1 Damage to the bronchial epithelium occurs after the inhalation of toxic substances and allergens, and through virus infections and it may lead to increased desquamation of epithelial cells in bronchoalveolar lavage (BAL).
2 In this study we compared two methods of staining the epithelial cells of BAL, the conventional cytochemical May Grunwald-Giemsa stain (MGG) and an immunocytochemical technique using a monoclonal antibody anti-human cytokeratin (CK) detected with APAAP immuno-alkaline phosphatase. BAL was obtained from 13 subjects and the epithelial cells were cytocentrifuged either immediately after collection (fraction A) or after washing (fraction B).
3 Higher percentages of epithelial cells were identified in fraction A with CK (20.0 ± 5.1 %) than in fraction A with MGG (11.2 ± 2.3%), which recognized only ciliated epithelial cells. In fact a proportion of CK-positive cells (34%) in fraction A were not ciliated. Underestimation of epithelial cells by MGG compared to CK was more pronounced in fraction B (8.0 ± 2.9% and 22.9 ± 3.0%, respectively) as there was a relative loss of ciliated CK+ cells after washings.
4 These results suggest that immunocytochemical staining with an anti-cytokeratin monoclonal antibody is more sensitive than using the MGG stain in detecting epithelial cells in BAL.
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References
1.
Jeffery PK & Reid LMRespiratory mucous membrane. In: Respiratory Defense Mechanisms, Part I, Brain JD, Proctor DF & Reid LM eds, pp. 229-45. New York: Marcel Dekker, Inc., 1977 .
2.
Weill H. & Jones RNOccupational pulmonary diseases. In: Pulmonary Diseases and Disorders, Fishman AP ed, 2nd edn, pp. 819-60. New York: McGraw-Hill, Inc., 1988.
3.
Saetta M., Di Stefano A., Maestrelli P. et al. Airway mucosal inflammation in occupational asthma induced by toluene diisocyanate. American Review Respiratory Disease1992; 145: 160-8.
4.
Empey DW, Laitinen LA, Jacobs L., Gold WM & Nadel JAMechanism of bronchial hyperreactivity in normal subjects after upper respiratory tract infection. American Review Respiratory Disease1976; 113: 131-9.
5.
Laitinen LA, Heino M., Laitinen A., Kava T. & Haahtela T.Damage of the airway epithelium and bronchial reactivity in patients with asthma. American Review Respiratory Disease1985; 131: 599-606.
6.
Beasley R., Roche WR, Roberts JA & Holgate STCellular events in the bronchi in mild asthma and after bronchial provocation . American Review Respiratory Disease1989 ; 139: 806-17.
7.
Boushey HA, Holtzman MJ, Sheller JR & Nadel JABronchial hyperreactivity. American Review Respiratory Disease1980; 121: 389-413.
8.
Reynolds HYBronchoalveolar lavage. American Review Respiratory Disease1987; 135: 250-63.
9.
Moll R., Franke WW & Schiller DLThe catalog of human cytokeratins: pattern of expression in normal epithelia, tumors and cultured cells. Cell1982; 31: 11-24.
10.
Fabbri LM, Boschetto P., Zocca E. et al. Bronchoalveolar neutrophilia during late asthmatic reactions induced by toluene diisocyanate. American Review Respiratory Disease1987; 136: 36-42.
11.
Hunninghake GW, Gadek JE, Kawanami Q., Ferrans VJ & Cristal RGInflammatory and immune processes in the human lung in health and disease: evaluation by bronchoalveolar lavage. American JournalPathology1979; 97: 149-206.
12.
Zavala DCBronchoscopy, lung biopsy and other procedures. In: Textbook of Respiratory Medicine, Murray JF & Nadel JA eds, Vol 1, p. 576. Philadelphia, PA: WB Saunders Company, 1988.
13.
Saltini C., Hance AJ, Ferrans VJ et al. Accurate quantification of cells recovered by bronchoalveolar lavage. American Review Respiratory Disease1984; 130: 650-8.
