Review

CD₈₊ T lymphocytes in bronchoalveolar lavage in idiopathic pulmonary fibrosis

Spyros A Papiris^1,7 , Androniki Kollintza² , Marilena Karatza³ , Effrosyni D Manali¹ , Christina Sotiropoulou⁴ , Joseph Milic-Emili⁵ , Charis Roussos² and Zoe Daniil⁶

¹  2^nd Pulmonary Department, National and Kapodistrian University of Athens, "Attikon" University Hospital, Athens, Greece

²  Department of Critical Care and Pulmonary Services, National and Kapodistrian University of Athens, "Evangelismos" Hospital, Athens, Greece

³  Hematology Department "Evangelismos" Hospital, Athens, Greece

⁴  Applied Biomedical Research & Training Laboratory "Marianthi Simou", National and Kapodistrian University of Athens, Greece

⁵  Meakins-Cristie Laboratories, McGill University, Montreal, Quebec, Canada

⁶  Medical School, University of Thessaly, 41222 Larissa, Greece

⁷  Associate Professor of Medicine and Chairman, 2^nd Pulmonary Department, National and Kapodistrian University of Athens, Medical School of Athens, "ATTIKON" University Hospital 1 Rimini Street, 12462 Haidari, Athens, Greece

author email corresponding author email

Journal of Inflammation 2007, 4:14doi:10.1186/1476-9255-4-14

Published:	19 June 2007

Abstract

Background

Recently it was shown that in Idiopathic Pulmonary Fibrosis (IPF) tissue infiltrating CD₈₊ T lymphocytes (TLs) are associated with breathlessness and physiological indices of disease severity, as well as that CD₈₊ TLs recovered by bronchoalveolar lavage (BAL) relate to those infiltrating lung tissue. Since BAL is a far less invasive technique than tissue biopsy to study mechanisms in IPF we further investigated the usefulness offered by this means by studying the relationship between BAL macrophages, neutrophils, eosinophils, CD₃₊, CD₄₊, CD₈₊, CD_8+/38+ TLs and CD₄₊/CD₈₊ ratio with breathlessness and physiological indices.

Patients and methods

27 IPF patients, 63 ± 9 years of age were examined. Cell counts were expressed as percentages of total cells and TLs were evaluated by flow cytometry. FEV₁, FVC, TLC, RV, DLCO, PaO₂, and PaCO₂ were measured in all. Breathlessness was assessed by the Medical Research Council (MRC) chronic dyspnoea scale.

Results

CD₈₊ TLs correlated positively (r_s = 0.46, p = 0.02), while CD₄₊/CD₈₊ ratio negatively (r_s = -0.54, p = 0.006) with the MRC grade. CD₈₊ TLs correlated negatively with RV (r_s = -0.50, p = 0.017). CD_8+/38+ TLs were negatively related to the FEV₁ and FVC (r_s = -0.53, p = 0.03 and r_s = -0.59, p = 0.02, respectively). Neutrophils correlated positively with the MRC grade (r_s = 0.42, p = 0.03), and negatively with the DLCO (r_s = -0.54, p = 0.005), PaO₂ (r_s = -0.44, p = 0.03), and PaCO₂ (r_s = -0.52, p = 0.01).

Conclusion

BAL CD₈₊ TLs associations with physiological and clinical indices seem to indicate their implication in IPF pathogenesis, confirming our previous tissue study.