Bronchoalveolar Lavage in Systemic Sclerosis Patients: A Systematic Review

Area of Science:

• Pulmonary Medicine
• Rheumatology
• Immunology

Background:

• Systemic sclerosis (SSc) frequently involves the lungs.
• Bronchoalveolar lavage (BAL) is a diagnostic tool for pulmonary conditions.

Purpose of the Study:

• To systematically review the literature on the value of BAL in evaluating pulmonary involvement in SSc.

Main Methods:

• Systematic literature review of clinical trials from 1980-2019.
• Searched PubMed and Scielo databases using keywords: scleroderma, systemic sclerosis, interstitial lung disease, bronchoalveolar lavage.
• Analyzed 22 relevant papers.

Main Results:

• Increased BAL cellularity (alveolitis) correlated with worse clinical symptoms, pulmonary function, and radiological findings.
• Elevated interleukin levels (TNF-α, IL-6, IL-7, IL-8) in BAL were associated with impaired lung function and increased disease severity.
• The majority of studies indicated a link between BAL findings and disease severity.

Conclusions:

• Alveolitis and increased cytokines in BAL appear to be markers of more severe pulmonary disease and worse prognosis in SSc.
• The added clinical value of BAL compared to other non-invasive procedures remains uncertain.