Bronchoalveolar lavage cellularity in healthy children.

Riedler, Josef; Grigg, Jonathan; Stone, C. A.; Tauro, G. P.; Robertson, C. F.

doi:10.1164/ajrccm.152.1.7599817

Cited by 112 publications

(118 citation statements)

References 26 publications

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“…Comparing our data from this study with our previously published results from normal non-atopic children [9]; mast cells and eosinophils were elevated in the atopic asthmatic but not the viral associated wheeze group. Both the volume return and total cell counts are in agreement with fibreoptic bronchoscopic investigations on adult asthmatics [17][18][19] and on normal and asthmatic children [6,9,[20][21][22]. Elevated eosinophil numbers are found in bronchoalveolar lavage fluid from adult atopic asthmatics compared with normals [17][18][19][23][24][25]; a finding which is also reported for children with atopic asthma [26][27].…”

Section: Discussionsupporting

confidence: 83%

Bronchoalveolar lavage findings suggest two different forms of childhood asthma

Stevenson¹,

Turner

Heaney³

et al. 1997

Clin Experimental Allergy

255

196

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SummaryBackground It seems plausible that children with atopy and persistent asthma symptoms will, like their adult counterparts, have chronic airways inflammation. However, many young children with no other atopic features have episodic wheezing that is triggered solely by viral respiratory infections. Little is known as to whether airways inflammation occurs in these two asthma patterns during relatively asymptomatic periods. Methods Using a non-bronchoscopic bronchoalveolar lavage (BAL) procedure on children presenting for an elective surgical procedure, this study has investigated the cellular constituents of BAL fluid in children with a history of atopic asthma (AA) non-asthmatic atopic children (NAA) or viral associated wheeze (VAW). Results A total of 95 children was studied: 52 with atopic asthma (8.0 years, range 1.1-15.3, 36 male), 23 with non-asthmatic atopy (median age 8.3 years, range 1.7-13.6, 11 male) and 20 with VAW (3.1 years, range 1.0-8.2, 13 male). No complications were observed during the lavage procedure and no adverse events were noted post-operatively. Total lavage fluid recovered was similar in all groups and the total cell numbers were higher in the VAW group. Eosinophil (P< 0.005) and mast cell (/'<0.05) numbers were significantly elevated in the group with atopic asthma. Conclusions During relatively asymptomatic periods there is on-going airways inflammation, as demonstrated by eosinophil and mast cell recruitment, in children with asthma and atopy but not in children with viral associated wheeze or atopy alone. This strongly suggests that there are different underlying pathophysiologicai mechanisms in these two groups of children who wheeze.

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Section: Discussionsupporting

confidence: 83%

Bronchoalveolar lavage findings suggest two different forms of childhood asthma

Stevenson¹,

Turner

Heaney³

et al. 1997

Clin Experimental Allergy

255

196

View full text Add to dashboard Cite

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“…The other possibility is to inject cells into a flow cytometre. The results of both technique yield similar results [19,33,37,38,39]. If cytospins are used, a minimum of 300±500 cells should be counted [35].…”

Section: Cellular Componentsmentioning

confidence: 77%

“…To improve comparison between centres the total volume instilled, the number of specimens, their volume and the percentage of recovery should be reported. Total cell counts are variable even in healthy children but should be included [19,33,34]. The percentage of individual cell population is the preferable method for data analysis.…”

Section: Reporting Resultsmentioning

confidence: 99%

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Bronchoalveolar lavage in children

Blic¹,

Midulla²,

Barbato³

et al. 2000

eur respir j

350

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Bronchoalveolar lavage (BAL) is routinely performed in adults for sampling cellular and biochemical components. Many studies have been performed that have enabled the proposal of recommendations for BAL, methodology and processing, as well as reference values in different clinical settings. In contrast, despite a world-wide increase in the use of BAL in children, including neonates, there are, at the present time, no clear recommendations on the methodology, the clinical applications and the research areas for BAL. A Task Force on BAL in children has been approved by the European Respiratory Society (ERS) Task Force committee 1996. The objectives of this task force were: 1) to provide recommendations and guidelines on how to perform BAL and how to process the return fluid in children; 2) to collect and discuss available reference values; 3) to list indications and results in both immunocompetent and immunocompromised children; 4) to define areas for future research.This task force included paediatric respiratory physicians involved in bronchoscopy and BAL and was run as a collaboration between the Paediatric Bronchology Group and the BAL scientific group of the ERS.

