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Published in: Clinical and Translational Allergy 1/2014

Open Access 01-12-2014 | Research

Bronchoalveolar lavage in infants with recurrent lower respiratory symptoms

Authors: Kristiina Malmström, Maili Lehto, Marja-Leena Majuri, Timo Paavonen, Seppo Sarna, Anna S Pelkonen, L Pekka Malmberg, Harry Lindahl, Merja Kajosaari, Sejal Saglani, Harri Alenius, Mika J Mäkelä

Published in: Clinical and Translational Allergy | Issue 1/2014

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Abstract

Background

Few data are available about the inflammatory cytokine profile of bronchoalveolar lavage (BAL) from young children with frequent wheeze. The first aim was to investigate the BAL cellular and cytokine profiles in infants with recurrent lower respiratory symptoms in whom bronchoscopy was indicated for clinical symptom evaluation. The second aim was to relate the BAL results with the histological findings of the endobronchial carina biopsies.

Methods

Thirty-nine infants (median age 0.9 years) underwent lung function testing by whole-body plethysmography prior to the bronchoscopy. The BAL differential cell counts and cytokine levels were quantified. These findings were compared with the histological findings of the endobronchial carina biopsies.

Results

The differential cytology reflected mainly that described for healthy infants with lymphocyte counts at the upper range level. A positive association between BAL CD8+ lymphocytes and neutrophils and endobronchial reticular basement membrane was found. Detectable levels of pro-inflammatory cytokine proteins IL-1β, IL-17A, IL-18, IL-23, and IL-33 were found, whereas levels of Th2-type cytokine proteins were low. Frequent wheeze was the only clinical characteristic significantly related to detectable combined pro-inflammatory cytokine profile. Lung function did not correlate with any cytokine.

