PT - JOURNAL ARTICLE AU - C. Quesnel AU - L. Nardelli AU - P. Piednoir AU - V. Leçon AU - J. Marchal-Somme AU - S. Lasocki AU - L. Bouadma AU - I. Philip AU - P. Soler AU - B. Crestani AU - M. Dehoux TI - Alveolar fibroblasts in acute lung injury: biological behaviour and clinical relevance AID - 10.1183/09031936.00074709 DP - 2010 Jun 01 TA - European Respiratory Journal PG - 1312--1321 VI - 35 IP - 6 4099 - http://erj.ersjournals.com/content/35/6/1312.short 4100 - http://erj.ersjournals.com/content/35/6/1312.full SO - Eur Respir J2010 Jun 01; 35 AB - Although fibroblasts are key cells in the lung repair/fibrosis process, their characteristics are poorly studied in acute lung injury (ALI) and acute respiratory distress syndrome (ARDS). The aims of our study were to: 1) determine the biological behaviour of alveolar fibroblasts during ALI; and 2) to evaluate the clinical relevance of positive alveolar fibroblast culture from patients with ALI/ARDS. Cells were cultured from bronchoalveolar lavage (BAL) obtained from 68 critically ill, ventilated patients: ALI n = 17; ARDS n = 31; and ventilated controls n = 20. Patients were followed for 28 days and clinical data was recorded. We studied proliferation, migration and collagen-1 synthesis capacities of fibroblasts. Cells expressing fibroblast markers were cultured from BAL obtained in six (35%) ALI patients and six (19%) ARDS patients, but never from ventilated controls. Alveolar fibroblasts exhibited a persistent activated phenotype with enhanced migratory and collagen-1 production capacities, with hyporesponsiveness to prostaglandin E2 compared to normal lung fibroblasts (p≤0.04). Positive fibroblast culture was associated with both an increased collagen-1 concentration and monocyte/macrophage percentage in BAL fluid (p≤0.01), and with a reduced duration of mechanical ventilation (p<0.001). We conclude that activated alveolar fibroblasts can be cultured either in ALI or ARDS and that their presence might reflect the initiation of the organising phase of ALI.