PT - JOURNAL ARTICLE AU - F Ratjen AU - E Rietschel AU - M Griese AU - M Ballmann AU - I Kleinau AU - G Doring AU - D Reinhardt AU - K Paul TI - Fractional analysis of bronchoalveolar lavage fluid cytology in cystic fibrosis patients with normal lung function. Bronchoalveolar lavage for the evaluation of anti-inflammatory treatment (BEAT) study group AID - 10.1183/09031936.00.15114100 DP - 2000 Jan 01 TA - European Respiratory Journal PG - 141--145 VI - 15 IP - 1 4099 - http://erj.ersjournals.com/content/15/1/141.short 4100 - http://erj.ersjournals.com/content/15/1/141.full SO - Eur Respir J2000 Jan 01; 15 AB - Cystic fibrosis (CF) is associated with a neutrophil dominated airway inflammation. So far bronchoalveolar lavage (BAL) studies in CF have used pooled BAL samples which may be more representative of the alveolar compartment rather than the airways. To assess whether the first sample of a BAL is more sensitive in the evaluation of airway inflammation, the authors have studied 105 stable CF patients aged 5-37 yrs with a mean forced expiratory volume in one second (FEV1) of 96+/-15% (mean+/-SD). BAL cytology of the first and pooled samples were compared to reference values obtained in children without respiratory disease. Absolute cell counts and the percentage of neutrophils were significantly increased in CF patients. If the 95% confidence interval was used as a cut-off point, 17/105 CF patients had a normal percentage of neutrophils in pooled BAL samples, but only three also had a normal percentage of neutrophils in the first BAL aliquot. Therefore, neutrophil dominated airway inflammation is more pronounced in the first, mainly bronchial, bronchoalveolar lavage sample suggesting that sequential analysis of bronchoalveolar lavage fluid may have a higher sensitivity to detect early inflammatory changes in CF patients.