Smoking-induced changes in epithelial lining fluid volume, cell density and protein

Burke, William M.; Roberts, Caleb; Bryant, David; Cairns, D.; Yeates, Michael G.; Morgan, Graeme; Martin, Barbara J.; Blake, Hu A.; Penny, Ronald; Zaunders, John

doi:10.1183/09031936.93.05070780

Cited by 28 publications

(5 citation statements)

References 15 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In smokers without lLD, the ELF volume was increased, whilst the albumin concentration was reduced compared with nonsmokers. This is likely to be a result of either increased ELF production or reduced clearance [7]. In contrast, in subjects with lLD, the ELF volume was increased whilst the albumin content was not significantly different from that of the nonsmokers without lLD (table 1).…”

Section: Discussionmentioning

confidence: 93%

“…All patients with connective tissue diseases attending an immunology clinic were asked to participate in this study, irrespective of whether they had pulmonary symptoms, and thus to this extent were unselected. The connective tissue diseases included scleroderma alone (16), scleroderma with Sjogren's syndrome (29), Sjogren's syndrome alone (15), mixed connective tissue disease (2), mixed connective tissue disease with Sjogren's syndrome (4), systemic lupus erythematosus with (7), or without Sjogren's syndrome (7), rheumatoid arthritis (1), polymyositis (I) and 10 patients with vasculitis or variety of other less welldefined connective tissue diseases. Patients with scleroderma, systemic lupus erythematosus, rheumatoid arthritis or mixed connective tissue disease each fulfilled the American Rheumatism Association criteria for that diagnosis.…”

Section: Patient Selectionmentioning

confidence: 99%

“…One suggested method for overcoming this problem is to use urea as an endogenous marker of ELF dilution [5], thus allowing the estimation of an apparent ELF volume. This then provides a frame of reference to measure protein concentration, as well as a more useful method for expressing cell numbers [6,7]. Although imperfect, this method allows consistent compensation to be made for the variable dilution of the ELF.…”

mentioning

confidence: 99%

See 2 more Smart Citations

Changes in epithelial lining fluid albumin associated with smoking and interstitial lung disease

Roberts

Cairns²,

Bryant

et al. 1993

Eur Respir J

View full text Add to dashboard Cite

Albumin is an important plasma protein which is useful in the assessment of in vivo membrane permeability in the lung. In subjects with interstitial lung disease (ILD) the relationship between albumin recovered from bronchoalveolar lavage (BAL) and other markers of inflammatory activity may provide useful information of the pathogenesis of the disease process. Unfortunately, its measurement is hampered by the variable dilution in BAL fluid. In this study, urea was used as a marker of epithelial lining fluid (ELF) dilution allowing the calculation of an apparent epithelial lining fluid volume and adjusted albumin content. We examined the relationship between ELF albumin content and BAL cell counts, immunoglobulin content, respiratory function tests and gallium lung scans in both smokers and nonsmokers with and without interstitial lung disease. Forty seven subjects with connective tissue disease and interstitial lung disease and 51 subjects with either connective tissue disease but no pulmonary involvement or non pulmonary malignancy (18 current smokers) underwent BAL, gallium lung scans and respiratory function tests. The subjects with ILD were further subdivided into those with active ILD or bronchiolitis using cluster analysis. In smokers without ILD an increased ELF volume and a decrease in ELF albumin were found. Increased ELF albumin was related to increased age. In subjects with ILD, increased albumin was strongly correlated with increased BAL lymphocyte absolute and differential counts, which overwhelmed any age or smoking effect. These findings suggest a possible causal relationship between lung vascular permeability and lymphocyte numbers in subjects with interstitial lung disease and reinforce the need to consider smoking and age as confounding factors in BAL analysis.

show abstract

Section: Discussionmentioning

confidence: 93%

Section: Patient Selectionmentioning

confidence: 99%

mentioning

confidence: 99%

See 1 more Smart Citation

Changes in epithelial lining fluid albumin associated with smoking and interstitial lung disease

Roberts

Cairns²,

Bryant

et al. 1993

Eur Respir J

View full text Add to dashboard Cite

show abstract

“…[12,13,15] Finally, alterations in the ELF volume, cell counts and protein concentrations in BAL have been associated with subjects who smoke and or have interstitial lung disease. [19,20] Therefore it is recommended that a standardized BAL procedure be established and used consistently to ensure that technical errors are minimized and that distal ELF samples are obtained. The assays for urea in plasma and BAL need to be precise and reliable.…”

Section: Elf Volume ¼mentioning

confidence: 99%

Penetration of Anti-Infective Agents into Pulmonary Epithelial Lining Fluid

Rodvold

George

Yoo

2011

Clinical Pharmacokinetics

208

205

View full text Add to dashboard Cite

The exposure-response relationship of anti-infective agents at the site of infection is currently being re-examined. Epithelial lining fluid (ELF) has been suggested as the site (compartment) of antimicrobial activity against lung infections caused by extracellular pathogens. There have been an extensive number of studies conducted during the past 20 years to determine drug penetration into ELF and to compare plasma and ELF concentrations of anti-infective agents. The majority of these studies estimated ELF drug concentrations by the method of urea dilution and involved either healthy adult subjects or patients undergoing diagnostic bronchoscopy. Antibacterial agents such as macrolides, ketolides, newer fluoroquinolones and oxazolidinones have ELF to plasma concentration ratios of >1. In comparison, β-lactams, aminoglycosides and glycopeptides have ELF to plasma concentration ratios of ≤1. Potential explanations (e.g. drug transporters, overestimation of the ELF volume, lysis of cells) for why these differences in ELF penetration occur among antibacterial classes need further investigation. The relationship between ELF concentrations and clinical outcomes has been under-studied. In vitro pharmacodynamic models, using simulated ELF and plasma concentrations, have been used to examine the eradication rates of resistant and susceptible pathogens and to explain why selected anti-infective agents (e.g. those with ELF to plasma concentration ratios of >1) are less likely to be associated with clinical treatment failures. Population pharmacokinetic modelling and Monte Carlo simulations have recently been used and permit ELF and plasma concentrations to be evaluated with regard to achievement of target attainment rates. These mathematical modelling techniques have also allowed further examination of drug doses and differences in the time courses of ELF and plasma concentrations as potential explanations for clinical and microbiological effects seen in clinical trials. Further studies are warranted in patients with lower respiratory tract infections to confirm and explore the relationships between ELF concentrations, clinical and microbiological outcomes, and pharmacodynamic parameters.

show abstract

“…Smoking affects the Bronchoalveolar Lavage fluid (BAL) cell profiles in different lung diseases, (34)(35)(36)(37)(38) and reference values for BAL fluid are potential diagnostic markers for interstitial lung diseases. (39,40) However, differential peripheral blood cell counts and lymphocyte subpopulations did not differ from the reference intervals between smokers and nonsmokers.…”

Section: Relative Class Values Of Monocytes and Dendritic Cellsmentioning

confidence: 99%

Determining reference ranges for immunological cells of healthy indigenous individuals from a region in Brazil

Morais,

Barbosa,

Almeida

et al. 2023

Einstein (São Paulo)

View full text Add to dashboard Cite

show abstract

Smoking-induced changes in epithelial lining fluid volume, cell density and protein

Cited by 28 publications

References 15 publications

Changes in epithelial lining fluid albumin associated with smoking and interstitial lung disease

Changes in epithelial lining fluid albumin associated with smoking and interstitial lung disease

Penetration of Anti-Infective Agents into Pulmonary Epithelial Lining Fluid

Determining reference ranges for immunological cells of healthy indigenous individuals from a region in Brazil

Contact Info

Product

Resources

About