PT  - JOURNAL ARTICLE
AU  - G. de Laurentiis
AU  - L. Vitiello
AU  - L. Racioppi
AU  - F. Perna
AU  - M. Galgani
AU  - G. Merola
AU  - P. Carratù
AU  - M. Maniscalco
AU  - S. Marsico
AU  - M. Sofia
TI  - CD8+ T-cell alveolitis in familial pulmonary alveolar microlithiasis
AID  - 10.1183/09031936.00145406
DP  - 2007 Jul 01
TA  - European Respiratory Journal
PG  - 165--171
VI  - 30
IP  - 1
4099  - http://erj.ersjournals.com/content/30/1/165.short
4100  - http://erj.ersjournals.com/content/30/1/165.full
SO  - Eur Respir J2007 Jul 01; 30
AB  - Pulmonary alveolar microlithiasis (PAM) is a rare diffuse lung disease characterised by the accumulation of calcium phosphate microliths within the alveoli. The causative mechanism of PAM has only recently been discovered, and involves a gene mutation of sodium phosphate co-transporter, which is expressed by alveolar epithelial cells. This mutation may have variable consequences on the clinical phenotype. However, pulmonary cell immune phenotyping in familial PAM has not previously been assessed. In the present article, the analysis of bronchoalveolar lavage fluid of two siblings with PAM diagnosis revealed a pattern of lymphocytic alveolitis with accumulation of CD8+ T-cells. The clonal complexity of this lymphocyte’s population was assayed by spectratyping, which showed an oligoclonal accumulation of T-cells with a restricted variable beta T-cell receptor (TCR) gene usage. TCR analysis in peripheral blood lymphocytes revealed no abnormal patterns of T-lymphocytes. In the pulmonary alveolar microlithiasis familial cases reported, CD8-mediated maladaptive immune response may have taken place in the bronchoalveolar compartment. The relationship between this immune dysregulation and genetic background in pulmonary alveolar microlithiasis warrants further investigation.