Skip to main content
Thorax logoLink to Thorax
. 1993 Aug;48(8):835–839. doi: 10.1136/thx.48.8.835

Relationship between plasma cell levels and profile of bronchoalveolar lavage fluid in patients with subacute extrinsic allergic alveolitis.

M Drent 1, S Wagenaar 1, H van Velzen-Blad 1, P G Mulder 1, H C Hoogsteden 1, J M van den Bosch 1
PMCID: PMC464717  PMID: 8105558

Abstract

BACKGROUND--Plasma cells are usually absent in bronchoalveolar lavage (BAL) fluid. Extrinsic allergic alveolitis is associated with increased numbers of T and B lymphocytes in BAL fluid, as well as the presence of a few plasma cells. The aim of this study was to investigate whether there is a relationship between the presence of plasma cells and other cells, and immunoglobulin levels in BAL fluid of patients with extrinsic allergic alveolitis. METHODS--Thirty non-smoking patients with extrinsic allergic alveolitis who had a bronchoalveolar lavage 2-7 days after their last exposure to the causative antigen were selected, retrospectively. RESULTS--Patients suffering from extrinsic allergic alveolitis with plasma cells in the BAL fluid (n = 18) had increased absolute numbers of lymphocytes, eosinophils and mast cells, a decreased percentage of alveolar macrophages and lower CD4/CD8 ratio, as well as higher immunoglobulin levels, when compared with patients with extrinsic allergic alveolitis having no plasma cells in the BAL fluid (n = 12). CONCLUSIONS--The results suggest a relationship between the presence of plasma cells and the other constituents in BAL fluid and a more intense alveolitis. In addition there was a positive relationship between the number of plasma cells in BAL fluid and immunoglobulin levels. These data support the concept of local production of immunoglobulins by plasma cells in the lung following antigen exposure in susceptible individuals.