Conclusions

A positive association between BAL CD8+ lymphocytes and neutrophils and endobronchial reticular basement thickness was found. Detectable production of pro-inflammatory cytokines associated positively with frequent wheeze.
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Literature
1.
go back to reference Saglani S, Malmström K, Pelkonen AS, Malmberg LP, Lindahl H, Kajosaari M, Turpeinen M, Rogers AV, Payne DN, Bush A, Haahtela T, Mäkelä MJ, Jeffery PK: Airway remodelling and inflammation in symptomatic infants with reversible airway obstruction. Am J Respir Crit Care Med. 2005, 171: 722-727. 10.1164/rccm.200410-1404OC.CrossRefPubMed Saglani S, Malmström K, Pelkonen AS, Malmberg LP, Lindahl H, Kajosaari M, Turpeinen M, Rogers AV, Payne DN, Bush A, Haahtela T, Mäkelä MJ, Jeffery PK: Airway remodelling and inflammation in symptomatic infants with reversible airway obstruction. Am J Respir Crit Care Med. 2005, 171: 722-727. 10.1164/rccm.200410-1404OC.CrossRefPubMed
2.
go back to reference Saglani S, Payne DN, Zhu J, Wang Z, Nicholson AG, Bush A, Jeffery PK: Early detection of air wall remodeling and eosinophilic inflammation in preschool wheezers. Am J Respir Crit Care Med. 2007, 176: 858-864. 10.1164/rccm.200702-212OC.CrossRefPubMed Saglani S, Payne DN, Zhu J, Wang Z, Nicholson AG, Bush A, Jeffery PK: Early detection of air wall remodeling and eosinophilic inflammation in preschool wheezers. Am J Respir Crit Care Med. 2007, 176: 858-864. 10.1164/rccm.200702-212OC.CrossRefPubMed
3.
go back to reference Heier I, Malmström K, Pelkonen AS, Malmberg LP, Kajosaari M, Turpeinen M, Lindahl H, Brandtzaeg P, Jahnsen FL, Mäkelä MJ: Bronchial response pattern of antigen presenting cells and regulatory T cells in children below two years of age. Thorax. 2008, 63: 703-709. 10.1136/thx.2007.082974.CrossRefPubMed Heier I, Malmström K, Pelkonen AS, Malmberg LP, Kajosaari M, Turpeinen M, Lindahl H, Brandtzaeg P, Jahnsen FL, Mäkelä MJ: Bronchial response pattern of antigen presenting cells and regulatory T cells in children below two years of age. Thorax. 2008, 63: 703-709. 10.1136/thx.2007.082974.CrossRefPubMed
4.
go back to reference de Blic J, Midulla F, Barbato A, Clement A, Dab I, Eber E, Green C, Grigg J, Kotecha S, Kurland G, Pohunek P, Ratjen F, Rossi G: Bronchoalveolar lavage in children. ERS Task Force on bronchoalveolar lavage in children. European Respiratory Society. Eur Respir J. 2000, 15: 217-231. 10.1183/09031936.00.15121700.CrossRefPubMed de Blic J, Midulla F, Barbato A, Clement A, Dab I, Eber E, Green C, Grigg J, Kotecha S, Kurland G, Pohunek P, Ratjen F, Rossi G: Bronchoalveolar lavage in children. ERS Task Force on bronchoalveolar lavage in children. European Respiratory Society. Eur Respir J. 2000, 15: 217-231. 10.1183/09031936.00.15121700.CrossRefPubMed
5.
go back to reference Stevenson EC, Turner G, Heaney LG, Schock BC, Taylor R, Gallagher T, Ennis M, Shields MD: Bronchoalveolar lavage findings suggest two different forms of childhood asthma. Clin Exp Allergy. 1997, 27: 1027-1035. 10.1111/j.1365-2222.1997.tb01254.x.CrossRefPubMed Stevenson EC, Turner G, Heaney LG, Schock BC, Taylor R, Gallagher T, Ennis M, Shields MD: Bronchoalveolar lavage findings suggest two different forms of childhood asthma. Clin Exp Allergy. 1997, 27: 1027-1035. 10.1111/j.1365-2222.1997.tb01254.x.CrossRefPubMed
6.
go back to reference Marguet C, Jouen-Boedes F, Dean TP, Warner JO: Bronchoalveolar cell profiles in children with asthma, infantile wheeze, chronic cough, or cystic fibrosis. Am J Respir Crit Care Med. 1999, 159: 1533-1540. 10.1164/ajrccm.159.5.9805028.CrossRefPubMed Marguet C, Jouen-Boedes F, Dean TP, Warner JO: Bronchoalveolar cell profiles in children with asthma, infantile wheeze, chronic cough, or cystic fibrosis. Am J Respir Crit Care Med. 1999, 159: 1533-1540. 10.1164/ajrccm.159.5.9805028.CrossRefPubMed
7.
go back to reference Bossley CJ, Fleming L, Gupta A, Regamey N, Frith J, Oates T, Tsartsali L, Lloyd CM, Bush A, Saglani S: Pediatric severe asthma in characterized by eosinophilia and remodeling without Th2 cytokines. J Allergy Clin Immunol. 2012, 129: 974-982. 10.1016/j.jaci.2012.01.059.PubMedCentralCrossRefPubMed Bossley CJ, Fleming L, Gupta A, Regamey N, Frith J, Oates T, Tsartsali L, Lloyd CM, Bush A, Saglani S: Pediatric severe asthma in characterized by eosinophilia and remodeling without Th2 cytokines. J Allergy Clin Immunol. 2012, 129: 974-982. 10.1016/j.jaci.2012.01.059.PubMedCentralCrossRefPubMed
