Pulmonary function tests of Mycobacterium avium-intracellulare infection: correlation with bronchoalveolar lavage fluid findings
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Published on: May 4, 2017
Y Yamazaki1, K Kubo, K Fujimoto
1Department of Medicine, Shinshu University School of Medicine, Matsumoto, Japan.
Insights
Pulmonary Mycobacterium avium-intracellulare (MAI) infection in women without lung disease involves small airway dysfunction. This dysfunction is linked to neutrophil-driven inflammation, as indicated by elevated cytokines and enzymes in bronchoalveolar lavage fluid.
Area of Science:
- Pulmonary Medicine
- Infectious Diseases
- Immunology
Background:
- Pulmonary Mycobacterium avium-intracellulare (MAI) infection predominantly affects thin, middle-aged to older females without prior lung disease or immunodeficiency.
- Characteristic chest CT findings include multiple nodules and bronchiectasis.
Purpose of the Study:
- To investigate the pathophysiology of MAI infection in individuals without predisposing lung disease or immunodeficiency.
- To correlate pulmonary function test (PFT) and bronchoalveolar lavage fluid (BALF) findings.
Main Methods:
- Pulmonary function tests (PFTs) and bronchoalveolar lavage (BAL) were performed on 15 female patients with MAI infection and 5 healthy female volunteers.
- BAL fluid was collected from affected lung segments identified by chest CT.
Main Results:
- Patients exhibited increased residual volume, increased slope of phase III (DeltaN2), and decreased V(25) compared to controls.
- BALF revealed significant increases in neutrophils, activated CD4 lymphocytes, proinflammatory cytokines, and neutrophil elastase (NE) in patients.
- A significant correlation was found between DeltaN2 and IL-8 concentration, IL-8/albumin ratio, and NE/albumin ratio in BALF.
Conclusions:
- Small airway dysfunction in MAI infection without predisposing lung disease is associated with inflammation.
- Neutrophil activity appears to play a key role in this inflammatory process.
Background:
The pulmonary Mycobacterium avium-intracellulare (MAI) infection in patients with neither predisposing lung disease nor immunodeficiency is recognized to occur predominantly in older or middle-aged and thin females, and has characteristic chest computed tomography (CT) findings with multiple nodules and bronchiectasis.
Objective:
To investigate the pathophysiology with and individual of MAI infection with neither predisposing lung disease nor immunodeficiency. The bronchoalveolar lavage (BAL) fluid (BALF) was recovered directly from the affected segments identified by the chest CT.
Methods:
We performed a pulmonary function test (PFT) and BAL in 15 patients (all females) with MAI infection and 5 normal female volunteers.
Results:
The residual volume and the slope of phase III (DeltaN(2)) were significantly increased and V(25) was significantly decreased in the 15 patients compared with the normal control subjects. The patients' BALF showed significant increases in neutrophils and activated CD4 lymphocytes, proinflammatory cytokines, and neutrophil elastase (NE) compared to those in the controls. We analyzed the PFT and BALF findings, and observed a significant correlation between the DeltaN(2) and interleukin (IL)-8 concentration (r = 0.65, p < 0.01), IL-8/albumin ratio (r = 0.51, p < 0.05) and NE/albumin ratio (r = 0.57, p < 0.05) in the BALF and DeltaN(2), respectively.
Conclusions:
These findings suggest that small airway dysfunction in MAI infection without predisposing lung disease is related to the inflammation probably related to the neutrophil.
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