Skip to main content

Bronchoalveolar Lavage in Asthma

  • Chapter
Methods in Asthmology

Abstract

A number of methods are available for the assessment of airways inflammation in asthma: (1) Large samples of airways can be studied in material sampled at autopsy or at surgery. (2) Bronchoscopy provides a means to both inspect and sample the lower respiratory tract. (3) Expectorated sputum contains inflammatory cells and mediators which can be characteristic of asthma.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 39.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 54.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Dunnill MS (1987) Pulmonary pathology, 2nd edn. Churchill Livingstone, Edinburgh

    Google Scholar 

  2. Naylor B (1962) The shedding of the mucosa of the bronchial tree in asthma. Thorax 17: 69–72

    Article  PubMed  CAS  Google Scholar 

  3. Linder J, Rennard SI (1988) Bronchoalveolar lavage. ASCP, Chicago

    Google Scholar 

  4. Reynolds HY (1987) Bronchoalveolar lavage. State of the Art. Am Rev Respir Dis 135: 250–263

    PubMed  CAS  Google Scholar 

  5. Soboyna RE (1984) Quantitative structural alterations in long-standing allergic asthma. Am Rev Respir Dis 130: 289–292

    Google Scholar 

  6. Jeffery PK, Wardlaw AJ, Nelson FC, Collins JV, Anokay AB (1989) Bronchial biopsies in asthma: an ultrastructural, quantitative study and correlation with hyperreactivity. Am Rev Respir Dis 140: 1745–1753

    Article  PubMed  CAS  Google Scholar 

  7. Laitinen LA, Heino M, Laitinen A, Kaua T; Hauntela T (1985) Damage of the airway epithelium and bronchial reactivity in patients with asthma. Am Rev Respir Dis 131: 599–606

    PubMed  CAS  Google Scholar 

  8. Ikeda S, Yanai N, Ishikawa S (1968) Flexible broncofiberscope. Keio J Med 17: 1–16

    Article  PubMed  CAS  Google Scholar 

  9. Sahn SA, Scoggin C (1976) Fiberoptic bronchoscopy in bronchial asthma. Chest 69: 39–42

    Article  PubMed  CAS  Google Scholar 

  10. Zavala D (1978) Complications following fiberoptic bronchoscopy. Chest 73: 783–785

    Article  PubMed  CAS  Google Scholar 

  11. Credle WF, Smiddy JF, Elliott RC (1974) Complications of fiberoptic bronchoscopy. Am Rev Respir Dis 109: 67–72

    PubMed  Google Scholar 

  12. Pereira W Jr, Kounat DM, Snider GC (1978) A Prospective cooperative study of complications following flexible fiberoptic bronchoscopy. Chest 73: 813–816

    Article  PubMed  Google Scholar 

  13. Zavala DC (1978) Transbronchial biopsy in diffuse lung disease. Chest 73 (5): 727(s)-733(s)

    Google Scholar 

  14. Strumpf IJ, Feld MK, Cornelius MJ, Keogh BA, Crystal RG (1981) Safety of fiberoptic bronchoalveolar lavage in evaluation of interstitial lung disease. Chest 80: 268–271

    Article  PubMed  CAS  Google Scholar 

  15. Rankin JA, Snyder RRT, Schacter EN, Mathay RA (1984) Bronchoalveolar lavage: its safety in subjects with mild asthma. Chest 85: 723–728

    Article  PubMed  CAS  Google Scholar 

  16. NHLBI Workshop Summaries (1985) Summary and recommendations of a workshop on the investigative use of fiberoptic bronchoscopy and bronchoalveolar lavage in asthmatics. Am Rev Respir Dis 132: 180–182.

