Effect of bronchial lavage volume on cellular and protein recovery.

To investigate the optimal lavage technique to study the airway response in patients with asthma, differential volume lavage was carried out in 22 normal subjects and 18 patients with red cedar asthma. Ten ml of fluid was instilled into a main-stem bronchus followed by 5, 10, 20, 50 and 100 ml into different segmental bronchi. Small volume lavage (less than 20 ml) in a main stem bronchus or a segmental bronchus recovered more epithelial cells and neutrophils while a lavage volume of 20-100 ml in a segmental bronchus recovered more lymphocytes, alveolar macrophages, albumin, IgG and alpha 1-antitrypsin. In patients with asthma, a higher proportion of epithelial cells was observed in the 20 ml segmental bronchus lavage 24 to 48 hours after bronchial challenge with plicatic acid, the chemical compound responsible for red cedar asthma. There was an increase in eosinophils and IgG with all volume lavages, but the changes were most marked in the 10 ml main bronchus lavage and the 10 and 20 ml segmental bronchus lavage. The results show the importance of using a systematic lavage protocol to characterize the cellular and protein changes in the airways of patients with asthma. A single volume lavage in one site may not encompass all the changes observed.

[1]  R. Matthay,et al.  Bronchoalveolar lavage. Its safety in subjects with mild asthma. , 1984, Chest.

[2]  T. Takishima,et al.  Mast cells in bronchoalveolar lumen of patients with bronchial asthma. , 1984, The American review of respiratory disease.

[3]  S. Zupo,et al.  Total and Specific IgE in Serum, Bronchial Lavage and Bronchoalveolar Lavage of Asthmatic Patients , 1983, Allergy.

[4]  R. Stockley,et al.  Lung secretion sol-phase proteins: comparison of sputum with secretions obtained by direct sampling. , 1983, Thorax.

[5]  M. Costanza,et al.  Analyses of sequential bronchoalveolar lavage samples from healthy human volunteers. , 2015, The American review of respiratory disease.

[6]  R. Matthay,et al.  Kinetic analysis of respiratory tract proteins recovered during a sequential lavage protocol. , 1982, The American review of respiratory disease.

[7]  M. Chan-yeung,et al.  Clinical features and natural history of occupational asthma due to western red cedar (Thuja plicata). , 1982, The American journal of medicine.

[8]  R. Crystal,et al.  Fibronectin in human bronchopulmonary lavage fluid. Elevation in patients with interstitial lung disease. , 1982, The Journal of clinical investigation.

[9]  H. Reynolds,et al.  Reaginic antibody in the lung lining fluid. Analysis of nomal human bronchoalveolar lavage fluid IgE and comparison to immunoglobulins G and A. , 1980, The Journal of laboratory and clinical medicine.

[10]  V. Ferrans,et al.  Inflammatory and immune processes in the human lung in health and disease: evaluation by bronchoalveolar lavage. , 1979, The American journal of pathology.

[11]  M. Mandel,et al.  Immunoglobulin content in the bronchial washings of patients with benign and malignant pulmonary disease. , 1976, The New England journal of medicine.

[12]  H. Reynolds,et al.  Analysis of proteins and respiratory cells obtained from human lungs by bronchial lavage. , 1974, The Journal of laboratory and clinical medicine.

[13]  S. Johansson,et al.  Immunoglobulins in tracheo-bronchial secretion with special reference to IgE. , 1974, Clinical and experimental immunology.

[14]  A. Okinaka,et al.  Immunoglobulins in the bronchial washings of patients with chronic obstructive pulmonary disease. , 1972, The American review of respiratory disease.

[15]  K. Ri.  IMMUNOGLOBULINS IN NORMAL HUMAN TRACHEOBRONCHIAL WASHINGS: A QUALITATIVE AND QUANTITATIVE STUDY. , 1964 .

[16]  G. Barbero,et al.  Composition of tracheobronchial secretions in cystic fibrosis of the pancreas and bronchiectasis. , 1959, Pediatrics.