Is bronchoalveolar lavage obsolete in the diagnosis of interstitial lung disease?

Current Opinion in Pulmonary Medicine

Volumn 9, Issue 5, 2003, Pages 418-425

  Rottoli, Paola ^a   Bargagli, Elena ^a  

^a UNIVERSITY HOSPITAL OF SIENA   (Italy)

Author keywords

Bronchoalveolar lavage; Differential cell pattern; Idiopathic interstitial pneumonia; Interstitial lung disease

Indexed keywords

CHEMOKINE; CHEMOKINE RECEPTOR; CHEMOKINE RECEPTOR CXCR4; CYTOKINE; INTERLEUKIN 10; INTERLEUKIN 12; MONOCYTE CHEMOTACTIC PROTEIN 1; RANTES; TRANSFORMING GROWTH FACTOR BETA;

BIOPSY TECHNIQUE; CELL ULTRASTRUCTURE; CLINICAL RESEARCH; DIAGNOSTIC ACCURACY; DIAGNOSTIC VALUE; EVALUATION; HUMAN; IDIOPATHIC DISEASE; INTERSTITIAL LUNG DISEASE; INTERSTITIAL PNEUMONIA; LUNG LAVAGE; OPTICAL RESOLUTION; PHENOTYPE; PRACTICE GUIDELINE; REVIEW; STANDARDIZATION;

BRONCHOALVEOLAR LAVAGE; DIAGNOSIS, DIFFERENTIAL; HUMANS; LUNG DISEASES, INTERSTITIAL;

EID: 0042738963     PISSN: 10705287     EISSN: None     Source Type: Journal    
DOI: 10.1097/00063198-200309000-00014     Document Type: Review

References (88)

