Abstract
We examined the effects of bronchoalveolar lavage (BAL) and BAL fluid characteristics on the systemic proinflammatory cytokine expression and their relation to clinical and laboratory findings. Thirty patients suspected to have lung cancer were subjected to fiber-optic bronchoscopy (FOB) and BAL. Clinical and laboratory findings were determined at baseline, 4 h, and 24 h, including lung auscultation, temperature, chest X-ray, WBC, neutrophils, and serum IL-1β, IL-6, and TNF-α. BAL fluid characteristics were determined including cytokine levels. Fifteen volunteers served as controls to determine serum variation of the same cytokines. Significant temperature elevation was defined as 1°C increase compared to baseline. BAL was associated with temperature and serum TNF-α and IL-6 but not IL-1β increase at 4 h. Four patients (13.3%) developed temperature over 38°C. In controls there were no significant changes between baseline and 24 h measurements for the same cytokines. Eleven patients (36.6%) developed a significant temperature elevation 4 h after BAL. These patients had a statistically significant (p < 0.05) increase in serum IL-6 at 4 h and in TNF-α at both 4 and 24 h after BAL compared with the nonsignificant temperature increase group. BAL characteristics were not different between the two groups. On the other hand, BAL fluid IL-6 and TNF-α levels were significantly higher (p < 0.05) in the nonfever group. Significant temperature increase was observed in 36.6% of the patients undergoing BAL and associated with significant serum TNF-α and IL-6 increase at 4 h. Lung cytokines levels, alveolar macrophages, and BAL fluid characteristics are not related to temperature and serum proinflammatory cytokine increase. The hypothesis of alveolar macrophages derive from cytokine production and shift to the systemic circulation cannot be supported by our data.
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InstitutionalAuthorNameAmerican Thoracic Society (1990) ArticleTitleClinical role of bronchoalveolar lavage in adults with pulmonary disease. Am Rev Respir Dis 142 481–486 Occurrence Handle2200319
R Baughman JA Golden FM Keith (2000) Bronchoscopy. Lung Biopsy and other Procedures. EJ Murray AJ Nabel JR Mason AH Boushey (Eds) Textbook of Respiratory Medicine, 3rd ed, vol. I. WB Saunders Philadelphia 725–780
InstitutionalAuthorNameBritish Thoracic Society (2001) ArticleTitleGuidelines on diagnostic flexible bronchoscopy. British Thoracic Society Bronchoscopy Guidelines Committee, a Sub-committee of the Standards of Care Committee of the British Thoracic Society. Thorax 56 IssueIDSuppl 1 i1–i21
MJ Cement JM Luce PC Hopewell (1988) ArticleTitleDiagnosis of pulmonary diseases. Clin Chest Med 9 497–499 Occurrence Handle3044685
P Cole C Turton H Lanyon J Collins (1980) ArticleTitleBronchoalveolar lavage for preparation of free lung cells: technique and complications. Br J Dis Chest 74 IssueID3 273–278 Occurrence Handle1:STN:280:Bi6D3sblsFY%3D Occurrence Handle7000129
DB Ettensohn MJ Jankowski PG Duncan PA Lalor (1988) ArticleTitleBronchoalveolar lavage in the normal volunteer subject: technical aspects and inter-subject variability. Chest 94 IssueID2 275–280 Occurrence Handle1:STN:280:BieB1czitl0%3D Occurrence Handle3396403
WJ Fulkerson (1984) ArticleTitleMedical intelligence, current concepts of fiberoptic bronchoscopy. N Engl J Med 311 511–515 Occurrence Handle1:STN:280:BiuB2s%2Fls1I%3D Occurrence Handle6749209
RB Low GS Davis MS Giancola (1978) ArticleTitleBiochemical analyses of bronchoalveolar lavage fluids of healthy human volunteer smokers and nonsmokers. Am Rev Respir Dis 118 IssueID5 863–875 Occurrence Handle1:CAS:528:DyaE1MXmslClug%3D%3D Occurrence Handle736357
