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THE ACUTE PHASE RESPONSE INDUCED BY BRONCHOSCOPY WITH LAVAGE
Citation:
Montilla, T., D. Levin, M Bassett, A J. Ghio, AND Huang, YuhChin T. THE ACUTE PHASE RESPONSE INDUCED BY BRONCHOSCOPY WITH LAVAGE. Presented at American Thoracic Society Annual Conference, San Diego, CA, March 20 - 25, 2005.
Description:
Bronchoscopy has been used to evaluate the inflammatory responses in vitro and in vivo. The procedure may affect acute inflammation in the lower respiratory tract. We reviewed consecutive bronchoscopies done in normal healthy non-smokers between April, 1998 and April, 2004. The bronchoscopy with lavage was performed using at least 170 ml of sterile saline to the superior segment of the lingula and one of the segments of the right middle lobe. Plasma levels of acute phase reactants and inflammatory mediators were also obtained in additional bronchoscopy subjects pre-, immediately post- and 24 hours post-procedure. A total of 347 bronchscopies met the criteria. Two patients had complaints of mild fever post-procedure. The total cell counts in the lavage fluid varied by approximately 40 fold (2 to 88 x 106). By logistic regression, the total cell count only negatively correlated with height, but not with age, sex, weight or the bronchoscopist. Intraindividual variability of the cell count was significantly smaller. There were no differences in plasma levels of ACE, soluble ICAM-1, interleukin-8 and nitrite/nitrate before and after bronchoscopy. However, significant increases in the white blood cell count and acute phase reactants (i.e. C reactive protein, fibrinogen, and ferritin) were noted. We conclude that there is significant variability in the retrieveable alveolar macrophages by bronchoscopy in normal volunteers and acute phase reactants can be induced. Research bronchoscopy in healthy normal volunteers is a safe procedure. Human research involving bronchoscopy that utilizes these parameters as endpoints may need to take into account of the variability of cell counts and the effects related to the enhanced production of acute phase responses. (Abstract does not reflect USEPA policy).