サルコイドーシス,特発性問質性肺炎におけるBALF細胞の特徴
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概要
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Bronchoalveolar lavage (BAL) was performed in 41 patients with pulmonary sar-coidosis (SAR), 19 patients with idiopathic interstitial pneumonia (IIP), and 24 healthy volunteers (HV) in order to make comparisons based on smoking degree. These three groups were classified as non smokers (NS), light smokers (LS), and heavy smokers (HS). In HV, NS were 13 cases, LS were 6 cases, and HS were 5 cases. In SAR, there were 24 cases, 12 cases and 5 cases of NS, LS and HS respectively. In IIP, there were 5 NS cases, 14 HS cases, but no LS cases. There were significant differences in total cell number (TCN), differential cell findings and T cell subsets between NS and HS in both SAR and HV. However there were no significant differences between NS and LS in either SAR or HV. There were significant differences in recovery rate (RR) and TCN between NS and HS in IIP, however there were no significant differences in cell differentiation nor T cell subsets between NS and HS. The BALF cells'characteristics of each disease group were investigated in terms of each smoking degree as compared with HV. For those characteristics which increased, the rates of those patients deviating more than the mean+2 S. D. of HV's BALF findings were defined as having a positive ratio. For those characteristics which decreased, the rates deviating less than the mean-2 S. D. of HV's BALF findings were considered a positive ratio. The positive ratios decreased in terms of smoking degree in SAR, however high positive ratios increased in HS of IIP. BALF cells findings were investigated in relation to the degree of disease activity. The value of S-ACE and patients' symptoms were characteristic of disease activity in SAR. HLA-DR positive lymphocytes were more related to the disease activity than TCN, Ly or CD4/CD8 ratio. In the comparison between HLA-DR positive lymphocyte numbers and T cell subset numbers, HLA-DR positive lymphocytes in SAR were dominant for CD4 antigen, however that was not the result in IIP. 2', 5' Oligoadenylate synthetase was measured in BALF cells of HV, IIP and SAR. The activity of this enzyme was elevated in the 3 groups, particularly in SAR. This means that interferon exists in the bronchoalveolar area.
- 札幌医科大学の論文
- 1991-02-01
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