    Google Scholar 

  17. Kirby JG, Hargreave FE, Gleich GJ, O’Byrne PM (1987) Bronchoalveolar cell profiles in asthmatic and nonasthmatic subjects. Am Rev Respir Dis 136: 379–383

    Article  PubMed  CAS  Google Scholar 

  18. Effensohn DB, Jankowski MJ, Redondo AA, Duncan PG (1988) Bronchoalveolar lavage in the normal volunteer subject: 2) safety and results of repeated BAL, and use in the assessment of intrasubject variability. Chest 94 (2): 281–285

    Article  Google Scholar 

  19. Bousquet J, Chaniz P, Yves Lacoste J, Barneau G, Ghavarian R, Enander I, Venge P, Ahlstedt S, Simony-Lafontaine J, Godard P, Michel F-B (1990) Eosinophilic inflammation in asthma. N Engl J Med 323: 1033–1039

    Article  PubMed  CAS  Google Scholar 

  20. Foresi A, Bortorelli G, Pesci A, Chetta A, Olivieri D (1990) Inflammatory markers in bronchoalveolar lavage and bronchial biopsy in asthma during remission. Chest 98: 528–535

    Article  PubMed  CAS  Google Scholar 

  21. Paggiaro P, Bacci E, Paoletti P, Bernard P, Dente F, Marchetti G, Talini D, Menconi GF, Giuntini C (1990) Bronchoalveolar lavage and morphology of the airways after cessation of exposure in asthmatic subjects sensitized to toluene diisocyanate. Chest 98: 536–542

    Article  PubMed  CAS  Google Scholar 

  22. Miadonna A, Tedeschi A, Brasca C, Folco G, Sala A, Murphy RC (1990) Mediator release after endobronchial antigen challenge in patients with respiratory allergy. J Allergy Clin Immunol 85: 906–913

    Article  PubMed  CAS  Google Scholar 

  23. Wardlaw AJ, Dunnette S, Gleich GJ, Collins JV, Kay AB (1988) Eosinophils and mast cells in bronchoalveolar lavage in subjects with mild asthma (relationship to bronchial hyperreactivity). Am Rev Respir Dis 137: 62–69

    Article  PubMed  CAS  Google Scholar 

  24. Metzger WJ, Nugent K, Richerson HB, Moseley P, Lakin R, Zavala D, Hunninghake GW (1985) Methods for bronchoalveolar lavage in asthmatic patients following bronchoprovocation and local antigen challenge. Chest 87 (1): 16(s)-19(s)

    Google Scholar 

  25. Smiddy JF, Ruth We, Kerby GR, Renz LE, Raucher C (1971) Flexible fiberoptic bronchoscope. Ann Intern Med 75 (6): 971–972

    PubMed  CAS  Google Scholar 

  26. Kounat DM, Schaaf JT, Rath GS, Snider GL (1974) Bronchoscopy in perspective. Chest 65 (6): 606–607

    Article  Google Scholar 

  27. Sackner MA (1975) State of the art: bronchofiberscopy. Am Rev Respir Dis 111: 62–88

    PubMed  CAS  Google Scholar 

  28. Goldstein RA, Rohatgi PK et al. (1990) ATS statement of clinical role of bronchoalveolar lavage in pulmonary disease. Am Rev Respir Dis 142: 481–486

    PubMed  CAS  Google Scholar 

  29. Fulkerson WJ (1984) Current concepts: fiberoptic bronchoscopy. N Engl J Med 111 (8):511–514

    Google Scholar 

  30. Klech H, Pohl W et al. (1989) Technical recommendations and guidelines for bronchoalveolar lavage (BAL): report of the European Society of Pneumology Task Group on BAL. Eur Respir J 2: 561–585

    Google Scholar 

  31. Klech H, Hutter C (1990) Clinical guidelines and indications for bronchoalveolar lavage (BAL): report of the European Society of Pneumology Task Group on BAL. Eur Respir J 3: 937–974

    Google Scholar 

  32. Djukanovic R, Wilson JW, Lai CKW, Holgate S, Howarth PH (1991) The safety aspects of fiberoptic bronchoscopy, bronchoalveolar lavage and endobronchial biopsy in asthma. Am Rev Respir Dis 143: 772–777

    PubMed  CAS  Google Scholar 

  33. Smiddy JF, Ruth WE, Kerby GR (1971) A new technique of bronchial visualization with fiberoptics (abstract). J Kans Med Soc 72: 441

    Google Scholar 

  34. Hodgkin JE, Rosenow EC III, Stubs SE (1975) Oral introduction of the flexible bronchoscope. Chest 68: 88–90

    Article  Google Scholar 

  35. Zavala DC, Rhodes ML, Richardson RH, Bedell GN (1974) Fiberoptic and rigid bronchoscopy. The state of the art. Chest 65: 605–606