1. Reynolds HY: Use of bronchoalveolar lavage in humans-past necessity and future imperative. Lung 2000, 178(5):271-93
2. Crystal RG, Gadek JE, Ferrans VJ et al: Interstitial lung disease: current concepts of pathogenesis, staging and therapy. Am J Med 1981 Mar, 70(3):542-68
3. Daniele RP, Elias JA, Epstein PE et al: Bronchoalveolar lavage: role in the pathogenesis, diagnosis, and management of interstitial lung disease. Ann Intern Med 1985, 102:93-108
4. Keogh BA, Hunninghake GW, Line BR et al: The alveolitis of pulmonary sarcoidosis. Evaluation of natural hystory and alveolitis-dependent changes in lung function. Am Rev Respir Dis 1983, 128(2):256-65
5. Semenzato G, Chilosi M, Ossi E et al: BAL and lung histology-comparative analysis of inflammatory and immunocompetent cells in patients with sarcoidosis and hypersensitivity pneumonitis. Am Rev Respir Dis 1985, 132:400-404
6. Klech H, Hutter C: Clinical guidelines and indications for BAL: report of the European Society of Pneumology Task Group on BAL. Eur Respir J 1990, 3:937-974
7. Baughman RP: The uncertainties of bronchoalveolar lavage. Eur Respir J 1997, 10:1940-1942
8. Raghu G: Is Bronchoalveolar Lavage Clinically Useful for Everyday Practice in Interstitial Lung Disease? J of Bronchology 1999, 6:217-221
9. Kantrow SP, Meyer KC, Kidd P et al: The CD4/CD8 ratio in BAL fluid is highly variable in sarcoidosis. Fur Respir J 1997, 10:2716-21
10. Haslam PL, Baughman RP: BAL Task Force. Eur Respir Rev 1999, 9(66):1-157
11. Costabel U, Guzman J: Bronchoalveolar lavage in interstitial lung diseases. Curt Opin Pulm Med 2001, 7:255-261
12. Baughman RP, Drent M: Role of bronchoalveolar lavage in interstitial lung disease. Clinic in Chest Med Jun 2001, 22(2):331-341
13. Drent M, Jacobs JA, Wagenaar SJ.: Bronchoalveolar lavage. Eur Respir Mon 2000, 14:63-78
14. Drent M, Jacobs JA, Cobben NAM et al: Computer programm supporting the diagnostic accuracy of cellular BALF analysis: a new release. Respir Med 2001, 95:781-786
15. Utz JP, Ryu JH, Douglas WW et al: High short-term mortality following lung biopsy for usual interstitial pneumonia. Eur Respir J 2001, 17:175-179
16. Sharma OP: Pulmonary Sarcoidosis: management. J of Postgraduate Med 2002, 48(2):135141. A very good review on sarcoidosis with special reference to treatment, including new therapeutic approaches
17. Mollers M, Aries SP, Dromann D et al: Intracellular cytokine repertoire in different T cell subsets from patients with sarcoidosis. Thorax 2001 Jun, 56(6):487-93
18. Hunninghake GW, Costabel U, Ando M et al: ATS/ERS/WASOG statement on Sarcoidosis. Sarcoidosis 1999, 16:149-173
19. Costabel U: Sarcoidosis: clinical update. Eur Respir J 2001, 18(Suppl. 32):56S-68S.
20. Costabel U: CD4/CD8 ratios in bronchoalveolar lavage fluid of value for diagnosis of Sarcoidosis? Eur Respir J 1997, 10:2699-2700
21. Drent M, Jacobs JA, De Vries J et al: Does the cellular broncoalveolar lavage fluid profile reflect the severity of Sarcoidosis? Eur Respir J 1999, 13:1338-1344
22. Tsiligianni I, Tzanakis N, Kyriakou D et al: Comparison of sputum induction with broncholveolar lavage cell differential counts in patients with sarcoidosis. Sarcoidosis 2002, 19:205-210
23. Travis WD, King TE, Bateman E et al: ATS/ERS International multidisciplinary consensus classification of the idiophatic interstitial pneumonias. Am J of Respir Crit Care Med 2002, 165:277-304 Excellent consensus statement summarizing the state of the art on IIP and proposing a new classification
24. Poletti V, Kitaichi M: Facts and controversies in the classification of idiopathic interstitial pneumonias. Sarcoidosis Vasc and Diffuse Lung Dis 1999, 17:229-238
25. Flaherty KR, Toews GB, Travis WD et al: Clinical significance of histological classification of idiopathic interstitial pneumonia. Eur Respir J 2002, 19:275-283 Very good study in a large series of patients evaluating the role of histopathological classification of IIPs and the utility of HRCT in predicting survival
26. Klech H, Pohl W. Technical recommendations and guidelines for BAL. Eur Respir J 1989, 2:561-585
27. ATS. Idiopathic pulmonary fibrosis: diagnosis and treatement: joint statement of the ATS and ERS. Am J Respir Crit Care Med 2000, 161:646-664
