Bronchoalveolar lavage differential cell count on prognostic assessment of patients with stable or acute interstitial lung disease: A retrospective real-life study

Johanna Salonen; Henri Lampela; Eerika Keskitalo; Hannu Vähänikkilä; Minna Purokivi; Riitta Kaarteenaho

doi:10.1016/j.clim.2020.108594

Bronchoalveolar lavage differential cell count on prognostic assessment of patients with stable or acute interstitial lung disease: A retrospective real-life study

Clin Immunol. 2020 Nov:220:108594. doi: 10.1016/j.clim.2020.108594. Epub 2020 Sep 12.

Authors

Johanna Salonen¹, Henri Lampela², Eerika Keskitalo³, Hannu Vähänikkilä⁴, Minna Purokivi⁵, Riitta Kaarteenaho⁶

Affiliations

¹ Respiratory Medicine, Research Unit of Internal Medicine, University of Oulu, P.O. Box 8000, 90014 Oulu, Finland; Medical Research Center (MRC) Oulu, Oulu University Hospital, P. O. Box 20, 90029 OYS, Oulu, Finland. Electronic address: johanna.salonen@oulu.fi.
² Respiratory Medicine, Research Unit of Internal Medicine, University of Oulu, P.O. Box 8000, 90014 Oulu, Finland. Electronic address: henri.lampela@student.oulu.fi.
³ Respiratory Medicine, Research Unit of Internal Medicine, University of Oulu, P.O. Box 8000, 90014 Oulu, Finland. Electronic address: eerika.keskitalo@student.oulu.fi.
⁴ Infrastructure of Population Studies, University of Oulu, P. O. BOX 8000, 90014 Oulu, Finland. Electronic address: hannu.vahanikkila@oulu.fi.
⁵ The Center of Medicine and Clinical Research, Division of Respiratory Medicine, Kuopio University Hospital, P. O. Box 100, 70029 KYS, Kuopio, Finland. Electronic address: minna.purokivi@kuh.fi.
⁶ Respiratory Medicine, Research Unit of Internal Medicine, University of Oulu, P.O. Box 8000, 90014 Oulu, Finland; Medical Research Center (MRC) Oulu, Oulu University Hospital, P. O. Box 20, 90029 OYS, Oulu, Finland. Electronic address: riitta.kaarteenaho@oulu.f.

PMID: 32927080
DOI: 10.1016/j.clim.2020.108594

Abstract

BAL cell differential counts of 133 therapy naive ILD patients and 43 patients during acute exacerbation of ILD (AE-ILD) were retrospectively evaluated. In the 20 patients who underwent BAL both at baseline and during an AE-ILD, there was an increase in neutrophils but a decrease in macrophages and eosinophils in the BAL obtained during AE-ILD. A detectable number of basophils at the baseline was a novel risk factor for earlier death and the occurrence of AE-ILD. Total BAL cell count >160 × 10⁹/L during AE-ILD was correlated with a more favorable prognosis. BAL cell counts <20% of lymphocytes or > 20% of neutrophils during AE-ILD were associated with shorter survival. AE-ILD exerted significant changes in BAL cell profiles in individual patients. Several BAL-parameters correlated with survival of ILD patients; of these, baseline basophils and total cell count during AE-ILD were novel prognostic markers.

Keywords: Acute exacerbation; Bronchoalveolar lavage; Idiopathic pulmonary fibrosis; Interstitial lung disease; Prognosis.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Acute Disease
Aged
Aged, 80 and over
Basophils / immunology*
Bronchoalveolar Lavage Fluid / cytology*
Bronchoalveolar Lavage Fluid / immunology*
Cell Count
Female
Humans
Lung Diseases, Interstitial / immunology*
Lung Diseases, Interstitial / mortality
Macrophages / immunology*
Male
Middle Aged
Neutrophils / immunology*
Prognosis
Retrospective Studies