    Google Scholar 

  36. Rees PJ, Hay JG, Webb JR (1983) Premedication for fiberoptic bronchoscopy. Thorax 38: 624–627

    Article  PubMed  CAS  Google Scholar 

  37. Prakash UB, Offort KP, Stubbs SE (1991) Bronchoscopy in North America: the ACCP survey. Chest 100: 1668–1675

    Article  PubMed  CAS  Google Scholar 

  38. Patterson JR, Blaschke TF, Hunt KK Jr, Meffin PJ (1975) Lidocaine blod concentrations during fiberoptic bronchoscopy. Am Rev Respir Dis 112: 53–57

    PubMed  CAS  Google Scholar 

  39. Thompson AB, Rennard SI (1988) Assessment of airways inflammation utilizing bronchoalveolar lavage. Clin Chest Med 9 (4): 577–590

    Google Scholar 

  40. Pingleton SK, Harrison GF, Stechshulte DJ, Wesselius LJ, Kerby GR, Ruth WE (1983) Effect of location pH and temperature of instillate in bronchoalveolar lavage in normal volunteers. Am Rev Respir Dis (1983) 128: 1035–1037

    PubMed  CAS  Google Scholar 

  41. Burns DM, Shure D, Francoz R, Kalafer M, Harrell J, Witztum K, Maser KM (1983) The physiologic consequences of saline labor lavage in health human adults. Am Rev Respir Dis 127: 695–701

    PubMed  CAS  Google Scholar 

  42. Marcy TW, Merrill WM, Rankin JA, Reynolds HY (1987) Limitations of using urea to quantify epithelial lining fluid recovered by bronchoalveolar lavage. Am Rev Respir Dis 135: 1276–1280

    PubMed  CAS  Google Scholar 

  43. Kelly CA, Fenwick JD, Corris PA, Fleetwood A, Hendrick DJ, Walters EH (1988) Fluid dynamics during bronchoalveolar lavage. Am Rev Respir Dis 138: 81–84

    Article  PubMed  CAS  Google Scholar 

  44. Reynolds HY, Fulmer JD, Kazmierowsky JA, Roberts WC, Frank MM, Crystal RG (1977) Analysis of cellular and protein content of bronchoalveolar lavage fluid from patients with idiopathic pulmonary fibrosis and chronic hypersensitivity pneumonitis. J Clin Invest 59: 165–175

    Article  PubMed  CAS  Google Scholar 

  45. Venet A, Clavel F, Israel-Biet D, Rouzioux C, Dennewald G, Stern MV, Vitti-coq D, Regnier B, Cayrol E, Chretien J (1985) Lung in acquired immune deficiency syndrome: infectious and immunological status assessed by bronchoalveolar lavage. Bull Eur Physiopathol Respir 21: 535–543

    PubMed  CAS  Google Scholar 

  46. Reynolds HY, Nesball HH (1974) Analysis of proteins and respiratory cells obtained from human lungs by bronchial lavage. J Lab Clin Med: 559–572

    Google Scholar 

  47. Merrill W, O’Hearn E, Rankin J, Matthay RA, Reynolds HY (1982) Kinetic analysis of respiratory tract proteins recovered during a sequential lavage protocol. Am Rev Respir Dis 126: 617–620

    PubMed  CAS  Google Scholar 

  48. Davis GS, Giancola MS, Costanza MC, Low RB (1982) Analysis of sequential bronchoalveolar lavage samples from healthy human volunteers. Am Rev Respir Dis 126: 611–616

    PubMed  CAS  Google Scholar 

  49. Dohn MN, Baughman RP (1985) Effect of changing instilled volume for bronchoalveolar lavage in patients with interstitial lung disease. Am Rev Respir Dis 132: 390–392

    PubMed  CAS  Google Scholar 

  50. Finley TN, Swenson EW, Curran WS, Huber GL, Ladman AJ (1967) Bronchoalveolar lavage in normal subjects and patients with obstructive lung disease. Ann Intern Med 66: 651–658