8.
go back to reference Kraemer R, Graf Bigler U, Casaulta Aebischer C, Weder M, Birrer P: Clinical and physiological improvement after inhalation of low-dose beclomethasone dipropionate and salbutamol in wheezy infants. Respiration. 1997, 64: 342-349. 10.1159/000196702.CrossRefPubMed Kraemer R, Graf Bigler U, Casaulta Aebischer C, Weder M, Birrer P: Clinical and physiological improvement after inhalation of low-dose beclomethasone dipropionate and salbutamol in wheezy infants. Respiration. 1997, 64: 342-349. 10.1159/000196702.CrossRefPubMed
9.
go back to reference Kankkunen P, Rintahaka J, Aalto A, Leino M, Majuri ML, Alenius H, Wolff H, Matikainen S: Trichothecene mycotoxins activate inflammatory response in human macrophages. J Immunol. 2009, 182: 6418-6425. 10.4049/jimmunol.0803309.CrossRefPubMed Kankkunen P, Rintahaka J, Aalto A, Leino M, Majuri ML, Alenius H, Wolff H, Matikainen S: Trichothecene mycotoxins activate inflammatory response in human macrophages. J Immunol. 2009, 182: 6418-6425. 10.4049/jimmunol.0803309.CrossRefPubMed
10.
go back to reference Cokugras H, Akcakaya N, Seckin I, Camcioğlu Y, Sarimurat N, Aksoy F: Ultrastructural examination of bronchial biopsy specimens from children with moderate asthma. Thorax. 2001, 56: 25-29. 10.1136/thorax.56.1.25.PubMedCentralCrossRefPubMed Cokugras H, Akcakaya N, Seckin I, Camcioğlu Y, Sarimurat N, Aksoy F: Ultrastructural examination of bronchial biopsy specimens from children with moderate asthma. Thorax. 2001, 56: 25-29. 10.1136/thorax.56.1.25.PubMedCentralCrossRefPubMed
11.
go back to reference Baraldo S, Turato G, Bazzan E, Ballarin A, Damin M, Balestro E, Lokar Oliani K, Calabrese F, Maestrelli P, Snijders D, Barbato A, Saetta M: Noneosinophilic asthma in children: relation with airway remodelling. Eur Respir J. 2011, 38: 575-583. 10.1183/09031936.00168210.CrossRefPubMed Baraldo S, Turato G, Bazzan E, Ballarin A, Damin M, Balestro E, Lokar Oliani K, Calabrese F, Maestrelli P, Snijders D, Barbato A, Saetta M: Noneosinophilic asthma in children: relation with airway remodelling. Eur Respir J. 2011, 38: 575-583. 10.1183/09031936.00168210.CrossRefPubMed
12.
go back to reference Betts RJ, Kemeny DM: CD8+ T cells in asthma: friend or foe?. Pharmacol Ther. 2009, 121: 123-131. 10.1016/j.pharmthera.2008.09.001.CrossRefPubMed Betts RJ, Kemeny DM: CD8+ T cells in asthma: friend or foe?. Pharmacol Ther. 2009, 121: 123-131. 10.1016/j.pharmthera.2008.09.001.CrossRefPubMed
13.
go back to reference van Rensen ELJ, Sont JK, Evertse CE, Willems LN, Mauad T, Hiemstra PS, Sterk PJ, AMPUL Study Group: Bronchial CD8 cell infiltrate and lung function decline in asthma. Am J Respir Crit Care Med. 2005, 172: 837-841. 10.1164/rccm.200504-619OC.CrossRefPubMed van Rensen ELJ, Sont JK, Evertse CE, Willems LN, Mauad T, Hiemstra PS, Sterk PJ, AMPUL Study Group: Bronchial CD8 cell infiltrate and lung function decline in asthma. Am J Respir Crit Care Med. 2005, 172: 837-841. 10.1164/rccm.200504-619OC.CrossRefPubMed
14.
go back to reference Mclennan C, Hutchinson P, Holdsworth S, Bardin PG, Freezer NJ: Airway inflammation in asymptomatic children with episodic wheeze. Ped Pulmonol. 2006, 41: 577-583. 10.1002/ppul.20415.CrossRef Mclennan C, Hutchinson P, Holdsworth S, Bardin PG, Freezer NJ: Airway inflammation in asymptomatic children with episodic wheeze. Ped Pulmonol. 2006, 41: 577-583. 10.1002/ppul.20415.CrossRef
15.
16.
go back to reference Le Bourgeois M, Concalves M, Le Clainche L, Benoist MR, Fournet JC, Scheinmann P, de Blic J: Bronchoalveolar cells in children < 3 years old with severe recurrent wheezing. Chest. 2002, 122: 791-797. 10.1378/chest.122.3.791.CrossRefPubMed Le Bourgeois M, Concalves M, Le Clainche L, Benoist MR, Fournet JC, Scheinmann P, de Blic J: Bronchoalveolar cells in children < 3 years old with severe recurrent wheezing. Chest. 2002, 122: 791-797. 10.1378/chest.122.3.791.CrossRefPubMed
Metadata
Title
Bronchoalveolar lavage in infants with recurrent lower respiratory symptoms
Authors
Kristiina Malmström
Maili Lehto
Marja-Leena Majuri
Timo Paavonen
Seppo Sarna
Anna S Pelkonen
L Pekka Malmberg
Harry Lindahl
Merja Kajosaari
Sejal Saglani
Harri Alenius
Mika J Mäkelä
Publication date
01-12-2014
Publisher
BioMed Central
Published in
Clinical and Translational Allergy / Issue 1/2014
Electronic ISSN: 2045-7022
DOI
https://doi.org/10.1186/2045-7022-4-35

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