ABSTRACT
The proinflammatory activity of bronchoalveolar lavage fluid (BALF) was studied in 40 patients with an exacerbation of pulmonary tuberculosis, by applying the biological test system--donor blood. The supernatant of BALF was purified by milli pore filtration and added to blood, and the nitro blue tetrazolium (NBT) recovery test was carried out. Hanks (balanced salt) solution was used in the control. The proinflammatory effect of BALF was determined as the ratio of the count of diformazan-positive neutrophils in test and control samples (stimulation index (SI)). BALF with a low inflammatory activity suppressed the reaction of donor blood neutrophil-induced NBT recovery (SI < 1.0). On the contrary, BALF from patients with a high inflammation activity intensely stimulated donor neutrophil-induced NBT recovery (SI > 1.5). In patients with the high proinflammatory activity of BALF, the neutrophils obtained during bronchoalveolar lavage restored the parameters of the NBT test twice more actively than in those with a low proinflammatory activity of BALF. The findings suggest that the assessment of the proinflammatory activity of BALF determines the activity of exacerbated tuberculosis that is exudative and destructive with the purpose of optimizing immunomodulating therapy.
Subject(s)
Bronchoalveolar Lavage Fluid/immunology , Bronchoalveolar Lavage/methods , Neutrophils/immunology , Tuberculosis, Pulmonary , Adult , Disease Progression , Female , Humans , Male , Tuberculosis, Pulmonary/diagnosis , Tuberculosis, Pulmonary/immunology , Tuberculosis, Pulmonary/physiopathologyABSTRACT
The authors estimated the cellular composition of bronchoalveolar lavage fluid, the functional activity of alveolar macrophages from the recovery of tetrazolium nitroblue (TNB test) in 39 patients with an exacerbation of secondary forms of pulmonary tuberculosis before and after prodigiosane stimulation, made a correlation analysis in order to elucidate the correlations between the parameters of a TNB test and the count of macrophages and neutrophils. On an exacerbation of tuberculosis, the activity of a population of alveolar macrophages did not increase, but in its infiltrative form, it even decreased as compared with the normal values. After prodiogiosane stimulation, the in vitro activity of alveolar macrophages increased by almost 60% in infiltrative tuberculosis and by 100% in fibrocavernous tuberculosis; there was no substantial rise in the activity in tuberculoma. The poor protective functions of alveolar macrophages were compensated by the enhanced inflow of alveolar macrophages and neutrophils into the airway lumens, as suggested by the correlation between their activity and count.
Subject(s)
Macrophages, Alveolar/physiology , Tuberculosis, Pulmonary/immunology , Adult , Bronchoalveolar Lavage Fluid , Female , Humans , Indicators and Reagents , Male , Middle Aged , Neutrophils/immunology , Nitroblue Tetrazolium , Tuberculoma/diagnosis , Tuberculoma/immunology , Tuberculoma/physiopathology , Tuberculosis, Pulmonary/classification , Tuberculosis, Pulmonary/diagnosis , Tuberculosis, Pulmonary/physiopathologyABSTRACT
Structural metabolic changes in the biopsies of the large bronchi mucous membrane were studied in 99 patients with chronic lung diseases. Progressing sclerosis of the connective tissue stroma resulted in the reduction of endotheliocyte metabolism which usually represent plastically active zone of the strom. This considerably influences basal cell proliferation resulting in changes of differentiation in bronchial epithelium. Endobronchial laser therapy induces proliferative and metabolic processes in the tunica propria of the mucous membrane. Congestion, intensive leucodia pedesis, leucocytic infiltrates and granulations develop in the mucous membrane, proliferative and metabolic activity of endotheliocytes and stromal cells increases this resulting in formation of fine fibrillar connective tissue.
Subject(s)
Bronchi/blood supply , Bronchitis/pathology , Laser Therapy , Bronchi/ultrastructure , Capillaries/pathology , Cell Differentiation/physiology , Chronic Disease , Mucous Membrane/pathologyABSTRACT
Structural and metabolic changes were studied in 162 large bronchial mucosa biopsy specimens from 63 patients with chronic lung diseases. Proliferative and metabolic processes were shown to be induced by endotracheal therapy with helium-neon laser for the damaged epithelium, which passed through a number of transitional forms and repaired its structure and differentiation into ciliary and goblet cells with normal ultrastructure. In lamina propria, there was hyperemia, intensive leukodiapedesis, formation of leukocytic infiltrated and granulations, the metabolic activity of endotheliocytes and interstitial cells increased, giving rise to delicate fibrous connective tissue. The simultaneous reorganization of the epithelium and underlying connective tissue is interpreted from the standpoint of a concept of parenchymal and stromal relationships.
Subject(s)
Bronchi/radiation effects , Inflammation/radiotherapy , Lasers , Regeneration , Biopsy , Bronchi/pathology , Bronchi/ultrastructure , Chronic Disease , Epithelium/pathology , Epithelium/radiation effects , Epithelium/ultrastructure , Humans , Inflammation/pathology , Laser Therapy , Lung/pathology , Lung/ultrastructure , Lung Abscess/metabolism , Lung Abscess/pathology , Lung Abscess/radiotherapy , Pneumonia/metabolism , Pneumonia/pathology , Pneumonia/radiotherapy , Time Factors , Tuberculosis, Pulmonary/metabolism , Tuberculosis, Pulmonary/pathology , Tuberculosis, Pulmonary/radiotherapyABSTRACT
Structural and metabolic changes were explored in 68 main bronchial mucosal biopsy specimens from 31 patients with fibrocavernous pulmonary tuberculosis. It was shown that He-Ne laser endobronchial therapy induced proliferative and metabolic processes (as judged from the level of DNA and RNA syntheses) in the damaged epithelium, which restored its structure and differentiation into celiary and goblet cells with normal ultrastructure having undergone a number of transitional forms. The proliferative and metabolic activity of endotheliocytes and stromal cells increased in the intrinsic layer of the mucosa, which was accomplished by formation of soft fiber connective tissue.
Subject(s)
Bronchi/radiation effects , Laser Therapy , Tuberculosis, Pulmonary/radiotherapy , Autoradiography , Biopsy , Bronchi/pathology , Bronchi/ultrastructure , Female , Humans , Male , Mucous Membrane/pathology , Mucous Membrane/radiation effects , Mucous Membrane/ultrastructure , Tuberculosis, Pulmonary/pathologyABSTRACT
Seventy specimens of bronchoalveolar lavage were obtained from 30 patients with pulmonary tuberculosis during treatment with endobronchial laser. The lavage is shown to undergo marked qualitative and quantitative changes in response to He-Ne laser treatment: the proportion of macrophages goes up while that of neutrophils tends to a decrease. The laser is capable to induce metabolic and proliferative activity of alveolar macrophages indicated by RNA and DNA synthesis. Morphological alterations in the cells of the respiratory compartment suggest weakening of exudative-necrotic component of the inflammation as an underlying cause of laser efficacy.
