The demonstration of phospholipase activity in bronchoalveolar secretions of experimental animals with P carinii pneumonia, whether derived from host or organism, suggests several possible mechanisms of cellular injury. Phospholipase Ag (PLAJ hydrolyzes membrane phospholipids, producing membrane-damaging lysophospholipids and free fatty acids, and has been implicated in the pathogenesis of adult respiratory distress syndrome. PLA action…
Pulmonary complications of human immunodeficiency virus (HIV) infection are common causes of morbidity and mortality among patients with AIDS. Pneumocystis carinii pneumonia has been the most common index diagnosis of AIDS and is among the most frequent causes of death. Nonspecific interstitial pneumonitis (NIP), characterized by diffuse alveolar damage and macrophage or lymphocytic infiltration, or…
The opposite would be classic cases of HP as characterized by bird fanciers lung where exposure could be insidious and long term. Since the function of CD4 + T cells in summer-type HP and those in bird fanciers lung was not compared, there is a possibility that the function of CD4+ T cells may not…
In addition, the chronic stage of bird fanciers lung has been reported to develop pulmonary fibrosis and have CD4+ T-cell-dominant BAL findings. In the present study, the fibrosis group revealed that the onset was insidious and the clinical symptoms to the home environments were not severe but mild. These observations lend support to the hypothesis…
These patients had been diagnosed as having HP because (1) they showed nonacute but unequivocal clincal symptoms related to the home environments, (2) their sera and BAL fluids had low but significant antibodies against several fungi detected by the enzyme-linked immunosorbent assay, and (3) their lung biopsy specimens showed granulomatous lung lesions. In this study,…
Although the reduced lymphocyte and neutrophil levels in the BAL fluids of the fibrosis group were consistent with the chronic nature of the disease, the number of lymphocytes was nevertheless increased above the normal ranges, indicating that the disease was still active. The determination of the T-lympho-cyte subsets revealed that increased lymphocytes were predominantly CD8…
There were no significant differences in ages between the two groups. The presence of granuloma was not always observed and was not correlated with pulmonary fibrosis (Table 1). The mode of onset was strongly related to the development of lung fibrosis. Nine of nine patients with insidious onset had lung fibrosis, whereas eight of eight…
Results Lung Fibrosis in Hypersensitivity Pneumonitis Lung fibrosis of grade 2 was found in 9 of 17 patients (fibrosis group), 5 patients with the bird fanciers disease, and 4 of 6 patients with HP of unknown antigen (Table 1). The other eight patients showed no lung fibrosis (nonfibrosis group). All cases evaluated were categorized into…
Grading of Fibrosis and Cell Infiltration of the Lung The degree of lung fibrosis was evaluated utilizing CT scans. The scans were performed on scanners (GE 9800 or GE 8800) at 1- or 1.5-cm and interval using 10-mm coUination from the apex of the lungs to the base of the diaphragm during breath holding after…
Bronchoalveolar lavage was performed as previously reported. Briefly, 50 ml of physiologic saline solution was introduced to the segmental bronchus of either the right B4 or B5 through the fiberoptic bronchoscope, followed by suction at low pressure. This procedure was repeated three times. A transbronchial lung biopsy (TBLB) was performed from parenchyma through right B8a…
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