Evaluation of Some Immunological Parameters in Interstitial Lung Disease by Discriminant Analysis

Abstract

In 37 subjects affected by interstitial lung diseases (19 patients with pulmonary sarcoidosis, 11 with hypersensitivity pneumonitis, 7 with idiopathic pulmonary fibrosis), we have compared by discriminant analysis (Statistical Package for the Social Sciences, version 8.3) 17 biological parameters derived from bronchoalveolar lavage analysis, gallium-67 scanning and lung biopsy. The aim of the study was to analyze the parameters of these three groups by forming one or more linear combinations of the discriminant variables. In particular, we tried to define the ability of such parameters to define these interstitial lung diseases and the relative importance of the data examined. The functions obtained are highly discriminant, so that the three groups are well distinguished among themselves; it means that the variables employed discriminate among the diseases studied. Among the variables considered, differential cell count, immune complex determination, gallium-67 lung scanning have the most important discriminant capacity. Discriminant analysis emphasizes that the three diseases are mediated by different immune mechanisms and underlines the role of each mechanism in determining the disease.

Effects of cigarette smoking on diagnostic tests for work‐related hypersensitivity pneumonitis: Data from an outbreak of lung disease in metalworkers

“…Gallium scans have long been utilized for diagnosis and monitoring of HP and other interstitial lung diseases [Bernstein et al, 1983;Niederman and Matthay, 1983;Bisson et al, 1987;Galietti et al, 1987;Rom et al, 1987;Vanderstappen et al, 1988;Nimkin and Oates, 1989;Kahn et al, 1994;Baughman and Fernandez, 1996], although their efficacy has been questioned by some investigators [Bertorelli et al, 1988;Leonard and Templeton, 1992]. At first glance, our results would appear to agree with the latter groups, and suggest that gallium is of little value for diagnosis of HP.…”

Quantitative pulmonary gallium scanning in interstitial lung disease

“…It has been shown that gallium is delivered to the site of acute inflammation bound to transferrin (Tsan 1985;Klech et al 1987) and remains there by becoming associated with neutrophils, bacteria or various proteins (Tsan 1985). In the pneumoconioses, there is evidence to support the association of gallium uptake by the lungs with macrophages (Bisson et al 1983(Bisson et al , 1987Begin et al 1986;Rom et al 1987), neutrophils (Bisson et al 1987) and, to a lesser extent, lymphocytes (Bisson et al 1987), while in idiopathic pulmonary fibrosis, abnormal gallium uptake has been reported to be associated with neutrophils Klech et al 1987;Bertorelli et al 1988;Gibson et al 1989) and macrophages Vergnon et al 1987). Studies looking at the mechanisms responsible for gallium uptake, however, have tended to include few patients with diffuse lung disease associated with connective tissue diseases, a condition which may have a different aetiology and perhaps therefore a different pathophysiology compared with other forms of interstitial lung disease.…”

Differences in BAL fluid variables in interstitial lung diseases evaluated by discriminant analysis

“…In previous studies, immunological parameters have been included in discriminant analysis [6,21] of the different ll...D. Thus, BERTORELLr et al [6] regard T-lymphocyte subpopulations, PMN and eosinophils in BALF, immune complex determination and gallium-67 lung scanning to possess the most important discriminant capacity. However, our study is not quite comparable with the above-mentioned study, because it included other variables and non-BALF parameters, and the use of different inclusion criteria.…”

“…However, our study is not quite comparable with the above-mentioned study, because it included other variables and non-BALF parameters, and the use of different inclusion criteria. The EAA population of BERTORELLI et al [6) was recently exposed to the causative antigen, and the authors do not state whether patients who had a BAL after provocation were also included. This is very important, because of the reported influence of the timing of BAL related to the last antigen exposure on the results of BALF analyses [11,12).…”

“…The increase in different cell types and immunoglobulins (lgs) in BAL fluid (BALF) may vary among the various D...D [l-4]. In order to discriminate between the ILDs, characteristic BAL features should be considered, together with unique clinical parameters [6,7]. can be found shortly after inhalation of antigen [ 11, 12}.…”