28. Nagai S, Kitaichi M, Itho H et al: Idiopathic nonspecific interstitial pneumonia/fibrosis and BOOP. Eur Respir J 1998, 12:1010-1019
29. Cordier JF, Loire R, Brune J: Idiopathic bronchiolitis obliterans organizing pneumonia. Definition of characteristic clinical profiles in a series of 16 patients. Chest 1989, 96:999-1004
30. Haslam PL, Poulter LW, Rossi GA et al: The clinical role of BAL in idiopathic pulmonary fibrosis. Eur Respir J 1990, 3:940-942
31. King TE Jr, Mortenson RL: Cryptogenic organizing pneumonitis. The North American experience. Chest 1992, 102:8S-13S
32. Costabel U, Teschler H, Guzman J: Bronchiolitis obliterans organizing pneumonia (BOOP): the cytological and immunocytological profile of bronchoalveolar lavage. Eur Respir J 1992, 5:791-797
33. Fraig M, Shreesha U, Savici D et al: Respiratory bronchiolitis: a clinicopathologic study in current smokers, ex-smokers and never smokers. Am J Surg Pathol 2002 May, 26(5):647-653 Very good study on a large series of patients with respiratory bronchiolitis
34. Nagai S, Kitaichi M, Izumi T: Classification and recent advances in idiopathic interstitial pneumonia. Curr Opin Pulm Med 1998, 4:256-260
35. King TE Jr: Respiratory bronchiolitis-associated interstitial lung disease. Clin Chest Med 1993, 14:693-698
36. Hunninghake GW, Crystal RG: Cigarette smoking and lung destruction. Accumulation of neutrophils in the lungs of cigarette smokers. Am Rev Respir Dis 1983, 128:833-838
37. Betsuyaku T, Munakata M, Yamaguchi E et al: Establishing diagnosis of pulmonary malignant lymphoma by gene rearrangement analysis of lymphocytes in BAL fluid. Am J Respir Crit Care Med 1994, 149:526-529
38. Bonaccorsi A, Cancellieri A, Chilosi M et al: Acute interstitial pneumonia: report of a series. Eur Respir J 2003 Jan, 21(1):187-191
39. Hartman TE, Swensen SJ, Hansell DM et al: Non specific interstitial pneumonia: variable appearance at chest HRCT. Radiology 2000, 217:701-705
40. Raghu G, Mageto YN, Lockhart D et al: The accuracy of the clinical diagnosis of new-onset idiopathic pulmonary fibrosis and other interstitial lung disease. A prospective study. Chest 1999, 116:1168-1174
41. Collard HR, King TE: Demystifying idiopathic interstitial pneumonia. Arch Intern Med 2003 Jan 13,163(1):17-29 Very good review on the new classification of IIP, explaining the importance of histopathological distinction and the utility of clinico-radiographic and surgical approach to diagnosis
42. Gross TJ, Hunninghake GW: Idiopathic pulmonary fibrosis. N Engl J Med 2001 Aug, 345(7):517-525
43. Cheema GS, Quismorio FP: Interstitial lung disease in systemic sclerosis. Curr Opin Pulm Med 2001, 7:283-290
44. King TE: Nonspecific interstitial pneumonia and systemic sclerosis. Am J Respir Crit Care Med 2002, 165:1578-1579
45. Bouros D, Wells AU, Nicholson AG et al: Histopathologic subsets of fibrosing alveolitis in patients with systemic sclerosis and their relationship to outcome. Am J Respir Crit Care Med 2002, 165:1581-86. Very good paper on pulmonary fibrosis associated with SSc, also comparing invasive and non-invasive parameters, including BAL, to distinguish the histopathologic subsets of interstitial pneumonia in SSc
46. Kumanovics G, Magyarlaki T, Komocsi A et al: Simultaneous presence of neutrophil alveolitis and Ki-67 positivity of alveolar macrophages in dermato/polymyositis and systemic sclerosis. Rheumatol Int 2003 Jan, 23(1):6-10
47. Nagao T, Nagai S, Kitaichi M: Usual interstitial pneumonia: idiopathic pulmonary fibrosis versus collagen vascular disease. Respiration 2001, 68:151-159
48. Kim DS, Yoo B, Lee JS: The major histopathologic pattern of pulmonary fibrosis in scleroderma is nonspecific interstitial pneumonia. Sarcoidosis 2002, 19(2):121-127
49. Wells AU, Hansell DM, Haslam PL et al: Bronchoalveolar lavage cellularity: lone cryptogenic fibrosing alveolitis compared with the fibrosing alveolitis of systemic sclerosis. Am J Respir Crit Med 1998, 157:1474-1482
50. Forlani S, Ratta L, Bulgheroni A et al: Cytokine profile of bronchoalveolar lavage in BOOP and UIP. Sarcoidosis Vasc Diffuse Lung Dis 2002, 19:47-53