Full text

PDF
835

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Barrios R., Fortoul T. I., Lupi-Herrera E. Pigeon breeder's disease: immunofluorescence and ultrastructural observations. Lung. 1986;164(1):55–64. doi: 10.1007/BF02713629. [DOI] [PubMed] [Google Scholar]
  2. Bice D. E., Gray R. H., Evans M. J., Muggenburg B. A. Identification of plasma cells in lung alveoli and interstitial tissues after localized lung immunization. J Leukoc Biol. 1987 Jan;41(1):1–7. doi: 10.1002/jlb.41.1.1. [DOI] [PubMed] [Google Scholar]
  3. Calvanico N. J., Ambegaonkar S. P., Schlueter D. P., Fink J. N. Immunoglobulin levels in bronchoalveolar lavage fluid from pigeon breeders. J Lab Clin Med. 1980 Jul;96(1):129–140. [PubMed] [Google Scholar]
  4. Cantin A., Bégin R., Boileau R., Drapeau G., Rola-Pleszczynski M. Features of bronchoalveolar lavage differentiating hypersensitivity pneumonitis and pulmonary sarcoidosis at time of initial presentation. Clin Invest Med. 1984;7(2):89–94. [PubMed] [Google Scholar]
  5. Clinical guidelines and indications for bronchoalveolar lavage (BAL): Report of the European Society of Pneumology Task Group on BAL. Eur Respir J. 1990 Sep;3(8):937–976. [PubMed] [Google Scholar]
  6. Cormier Y., Bélanger J., Laviolette M. Persistent bronchoalveolar lymphocytosis in asymptomatic farmers. Am Rev Respir Dis. 1986 May;133(5):843–847. [PubMed] [Google Scholar]
  7. Costabel U. The alveolitis of hypersensitivity pneumonitis. Eur Respir J. 1988 Jan;1(1):5–9. [PubMed] [Google Scholar]
  8. Daniele R. P., Elias J. A., Epstein P. E., Rossman M. D. Bronchoalveolar lavage: role in the pathogenesis, diagnosis, and management of interstitial lung disease. Ann Intern Med. 1985 Jan;102(1):93–108. doi: 10.7326/0003-4819-102-1-93. [DOI] [PubMed] [Google Scholar]
  9. Emura M., Nagai S., Takeuchi M., Kitaichi M., Izumi T. In vitro production of B cell growth factor and B cell differentiation factor by peripheral blood mononuclear cells and bronchoalveolar lavage T lymphocytes from patients with idiopathic pulmonary fibrosis. Clin Exp Immunol. 1990 Oct;82(1):133–139. doi: 10.1111/j.1365-2249.1990.tb05416.x. [DOI] [PMC free article] [PubMed] [Google Scholar]
  10. Fournier E., Tonnel A. B., Gosset P., Wallaert B., Ameisen J. C., Voisin C. Early neutrophil alveolitis after antigen inhalation in hypersensitivity pneumonitis. Chest. 1985 Oct;88(4):563–566. doi: 10.1378/chest.88.4.563. [DOI] [PubMed] [Google Scholar]
  11. Hance A. J., Saltini C., Crystal R. G. Does de novo immunoglobulin synthesis occur on the epithelial surface of the human lower respiratory tract? Am Rev Respir Dis. 1988 Jan;137(1):17–24. doi: 10.1164/ajrccm/137.1.17. [DOI] [PubMed] [Google Scholar]
  12. Haslam P. L. Bronchoalveolar lavage in extrinsic allergic alveolitis. Eur J Respir Dis Suppl. 1987;154:120–135. [PubMed] [Google Scholar]
  13. Johnson M. A., Nemeth A., Condez A., Clarke S. W., Poulter L. W. Cell-mediated immunity in pigeon breeders' lung: the effect of removal from antigen exposure. Eur Respir J. 1989 May;2(5):445–450. [PubMed] [Google Scholar]
  14. Keller R. H., Swartz S., Schlueter D. P., Bar-Sela S., Fink J. N. Immunoregulation in hypersensitivity pneumonitis: phenotypic and functional studies of bronchoalveolar lavage lymphocytes. Am Rev Respir Dis. 1984 Nov;130(5):766–771. doi: 10.1164/arrd.1984.130.5.766. [DOI] [PubMed] [Google Scholar]
  15. Kelley J. Cytokines of the lung. Am Rev Respir Dis. 1990 Mar;141(3):765–788. doi: 10.1164/ajrccm/141.3.765. [DOI] [PubMed] [Google Scholar]
  16. Kuwano K., Matsuba K., Ikeda T., Murakami J., Araki A., Nishitani H., Ishida T., Yasumoto K., Shigematsu N. The diagnosis of mild emphysema. Correlation of computed tomography and pathology scores. Am Rev Respir Dis. 1990 Jan;141(1):169–178. doi: 10.1164/ajrccm/141.1.169. [DOI] [PubMed] [Google Scholar]
  17. Laviolette M., Cormier Y., Loiseau A., Soler P., Leblanc P., Hance A. J. Bronchoalveolar mast cells in normal farmers and subjects with farmer's lung. Diagnostic, prognostic, and physiologic significance. Am Rev Respir Dis. 1991 Oct;144(4):855–860. doi: 10.1164/ajrccm/144.4.855. [DOI] [PubMed] [Google Scholar]
  18. Nakajima H., Iwamoto I., Tomoe S., Matsumura R., Tomioka H., Takatsu K., Yoshida S. CD4+ T-lymphocytes and interleukin-5 mediate antigen-induced eosinophil infiltration into the mouse trachea. Am Rev Respir Dis. 1992 Aug;146(2):374–377. doi: 10.1164/ajrccm/146.2.374. [DOI] [PubMed] [Google Scholar]
  19. Ojanen T., Terho E. O., Tukiainen H., Mäntyjärvi R. A. Class-specific antibodies during follow up of patients with farmer's lung. Eur Respir J. 1990 Mar;3(3):257–260. [PubMed] [Google Scholar]
  20. Pesci A., Bertorelli G., Dall'Aglio P. P., Neri G. P., Olivieri D. Evidence in bronchoalveolar lavage for third type immune reactions in hypersensitivity pneumonitis. Eur Respir J. 1990 Mar;3(3):359–361. [PubMed] [Google Scholar]
  21. Reynolds H. Y. Lung immunology and its contribution to the immunopathogenesis of certain respiratory diseases. J Allergy Clin Immunol. 1986 Nov;78(5 Pt 1):833–847. doi: 10.1016/0091-6749(86)90227-7. [DOI] [PubMed] [Google Scholar]
  22. Rose C., King T. E., Jr Controversies in hypersensitivity pneumonitis. Am Rev Respir Dis. 1992 Jan;145(1):1–2. doi: 10.1164/ajrccm/145.1.1. [DOI] [PubMed] [Google Scholar]
  23. Rosen F. S., Cooper M. D., Wedgwood R. J. The primary immunodeficiencies (1). N Engl J Med. 1984 Jul 26;311(4):235–242. doi: 10.1056/NEJM198407263110406. [DOI] [PubMed] [Google Scholar]
  24. Trentin L., Marcer G., Chilosi M., Zambello R., Agostini C., Masciarelli M., Bizzotto R., Gemignani C., Cipriani A., Di Vittorio G. Longitudinal study of alveolitis in hypersensitivity pneumonitis patients: an immunologic evaluation. J Allergy Clin Immunol. 1988 Oct;82(4):577–585. doi: 10.1016/0091-6749(88)90967-0. [DOI] [PubMed] [Google Scholar]
  25. Yamaguchi E., Saito S., Okazaki N., Abe S., Kawakami Y. Plasma cells in the bronchoalveolar lavage fluid of a patient with eosinophilic pneumonia. Morphologic proof of local production of antibodies. Chest. 1988 Jan;93(1):110–113. doi: 10.1378/chest.93.1.110. [DOI] [PubMed] [Google Scholar]
  26. van den Bosch J. M., Heye C., Wagenaar S. S., van Velzen-Blad H. C. Bronchoalveolar lavage in extrinsic allergic alveolitis. Respiration. 1986;49(1):45–51. doi: 10.1159/000194858. [DOI] [PubMed] [Google Scholar]
  27. van den Bosch J. M., Heye C., Wagenaar S. S., van Velzen-Blad H. C. Bronchoalveolar lavage in extrinsic allergic alveolitis. Respiration. 1986;49(1):45–51. doi: 10.1159/000194858. [DOI] [PubMed] [Google Scholar]

Articles from Thorax are provided here courtesy of BMJ Publishing Group

RESOURCES