Lung Lavage Samples Research Articles

Surfactant protein A (SP-A) is decreased in acute parenchymal lung injury associated with polytrauma.

To further investigate if the pulmonary surfactant system is altered in acute parenchymal lung injury of adults following polytrauma we measured SP-A level and phospholipid composition in 150 sequentially obtained lung lavage samples from poly-traumatized patients (n = 19) beginning at the day of trauma and ending 18 days later or when the patient was extubated. Out of the 19 patients studied 10 had severe parenchymal lung injury (ARDS), nine had moderate lung injury. SP-A was measured using a two-monoclonal sandwich ELISA-assay. Phospholipids were separated using high-performance liquid chromatography and their composition was calculated by comparison with standard phospholipid mixtures. We found immunoreactive SP-A concentrations ranging from 0.1 micrograms ml-1 to 8.5 micrograms ml-1 lung lavage fluid obtained from all patients. The mean SP-A concentration in patients who had severe parenchymal lung injury (ARDS) was 1.06 +/- 0.16 micrograms ml-1 lavage fluid, the mean concentration in patients who had only moderate parenchymal lung injury was 1.92 +/- 0.18 micrograms ml-1 lavage fluid. Both concentrations were lower than in healthy controls (2.74 +/- 0.3 micrograms ml-1 lavage fluid; n = 12). In patients who had moderate lung injury the SP-A level normalized, but in patients who had severe lung injury the SP-A level remained low during the timespan examined. SP-A alterations did not correlate to changes in phospholipid composition as determined in lung lavage samples of individual patients. We conclude that alveolar SP-A concentrations decrease in polytraumatized patients who have acute parenchymal lung injury soon after the trauma occurs.(ABSTRACT TRUNCATED AT 250 WORDS)

Disordered pathways of fibrin turnover in lung lavage of premature infants with respiratory distress syndrome.

Premature infants who have self-limited respiratory distress syndrome (RDS) rapidly improve, whereas infants with a complicated respiratory course are more likely to develop bronchopulmonary dysplasia (BPD), a chronic lung disorder that is the result of prolonged lung injury and impaired healing. The balance of competing activities of coagulation and fibrinolysis may contribute to the premature lung's response to acute injury and determine, in part, whether there is early resolution or protracted alveolar inflammation. To determine the relative activities of the coagulation and fibrinolytic pathways in neonatal lung injury, procoagulant (PC) and plasminogen activator (PA) activities were measured in undiluted cell-free lung lavage samples obtained serially over the first 28 days of life from 11 infants with self-limited RDS, 11 infants with evolving BPD, and 5 mechanically ventilated control infants without lung disease. Lung lavage from all three groups contained readily detectable procoagulant activity due mainly to the tissue factor-Factor VII complex. Plasminogen activator activity was relatively high in control lavage samples but depressed on the first day of life in the two groups of infants with lung disease: median, 0.3814 IU/ml (control); 0.0541 IU/ml (RDS); and 0.0454 IU/ml (BPD), p < 0.05 in each case compared with control. Two infants with severe lung disease had no detectable plasminogen activator activity in lung lavage on the first day of life. Depressed fibrinolytic activity correlated with severity of lung disease assessed radiographically and by pulmonary function measurements. Plasminogen activator activity was due to both tissue plasminogen activator and urokinase.(ABSTRACT TRUNCATED AT 250 WORDS)

Influenza Virus-specific T Cells Lead to Early Interferon in Lungs of Infected Hosts: Development of a Sensitive Radioimmunoassay

A sensitive immunoradiometric assay for murine interferon gamma (MuIFN-gamma) has been developed and used reproducibly to measure low levels of MuIFN-gamma in lung lavage samples from influenza-infected mice. In control infected mice, IFN-gamma peaked on day 6, but transfer of virus-specific cytotoxic T cells or T helper cells, which reduced virus replication in vivo in infected hosts, resulted in an earlier peak on day 4.

Uptake of the 35 kDa major surfactant apoprotein (SP-A) by neonatal rabbit lung tissue

Secreted surfactant is made up of both phospholipid and protein components. Therefore, we investigated the possibility that surfactant apoproteins might be taken up by the alveolar type II cell in a manner similar to the uptake of surfactant phosphatidylcholines. Day 2 neonatal rabbits were infused via the trachea with a solution of carrier surfactant and 125I-labelled surfactant apoprotein (SP-A, M r approx. 35 000). Most of the 125I-SPA-A remained within the alveolus; however, a fraction of the 125I-SP-A was taken up by the lung tissue from the alveolus in a time-dependent manner. The small amount of radiolabeled material detected in blood, liver or kidney tissues of 125I-SP-A-infused animals was not trichloroacetic acid (TCA) precipitable i.e., probably represented degradation products. In contrast, the proportion of TCA-precipitable 125I-SP-A in lung tissue or lavage samples did not change as function of time after tracheal administration. Two-dimensional gel electrophoresis of the 125I-SP-A present in the lavage samples or associated with lung tissue was used to show that a small proportion of the 125I-SP-A was partially degraded in the lung tissue and alveolus. These data are suggestive that the SP-A is taken up by lung tissue, perhaps in a manner similar to the uptake of surfactant phospholipid by the alveolar type II cell.

Lung immunoglobulins in the sudden infant death syndrome.