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“…Immediately after intubation, children underwent bronchoalveolar lavage (BAL) as described previously [20,21]. Briefly, the child's head was turned to the left and a suction catheter (6 French Gauge (FG) <1 year, 8 FG 1-5 years and 10 FG >5 years) was wedged in the lower airway.…”

Section: Bronchoalveolar Lavagementioning

confidence: 99%

Suppression of autologous peripheral blood mononuclear cell proliferation by alveolar macrophages from young infants

Bunn¹,

Hewitt

Grigg³

2002

Clinical and Experimental Immunology

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The lung is constantly exposed to respirable antigens and allergens. In the mature lung, alveolar macrophages (AM) prevent inappropriate immune activation by removing inhaled antigen via phagocytosis, and by directly suppressing pulmonary T cell proliferation [1]. Thus depletion of rat AM in vivo using cytotoxic liposomes removes the suppressive milieu, and results in an increase in the number of airway and parenchymal T lymphocytes, and an increased response to polyclonal and antigenic stimuli [2,3]. This innate lymphocytostatic activity of resident AM can be reproduced in vitro [4,5]. In both the rat and human, the pattern of suppression seen with AM in vitro is broadly similar. First, high AM : T cell ratios are suppressive, whereas low AM : T cell ratios are stimulatory [4]. Second, the concentration and nature of the stimulatory molecule determines the relative degree of suppression produced by AM; antigenic stimulation of T cell proliferation is more susceptible to AM suppression than mitogenic stimulation [6,7], and suppression is reduced when suboptimal doses of mitogen are used [8]. Third, AM are maximally suppressive if added at the onset of T cell proliferation, but are less so when added once T cell proliferation is established [8]. Fourth, suppression of T cell proliferation occurs partly by cell-to-cell contact and partly by soluble factors [6,9].There are, however, differences between animal models and humans. In rats and mice, the most important soluble factor mediating suppression by AM is nitric oxide (NO), which is released by interstitial macrophages [10] and AM, in response to cytokines released by T cells following cell-to-cell contact [9,11]. NO inhibits tyrosine phosphorylation of the kinases involved in production of the interleukin-2 (IL-2) receptor, the expression of which is essential for T cell proliferation [12]. Human AM also inhibit tyrosine phosphorylation of proteins involved in IL-2 receptor-associated signal transduction [6], but nitrogen intermediates are not involved [7]. In humans, cell-to-cell (AM/T cell) contact mechanisms may therefore play a more significant role. Indeed, the AM concentration required to induce suppression of T cell proliferation is orders of magnitude greater in humans [7], and the inhibitory effect of human AM can be reproduced partially using paraformaldehylde-fixed AM or a phospholipid component of the AM cell membrane [13]. SUMMARYMaintenance of lung homeostasis involves a complex interaction between T lymphocytes and alveolar macrophages (AM), in which AM suppress pulmonary T cell proliferation to antigenic stimuli. To assess whether AM-mediated suppression is attenuated in healthy young infants, AM and peripheral blood mononuclear cells (PBMC) were sampled prior to elective surgery. Children were divided into <4 months of age (Group I) and >4 months (Group II). Autologous PBMC and AM were co-cultured in vitro with phytohaemaglutinin (PHA) at AM : PBMC ratios ranging from 2 : 1 to 1 : 5. Methyl-tritiated thymidine was added after 48 h and uptake ...

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Bronchoalveolar lavage cellularity in healthy children.

Cited by 112 publications

References 26 publications

Bronchoalveolar lavage findings suggest two different forms of childhood asthma

Bronchoalveolar lavage findings suggest two different forms of childhood asthma

Bronchoalveolar lavage in children

Suppression of autologous peripheral blood mononuclear cell proliferation by alveolar macrophages from young infants

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