Document Detail

Inflammatory cells in lung disease associated with rheumatoid arthritis.
MedLine Citation:
PMID:  19602788     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: Rheumatoid arthritis (RA) is associated with numerous pulmonary manifestations. However, the inflammatory mechanism remains undetermined. We studied the features of inflammatory cells in bronchoalveolar lavage (BAL) fluid and biopsy lung tissue from patients with RA-associated lung disease. METHODS: BAL findings were statistically compared between diseases. We divided RA patients into two groups, airway lesion group (AW) and interstitial lesion group (INT) according to predominant HRCT findings and compared the BAL findings. We immunohistochemically stained lung tissue for CD4, CD8, CD20, and CD163 and counted the immunopositive cells in five different regions. PATIENTS: Twenty patients fulfilling the Japanese criteria for RA, 13 patients with systemic sclerosis (SSc), and 21 patients with polymyositis and dermatomyositis (PM-DM) with pulmonary disease detected by high-resolution CT (HRCT) were enrolled in this study. RESULTS: As for BAL in RA, we found a lower lymphocyte frequency with higher CD4/8 ratio compared with PM-DM and a higher neutrophil percentage than both PM-DM and SSc. Nine and eleven patients with RA were classified into AW and INT groups, respectively. BAL findings did not differ between the two groups. Immunohistochemically, most CD4(+) and CD20(+) lymphocytes were accumulated in lymphoid follicles and in the alveolar wall and T-lymphocytes; in particular CD8(+) lymphocytes were predominant in lung interstitium. CONCLUSION: These results suggest that 1) neutrophils may play an important role, 2) the inflammatory mechanism may be similar between airway lesion and interstitial pneumonia, and 3) CD8(+) lymphocytes may be major inflammatory cells in lung interstitium in RA-associated interstitial lung disease.
Yoshiya Nagasawa; Toshinori Takada; Takashi Shimizu; Jun-ichi Narita; Hiroshi Moriyama; Masaki Terada; Eiichi Suzuki; Fumitake Gejyo
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Publication Detail:
Type:  Journal Article     Date:  2009-07-15
Journal Detail:
Title:  Internal medicine (Tokyo, Japan)     Volume:  48     ISSN:  1349-7235     ISO Abbreviation:  Intern. Med.     Publication Date:  2009  
Date Detail:
Created Date:  2009-07-15     Completed Date:  2009-10-01     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9204241     Medline TA:  Intern Med     Country:  Japan    
Other Details:
Languages:  eng     Pagination:  1209-17     Citation Subset:  IM    
Division of Respiratory Medicine, Graduate School of Medical and Dental Sciences, Niigata University, Niigata.
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MeSH Terms
Arthritis, Rheumatoid / complications*
Bronchoalveolar Lavage Fluid / cytology
Lung Diseases / complications*,  immunology*,  pathology
Middle Aged
Young Adult

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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