51. Devouassoux G, Drouet C, Pin I et al: Alveolar neutrophilia is a predictor for the bronchiolitis obliterans syndrome and increases with degree of severity. Transpl Immunol 2002 Nov, 10(4):303-31 Very interesting paper on the application of BAL to early detection of lung rejection
52. Nord M, Shubert K, Cassel NT et al: Decreased serum and bronchoalveolar lavage levels of Clara cells secretory proteins (CC16) is associated with bronchiolitis obliterans syndrome and airway neutrophilia in lung transplant recipiens. Transplantation 2002, 73(8):1264-1269
53. Reynaud-Gaubert M, Thirion X, Badier M et al: Upregulation of chemochines in bronchoalveolar lavage fluid as a predictive marker of post-transplant airway obliteration. J Heart Lung Transplant 2002 July, 21(7):721-730
54. Sartorelli P, Scancarello G, Romeo R et al: Asbestos exposure assessment by mineralogical analysis of bronchoalveolar lavage fluid. J Occup Environ Med 2001, 43:872-881
55. Rossman MD, Kern JA, Elias R et al: Proliferative response of bronchoalveolar ltmphocytes to beryllium. A test for chronic berllium disease. Ann Intern Med 1988, 108:687-693
56. Brichet A, Tonnel AB, Brambilia E et al: Chronic interstitial pneumonia with honeycombing in coal workers. Sarcoidosis Vasc Diffuse Lung Dis 2002, 19:211-219
57. Ratjen F, Costabel U, Griese M et al: Bronchoalveolar lavage fluid findings in children with hypersensitivity pneumonitis. Eur Respir J 2003, 21:144-148 Very good paper on the application of BAL to clinical study of ILD in children.
58. Lukacs NW, Hogaboam C, Chensue SW et al: Type 1/Type 2 cytokine paradigm and the progression of pulmonary fibrosis. Chest 2001 Jul, 120 (1 Suppl):5S-8S
59. + lung and blood T cell in sarcoidosis. A, J Respir Crit Care Med 2001, 163:115-121
60. Rottoli P, Peran MG, Fossi A et al: Can the study of BAL protein composition help to characterize the type of immune response in ILD? Eur Respir J 2002, 20(38):586S
61. Selman M, King TE, Pardo A: Idiopathic pulmonary fibrosis: prevailing and envolving hypoteses about its pathogenesis and implications for therapy. Ann Intern Med 2001, 134:136-151
62. Pardo A Selman M: Idiopathic pulmonary fibrosis: new insights in its pathogenesis. The International Journal of Biochemistry & Cell Biology 2002 Dec, 34(12):1534-1538 Very good paper on the pathogenesis of IPF
63. Grunewald J, Wahlstrom J, Berlin M et al: Lung restricted Tcell receptor AV2S3+CD4+ T cell expansions in sarcoidosis patients with a shared HLA-DRβ chain conformation. Thorax 2002, 57:348-352 Interesting paper on the identification of a new group of Scandinavian sarcoidosis patients with lung restricted Tcell expansions expressing AV2S3
64. Fontenot AP, Canavera SJ, Gharavi L et al: Target organ localization of memory CD4+ T cells in patients with chronic berillium disease. J Clin Invest 2002, 110:1473-1482
65. Kunisawa A, Kawanishi Y, Tago H et al: Direct demonstration of the productive capability of cytokines in lung sarcoidosis using multicolor citometry. Respiration 2002, 69(2):155-164
66. Shimizudani N, Murata H, Keino H et al: Conserved CDR 3 region of T cell receptor BV gene in lymphocytes from bronchoalveolar lavage fluid of patients with idiopathic pulmonary fibrosis. Clin Exp Immunol 2002, 129:140-149
67. Kittle LA, Sawyer RT, Fadok VA et al: Beryllium induces apoptosis in human lung macrophages. Sarcoidosis Vasc Diffuse Lung Dis 2002, 19:101-113 Very interesting paper examining the mechanisms regulating Be-induced macrophage apoptosis
68. Stridh H, Plank A, Gigliotti D et al: Apoptosis resistant BAL fluid lymphocytes in sarcoidosis. Thorax 2002, 57:897-901
69. Laflamme C, Israel-Assayag E, Cormier Y: Apoptosis of bronchoalveolar lavage lymphocytes in hypersensitivity pneumonitis. Eur Respir J 2003 feb, 21(2):225-231
70. Kinnula V.L, Lehtonen S, Kaarteenaho-Wiik R et al: Cell specific expression of peroxiredoxins in human lung and pulmonary sarcoidosis. Thorax 2002, 57:157-164
71. Montaldo C, Cannas E, Ledda M et al: Bronchoalveolar glutathione and nitrite/nitrate in idiopathic pulmonary fibrosis. Sarcoidosis Vasc Diffuse Lung Dis 2002, 19:54-58
72. Failli P, Palmieri L, D'Alfonso C et al: Effect of N-acetyl-L-cysteine on peroxynitrite and superoxide anion production of lung alveolar macrophages in systemic sclerosis. Nitric Oxide 2002 Dec, 7(4):277-282