JW Sobolowski LW Burgher FL Jones (1987) ArticleTitleGuidelines for fiberoptic bronchoscopy in adults. Am Rev Respir Dis 136 1066 Occurrence Handle3662229
JP Utz UBS Prakash (1994) Indications for and contraindications to bronchoscopy. UBS Prakash (Eds) Bronchoscopy. Raven Press New York 81–89
EM Cordasco Jr AC Mehta M Ahmad (1991) ArticleTitleBronchoscopically induced bleeding: A summary of nine years' Cleveland Clinic experience and review of the literature. Chest 100 IssueID4 1141–1147 Occurrence Handle1:STN:280:By2D3cnnsFQ%3D Occurrence Handle1914575
WF Credle JF Smiddy RC Elliott (1974) ArticleTitleComplications of fiberoptic bronchoscopy. Am Rev Respir Dis 109 67 Occurrence Handle4809166
MI Pedro–Botet J Ruiz M Sabria et al. (1991) ArticleTitleBacteraemia after fiberoptic bronchoscopy: Prospective study. Enferm Infecc Microbiol Clin 9 159–161 Occurrence Handle1:STN:280:By6A383ht1Q%3D Occurrence Handle1863608
CA Pue ER Pacht (1995) ArticleTitleComplications of fiberoptic bronchoscopy at a university hospital. Chest 107 IssueID2 430–432 Occurrence Handle1:STN:280:ByqC2crgsFQ%3D Occurrence Handle7842773
Y Yigla I Oren L Bentur A Solomonov N Elias R Altshuler AE Rubin F Lejbkowicz (1999) ArticleTitleIncidence of bacteremia following fiberoptic bronchoscopy. Eur Respir J 14 IssueID4 789–791 Occurrence Handle10.1034/j.1399-3003.1999.14d10.x Occurrence Handle1:STN:280:DC%2BD3c%2FjslyqsA%3D%3D Occurrence Handle10573221
A Krause B Hohberg F Heine M John GR Burrnester C Witt (1997) ArticleTitleCytokines derived from alveolar macrophages induce fever after bronchoscopy and bronchoalveolar lavage. Am J Respir Crit Care Med 155 IssueID5 1793–1797 Occurrence Handle1:STN:280:ByiB1MbnsVE%3D Occurrence Handle9154894
TJ Standiford SL Kunkel RM Stricter (1991) ArticleTitleElevated serum level of tumor necrosis factor alpha after bronchoscopy and bronhoalveolar lavage. Chest 99 1529–1530 Occurrence Handle1:STN:280:By6B2czks1M%3D Occurrence Handle2036847
T Terashima K Amakawa A Matsumaru S Van Eeden JC Hogg K Yamaguchi (2001) ArticleTitleBAL induces an increase in peripheral blood neutrophils and cytokine levels in healthy volunteers and patients with pneumonia. Chest 119 1724–1729 Occurrence Handle10.1378/chest.119.6.1724 Occurrence Handle1:STN:280:DC%2BD3MzjtFGqsA%3D%3D Occurrence Handle11399697
E Picard S Schwartz S Goldberg T Glick T Villa E Kerem (2000) ArticleTitleA prospective study of fever and bacteremia after flexible fiberoptic bronchoscopy in children. Chest 117 573–577 Occurrence Handle10.1378/chest.117.2.573 Occurrence Handle1:STN:280:DC%2BD3c7jsFyitA%3D%3D Occurrence Handle10669705
AK Sundgren P Ostlund T Bartfai (1998) ArticleTitleIL-6 is essential in TNF-α induced fever. Am J Physiol 275 IssueID6 R2028–2034 Occurrence Handle9843893
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Abbreviations: NSCLC = non-small-cell lung carcinoma, BAL = bronchoalveolar lavage, FOB = fiber-optic bronchoscopy, IL-6 = interleukin 6, IL-1β = interleukin 1-beta, TNF-α = tumor necrosis factor alpha, WBC = white blood cells, G-CSF = granulocyte colony stimulating factor, IM = intramuscular, ECG = electrocardiogram.
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Georgiades, G., Myrianthefs, P., Venetsanou, K. et al. Temperature and Serum Proinflammatory Cytokine Changes in Patients with NSCLC after BAL . Lung 181, 35–47 (2003). https://doi.org/10.1007/s00408-003-1001-6
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DOI: https://doi.org/10.1007/s00408-003-1001-6