The incidence of the sudden infant death syndrome parallels that of respiratory tract infections in the paediatric community. On the basis that the aetiology of the sudden infant death syndrome may lie in an unusual response to a trivial intercurrent respiratory infection a necropsy study was carried out investigating pulmonary immunoglobulins in 16 victims of the syndrome and a series of infants (controls) who had died of non-pulmonary causes. Compared with the controls victims of the sudden infant death syndrome had grossly raised concentrations of IgG, IgM, and to a less extent IgA in lung lavage samples. In addition, pulmonary interstitial and terminal airway cells expressing these immunoglobulins were identified far more often in victims than controls. The study failed to determine whether the increased immunoglobulin concentrations were a consequence of an unusual response to a trivial infection or an expression of otherwise altered immunological control in the respiratory tract. Epidemiological evidence and the findings of this study suggest that the respiratory tract is the prime target organ in the sudden infant death syndrome.

Surface-tension measurements of pulmonary lavage from ozone-exposed rats.

Ozone, an important component of photochemical air pollution, has been shown to cause morphological and functional changes in the lung after acute, high-level exposure in controlled animal studies. Previous exposures of rats to 0.8 ppm ozone for 18 h showed trends toward decreased lung volumes, as well as modifications in phospholipid composition of lung lavage fluid. These results suggested that exposure to ozone may have diminished the ability of surfactant to reduce surface tension. The purpose of this pilot study was to determine if changes in the surface tension of lavaged pulmonary surfactant occur with ozone exposure. The lavage fluid from rats exposed to ozone at 0.8 ppm for 18 h had a 360% increase in protein and a 30% increase in lipid phosphorus content. Lung lavage samples from ozone-exposed rats were more potent in reducing surface tension as measured on a Wilhelmy plate balance. This difference was evident whether determined with half the total lavage or with equivalent microgram amounts of lipid phosphorus. It is concluded that at this dose and duration of ozone exposure, contrary to our hypothesis, surface-tension-lowering ability of surfactant increases and therefore does not appear to be a contributory factor in the previously observed changes in pulmonary function.

The chronically reserpinized rat as an animal model for cystic fibrosis: I. Acute effect of isoproterenol and pilocarpine upon pulmonary lavage fluid.

Summary: Lung lavage samples from rats treated in a chronic fashion with reserpine had mean increases of 133, 170, and 120% in the total protein, lipid, and carbohydrate contents, respectively, when compared with those of untreated control animals, when these values were expressed in terms of body weight. An acute single ip injection of the β-adrenergic agent isoproterenol (10 mg) increased the glycoprotein content of pulmonary lavage fluid from control rats approximately 15–19%, but only 9–10% in those from reserpine treated rats. By contrast, pilocarpine (10 mg), administered in the same manner, caused a 15% increase in the total protein, carbohydrate, and lipid content of lavage samples from control rats and increased these same constituents in the lavage samples of reserpine treated rats 98, 102, and 80%, respectively. The increased total carbohydrate content in the lavage samples of the treated animals was not associated with changes in the percent distribution of neutral sugars, amino sugars, or sialic acid. The ratio of these various sugar components did not change in the lavage samples of control or reserpine treated rats upon stimulation with either pilocarpine or isoproterenol. The increased total lipid content fround in the lavage samples from the treated rats probably results from an increase in phospholipids. A decrease in phospholipid content occurred in the lavage samples of reserpine treated rats upon stimulation, while the opposite was observed in those of control animals. Chronic treatment of rats with reserpine, thus, appears to induce an enhanced production of glycoproteins in the airways and to interfere with phospholipid metabolism in the lung. In addition, the drug treatment enhances the secretory response to pilocarpine in comparison with the responses of control animals. The enhanced response or hypersecretion of glycoproteins is a quantitative one and does not seem to involve alterations in the ratios or distribution of the various sugar components. This disturbance in the secretory function of the respiratory tract, a target organ which is prominently involved in cystic fibrosis (CF) together with alterations in other exocrine glands which resemble those of CF patients, makes the reserpine treated rat a useful model for the further study of possible pathogenetic mechanisms in CF.Speculation: The experimental animal model for CF developed by the chronic administration of reserpine to rats has been found to have changes in the protein content of lung lavage samples, in addition to morphologic and secretory alterations in the salivary glands and the pancreas. Further analysis of the organic composition of lung lavage samples shows that the protein, carbohydrate, and lipid contents are significantly increased after chronic reserpine administration and that the response to stimulation with pilocarpine is enhanced in the treated animals when compared to that of untreated control rats. It therefore appears that chronic reserpine administration causes a hypersecretion of glycoproteins and changes in lipid metabolism in the respiratory tract of the rat and that, in conjunction with previous findings in other exocrine glands, these effects on lung function make the reserpine treated rat a useful tool for the study of the pathologic disturbance seen in the major exocrine glands affected in CF.

The chronically reserpinized rat as a possible animal model for cystic fibrosis. IV. The protein composition of pulmonary lavage fluid.

Lung lavage samples obtained from patients with cystic fibrosis (CF) had significantly higher levels of total protein per ml lavage fluid (0.49 vs. 0.30 mg/ml). A significant increase in the absolute and relative amounts of a low molecular weight glycoprotein (15,000 mol wt) was noted in lavage specimens from CF patients. Reserpine-treated rats also showed a significant increase in the total protein recovered in the lung lavage fluid with a 233% increase in the absolute and relative amounts of a low molecular weight glycoprotein (15,000 mol wt). Thus, reserpine induced changes in the secretions of the lung of the rat which are similar to those observed in samples obtained from the lung of CF patients.