Inflammatory Cells in Lung Disease Associated with Rheumatoid Arthritis
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概要
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Objective Rheumatoid arthritis (RA) is associated with numerous pulmonary manifestations. However, the inflammatory mechanism remains undetermined. We studied the features of inflammatory cells in bronchoalveolar lavage (BAL) fluid and biopsy lung tissue from patients with RA-associated lung disease. Methods BAL findings were statistically compared between diseases. We divided RA patients into two groups, airway lesion group (AW) and interstitial lesion group (INT) according to predominant HRCT findings and compared the BAL findings. We immunohistochemically stained lung tissue for CD4, CD8, CD20, and CD163 and counted the immunopositive cells in five different regions. Patients Twenty patients fulfilling the Japanese criteria for RA, 13 patients with systemic sclerosis (SSc), and 21 patients with polymyositis and dermatomyositis (PM-DM) with pulmonary disease detected by high-resolution CT (HRCT) were enrolled in this study. Results As for BAL in RA, we found a lower lymphocyte frequency with higher CD4/8 ratio compared with PM-DM and a higher neutrophil percentage than both PM-DM and SSc. Nine and eleven patients with RA were classified into AW and INT groups, respectively. BAL findings did not differ between the two groups. Immunohistochemically, most CD4+ and CD20+ lymphocytes were accumulated in lymphoid follicles and in the alveolar wall and T-lymphocytes; in particular CD8+ lymphocytes were predominant in lung interstitium. Conclusion These results suggest that 1) neutrophils may play an important role, 2) the inflammatory mechanism may be similar between airway lesion and interstitial pneumonia, and 3) CD8+ lymphocytes may be major inflammatory cells in lung interstitium in RA-associated interstitial lung disease.
- 社団法人 日本内科学会の論文
著者
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Terada Masaki
Division Of Respiratory Medicine Graduate School Of Medical And Dental Sciences Niigata University
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Takada Toshinori
Division Of Respiratory Medicine Department Of Homeostatic Regulation And Development Course In Biol
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Narita Jun-ichi
Division Of Respiratory Medicine Graduate School Of Medical And Dental Sciences Niigata University
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Gejyo Fumitake
Division Of Clinical Infection Control And Prevention Niigata University Graduate School Of Medical
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Moriyama Hiroshi
Division Of Cardiology South-1 Hospital
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Shimizu Takashi
Division Of Biolobical Sciences Graduate School Of Science Hokkaido University
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Suzuki Eiichi
Department Of Applied Chemistry Tokyo Institute Of Technology
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Takada Toshinori
Division of Respiratory Medicine, Graduate School of Medical and Dental Sciences, Niigata University
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Terada Masaki
Division of Respiratory Medicine, Graduate School of Medical and Dental Sciences, Niigata University
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Nagasawa Yoshiya
Division of Respiratory Medicine, Graduate School of Medical and Dental Sciences, Niigata University
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