    PubMed  CAS  Google Scholar 

  51. Low RB, Davis GS, Giancola MS (1978) Biochemical analysis of bronchoalveolar lavage fluids of healthy human volunteer smokers and nonsmokers. Am Rev Respir Dis 118: 863–874

    PubMed  CAS  Google Scholar 

  52. Ettensohn DB, Jankowski M, Duncan PG, Lalor PA (1988) Bronchoalveolar lavage in the normal volunteer subject. 1.) technical aspects and intersubject variability. Chest 94 (2): 275–280

    Article  PubMed  CAS  Google Scholar 

  53. Martin TR, Raghu G, Maunder J, Springmeyer SC (1985) The effects of chronic bronchitis and chronic air-flow obstruction on lung cell populations recovered by bronchoalveolar lavage. Am Rev Respir Dis 132: 254–260

    PubMed  CAS  Google Scholar 

  54. Albertini R, Harrel JH, Moser KM (1974) Hypoxemia during fiberoptic bronchoscopy. Chest 65 (1): 117

    Article  PubMed  CAS  Google Scholar 

  55. Dubrawsky C, Awe RJ, Jenkins DE (1975) The effect of bronchofiberscopic examination on oxygenation status. Chest 67 (2): 137–140

    Article  PubMed  CAS  Google Scholar 

  56. Albertini RE, Harrel JH, Moser KM (1975) Management of arterial hypoxemia induced by fiberoptic bronchoscopy. Chest 62 (2): 134–136

    Article  Google Scholar 

  57. Gurney JW, Harrison WC, Sears K, Robbins RA, Dobry CA, Rennard SI (1987) Bronchoalveolar lavage: radiographic manifestations. Radiology 163: 71–74

    PubMed  CAS  Google Scholar 

  58. Stover DE, Zaman MB, Hajdu SJ, Langem M, Gold J, Armstrong D (1984) Bronchoalveolar lavage in the diagnosis of diffuse pulmonary infiltrates in the immunosuppressed host. Ann Intern Med 101: 1–7

    PubMed  CAS  Google Scholar 

  59. Reynolds HY, Chretien J (1984) Respiratory tract fluids: analysis of content and contemporary use in understanding lung disease. DM 30: 1–103

    CAS  Google Scholar 

  60. Crystal RG, Raynolds HY, Kalica AR (1986) Bronchoalveolar lavage. The report of an international conference. Chest 90: 122–131

    Google Scholar 

  61. Eschenbacher WL, Gravelyn TR (1987) A technique for isolated airway segment lavage. Chest 92: 105–109

    Article  PubMed  CAS  Google Scholar 

  62. Zehr BB, Casale TB, Wood D, Floerchinger C, Richerson HB, Hunninghake GW (1989) Use of segmental airway lavage to obtain relevant mediators form the lungs of asthmatic and control subjects. Chest 95: 1059–1063

    Article  PubMed  CAS  Google Scholar 

  63. Kelly CA, Kotre CJ, Ward C, Hendrick DJ, Walters EH (1987) Anatomical distribution of bronchoalveolar lavage fluid as assessed by digital subtraction radiography. Thorax 42: 624–628

    Article  PubMed  CAS  Google Scholar 

  64. Lam S, LeRiche JC, Kijek K, Phillips D (1985) Effect of bronchial lavage on cellular and protein recovery. Chest 88 (6): 856–859

    Article  PubMed  CAS  Google Scholar 

  65. Chafouri MA, Rasmussen JK, Sears K et al. (1985) Use of sequential bronchoalveolar lavage to enrich for “bronchial” and “alveolar” material. Clin Res 33: 464A

    Google Scholar 

  66. Thompson A, Ghafouri M, Stahl M et al. (1986) Assessment of neutrophilic bronchial inflammation by bronchoalveolar lavage in bronchitis. Am Rev Respir Dis 133: A325

    Google Scholar 

  67. Thompson AB, Robbins RA, Shoji S et al. (1986) Chronic bronchitis is associated with enrichment of airways epithelial lining fluid with C3. Chest 89: 499 (s)

