smokers should be assessed carefully, since some parameters depend on BAL fluid recovery, which in all study groups is negatively age-correlated. However, some recovery-independent changes were found, as higher BAL lymphocytosis in older PS patients (Rs= +0.32, p<0.01). No relation between age and AL apoptosis was showed.
CONCLUSIONS: In ILD diagnostics, BAL cytoimmunological pattern should be considered in the context of patient age. Age-related changes seem to be more expressed in controls than in ILD.
- © 2014 ERS