73. Lanone S, Zheng T, Zhu Z et al: Overlapping and enzyme-specific contributions of matrix metalloproteinases-9 and -12 in IL-13-induced inflammation and remodelling. J Clin Invest 2002, 110(4):463-474 Very interesting papers on the role of MMPs to the development of pulmonary fibrosis
74. Choi KH, Lee HB, Jeong MY et al: The role of matrix metalloprototeinase-9 and tissue inhibitor of metalloproteinase-1 in cryptogenic organizing pneumonia. Chest 2002, 121:1478-1485 Very interesting paper on imbalance between MMP9 and TIMP-1 suggesting a possible future diagnostic application.
75. Zuo F, Kaminski N, Eugui E et al: Gene expression analysis reveals matrylisin as a key regulator of pulmonary fibrosis in mice and humans. Proc Natl Acad Sci 2002 Apr, 99(9): 6292-6297 Very interesting paper on the application of microarray techonology to the study of the pathogenesis of pulmonary fibrosis
76. Luzina IG, Atamas S.P, Wise R et al: Gene expression in bronchoalveolar lavage cells from scleroderma patients. Am J Respir Cell Mol Biol 2002 May, 26(5):549-557 Very good paper on BAL application of new microarray technology to the identification of distinct gene expression profiles in subgroups of SSc patients
77. Thonhofer R, Maercker C, Popper HH: Expression of sarcoidosis related genes in lung lavage cells. Sarcoidosis Vasc Diffuse Lung Dis 2002, 19:59-65 Very good paper on the identification of genes exclusively upregulated in sarcoidosis by microarray technology
78. Noel-Georis I, Bernard A, Falmagne P et al: Database of bronchoalveolar lavage fluid proteins. J of Chromatography B 2002, 771:221-236 Very good review on the proteomic approach to the study of BAL
79. Magi B, Bini L, Perari MG et al: Bronchoalveolar lavage fluid protein composition in patients with sarcoidosis and idiopathic pulmonary fibrosis: a two-dimensional electrophoretic study. Electrophoresis 2002, 23:3434-3444 Very interesting study identifying distinct protein profiles in BAL from sarcoidosis and IPF patients by 2D-electrophoresis, suggesting future diagnostic applications
80. Petrek M, Kolek V, Szotkowska J et al: CC and C chemokine expression in pulmonary sarcoidosis. Eur Respir J 2002, 20:1206-1212 Very good paper showing upregulation of MCP-1, RANTES and SCM-1α in sarcoidosis patients
81. Mrazek F, Sekerova V, Drabek et al: Expression of the chemokine PARC mRNA in bronchoalveolar cells of patients with sarcoidosis. Immunology Letters 2002 Oct, 84(1):17-22.
82. Miyazaki E, Nureki S, Fukami T et al: Elevated levels of thymus and activation regulated chemokine in bronchoalveolar lavage fluid from patients with eosinophilic pneumonia. Am J Respir Crit Care Med 2002, 165:1125-31 Interesting paper showing a role for TARC in the pathogenesis of EP.
83. Agostini C, Miorin M, Semenzato G: Gene expression profile analysis by DNA microarrays: a new approach to assess functional genomics in diseases. Sarcoidosis Vasc Diffuse Lung Dis 2002, 19:5-9 Very good review on the application of gene expression analysis to the study of diseases
84. Ishii H, Mukae H, Kadota J et al: High serum concentrations of surfactant protein A in usual interstitial pneumonia compared with non-specific interstitial pneumonia. Thorax 2003, 58:52-57 Very interesting paper on SP-A and SP-D levels in BAL and serum of UIP and NSIP patients, suggesting possible diagnostic application
85. Schoch OD, Schanz U, Koller M et al: BAL findings in a patient with pulmonary alveolar proteinosis successfully treated with GM-CSF. Thorax 2002 Mar, 57(3):277-280
86. Li Y, Azuma A, Takahashi S et al: Fourteen-membered ring macrolides inhibit vascular cell adhesion molecule 1 messenger RNA induction and leukocyte migration. Chest 2002, 122:2137-2145
87. Ziegenhagen MW, Rothe ME, Zissel G et al: Exaggerated TNFα release of alveolar macrophages in corticosteroid resistant sarcoidosis. Sarcoidosis Vasc Diffuse Lung Dis 2002, 19:185-190 Very interesting paper on a possible role of TNFα in steroid resistance in sarcoidosis patients
88. Pantelidis P, McGrath DS, Southcott et al: Single-cell analysis: a novel approach to TNF-α synthesis and secretion in sarcoidosis. Eur Respir J 2002, 20:1179-1184