    Google Scholar 

  68. Lam S, LeRiche J, Phillips D, Chan-Yeung M (1987) Cellular and protein changes in bronchial lavage fluid after late asthmatic reaction in patients with red cedar asthma. J Allergy Clin Immunol 80: 44–50

    Article  PubMed  CAS  Google Scholar 

  69. Rennard SI, Ghafouri MA, Thompson AB, Linder J et al. (1990) Fractional processing of sequential bronchoalveolar lavage to separate bronchial alveolar samples. Am Rev Respir Dis 141: 208–217

    PubMed  CAS  Google Scholar 

  70. Cherwick WS, Barbero GJ (1959) Composition of tracheobronchial secretions in cystic fibrosis of the pancreas and bronchiectasis. Pediatrics 739–745

    Google Scholar 

  71. Keimowitz RI (1964) Immunoglobulins in normal human tracheobronchial washings. J Lab Clin Med 63: 54–59

    PubMed  CAS  Google Scholar 

  72. Falk GA, Okinaka AJ, Siskin GW (1972) Immunoglobulins in the bronchial washings of patients with chronic obstructive pulmonary disease. Am Rev Respir Dis 105: 14–21

    PubMed  CAS  Google Scholar 

  73. Mandell MA, Dvorak KJ, Worman LW, de Cosse JJ (1976) Immunoglobulin content in bronchial washings of patients with benign and malignant disease. N Engl J Med 295: 694–698

    Article  Google Scholar 

  74. Wiggens J, Hill SL, Stockly RA (1983) Lung secretion solphase proteins: comparison of sputum with secretions obtained by direct sampling. Thorax 38: 102–107

    Article  Google Scholar 

  75. Metzger WJ, Moseley P, Nugent K, Richerson HB, Hunninghake GW (1985) Local antigen challenge and bronchoalveolar lavage of allergic asthmatic lungs. Chest 87:155(s)-156(s)

    Google Scholar 

  76. Wenzel SE, Westcott JY, Larsen GL (1991) Bronchoalveolar lavage fluid mediator levels five minutes after allergen challenge in atopic subjects with asthma: relationship to the development of late asthmatic response. J Allergy Clin Immunol 87: 540–548

    Article  PubMed  CAS  Google Scholar 

  77. Fick RB, Metzger WJ, Richerson HB, Zavala DC et al. (1987) Increased bronchovascular permeability after allergen exposure in sensitivie asthmatics. J Appl Physiol 63 (3): 1147–1155

    PubMed  Google Scholar 

  78. Beasley R, Roche WR, Roberts JA, Holgate ST (1989) Cellular events in the bronchi in mild asthma after bronchial provocation. Am Rev Respir Dis 139: 806–817

    PubMed  CAS  Google Scholar 

  79. Rossi GA (1986) Bronchoalveolar lavage in the investigation of disorders of the lower respiratory tract. Eur J Respir Dis 69: 293–315

    PubMed  CAS  Google Scholar 

  80. Pirozynski M, Silwinski P, Polubiez M, Zielinsk J, Radwan L (1988) Atropine influences bronchoalveolar lavage-induced arterial oxygen desaturation. Eur Respir J 1 [Suppl]: 312

    Google Scholar 

  81. Schmidt RM, Rosenkranz H (1970) Antimicrobial activity of local anesthetics: lidocaine and procaine. J Infect Dis 121: 597–607

    Article  PubMed  CAS  Google Scholar 

  82. Wimberly N, Willey S, Sullivan N, Bartlett JG (1979) Antibacterial properties of Lidocaine. Chest 76: 37–40

    Article  Google Scholar 

  83. Von Essen SG, Robbins RA, Spurzem JR, Thompson AB et al. (1991) Bronchoscopy with bronchoalveolar lavage causes neutrophil recruitment to the lower respiratory tract. Am Rev Respir Dis 144: 848–854

    Article  Google Scholar 

  84. Kazmierowski JA, Gallin JI, Reynolds HY (1977) Mechanism for the inflammatory response in primate lungs. J Clin Invest 59: 273–281

    Article  PubMed  CAS  Google Scholar 

  85. Cohen AB, Batra GK (1980) Bronchoscopy and lung lavage induced bilateral pulmonary neutrophil influx and blood leukocytes in dogs and monkeys. Am Rev Respir Dis 122: 239–247

