Increase of Activated T-cells in BAL Fluid of Japanese Patients With Bronchiolitis Obliterans Organizing Pneumonia and Chronic Eosinophilic Pneumonia

¹ From the Third Department of Internal Medicine, Miyazaki Medical College, Miyazaki, Japan
² From the Second Department of Internal Medicine, Nagasaki University School of Medicine, Nagasaki, Japan

To study the role of T cells in bronchiolitis obliterans organizing pneumonia (BOOP) and chronic eosinophilic pneumonia (CEP) and to examine the influence of differing racial background, T-cell subsets in bronchoalveolar lavage (BAL) fluid (BALF) and in peripheral blood of 8 Japanese patients with idiopathic BOOP and 5 with CEP were compared with those of 15 normal subjects. The BALF pattern in BOOP was characterized by a significantly high number and percentage of lymphocyte and by a low CD4 to CD8 ratio compared with patients with CEP and healthy volunteers. Patients with CEP showed a significantly higher percentage of BALF eosinophils compared with other groups. There was no significant difference in BALF CD4 to CD8 ratio between patients with CEP and volunteers. Two-color analysis of T-cell subsets revealed that CD3⁺HLA-DR⁺ cells (activated T cell) in BALF of patients with BOOP and CEP increased significantly compared with volunteers, while BALF CD3⁺CD25⁺ cells (interleukin 2 receptor⁺ T-cell) did not. In addition, BALF CD8⁺HLA-DR⁺ cells (activated suppressor/cytotoxic T cell) in patients with BOOP and CD4⁺HLA-DR⁺ cells (activated helper T cell) in patients with CEP were significantly higher than levels detected in healthy subjects. The percentage of CD8⁺CD57⁺ cells and the number of CD8⁺ CD11b^- cells (cytotoxic T cell) in BALF were significantly higher in patients with BOOP compared with patients with CEP and healthy volunteers. There were no significant differences in the expression of peripheral blood T-lymphocyte surface antigens among the groups. These findings indicate that cytotoxic T cells in Japanese patients with idiopathic BOOP and helper T cells in CEP appear in the lungs is consistent with a previous report in Caucasians, supporting the hypothesis that T cells may play an important role in the pathogenesis of these diseases.

Key Words: bronchiolitis obliterans organizing pneumonia • bronchoalveolar lavage • chronic eosinophilic pneumonia • flow cytometry • T-cell subset

Submitted on September 13, 1994
Accepted on January 11, 1995

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