    PubMed  CAS  Google Scholar 

  86. Saltini C, Hance AJ, Ferran VJ, Basset F, Bitterman PB, Crystal RG (1984) Accurate quantification of cells recovered by bronchoalveolar lavage. Am RevRespir Dis 130: 650-658

    Google Scholar 

  87. Chamberlain DW, Brande AC, Rebuck AS (1987) A critical evaluation of bronchoalveolar lavage: criteria for identifying unsatisfactory specimens. Acta Cytol 31 (5): 599–605

    PubMed  CAS  Google Scholar 

  88. Fleury-Feith J, Escudier E, Pocholle MJ, Carre C, Bernaudin JF (1987) The effects of cytocentrifugation on differential cell counts in samples obtained by bronchoalveolar lavage. Acta Cytol 31 (5): 606–610

    PubMed  CAS  Google Scholar 

  89. Thompson AB, Robbins RA, Ghafouri MA, Linder J, Rennard SI (1989) Bronchoalveolar lavage fluid processing: effect of membrane filtration preparation on neutrophil recovery. Acta Cytol 33 (4): 544–549

    PubMed  CAS  Google Scholar 

  90. Rankin JA, Naegel GP, Reynolds HY (1986) Use of a central laboratory for analysis of bronchoalveolar lavage fluid. Am Rev Respir Dis 133: 186–190

    PubMed  CAS  Google Scholar 

  91. Costabel U, Teschler H, Ziesche R, Guzman J et al. (1989) Transport of bronchoalveolar lavage cells in appropriate medium for 24 hours does not affect cell differentials and lymphocyte subsets. Am Rev Respir Dis 139: (A) 472

    Google Scholar 

  92. Thorpe JE, Baughman RP, Frame PT, Wesseler TA, Staneck JL (1987) Bronchoalveolar lavage for diagnosing acute bacterial pneumonia. J Infect Dis 155 (5): 855–861

    Article  PubMed  CAS  Google Scholar 

  93. Guerra LF, Baughman RP (1990) Use of bronchoalveolar lavage to diagnose bacterial pneumonia in mechanically ventilated patients. Crit Care Med 18: 169–173

    Article  PubMed  CAS  Google Scholar 

  94. Kahn FW, Jones JM (1987) Diagnosing bacterial respiratory infection by bronchoalveolar lavage. J Infect Dis 155 (5): 862–869

    Article  PubMed  CAS  Google Scholar 

  95. Chastre J, Fagon J-Y, Solber P et al. (1988) Diagnosis of nosocomial pneumonia in intubated patient undergoing ventilation: comparison of usefulness of bronchoalveolar lavage and the protected specimen brush. Am J Med 85: 499–505

    Article  PubMed  CAS  Google Scholar 

  96. Meduri GU, Beals D, Majjab G, Buselski V (1991) Protected bronchoalveolar lavage: a new bronchoscopic technique to retrieve uncontaminated lower distal airway secretions. Am Rev Respir Dis 143: 855–864

    PubMed  CAS  Google Scholar 

  97. Meduri GM, Baselski V (1991) The role of bronchoalveolar lavage in diagnosing nonopportunistic bacterial pneumonia. Chest 100: 179–190

    Article  PubMed  CAS  Google Scholar 

  98. Chastre J, Fagon JY, Soler P, Domart Y, Pierre J, Dombret MC et al. (1989) Quantification of BAL cells containing intracellular bacteria rapidly identifies ventilated patients with nosocomial pneumonia. Chest 95:190(s)-192(s)

    Google Scholar 

  99. Grocott RG (1955) A stain for fungi in tissue sections and smears. Am J Clin Pathol 25: 975–979

    PubMed  CAS  Google Scholar 

  100. Chalvardijian M, Grave LA (1963) A new procedure for the identification of pneumocystis carinii cysts in tissue sections and smears. Am J Clin Pathol 16: 383–385

    Article  Google Scholar 

  101. Mahan CT, Sale HT, George E (1978) Rapid methenamine silver stain for pneumocystis and fungi. Arch Pathol Lab Med 102: 351–352

    PubMed  CAS  Google Scholar 

  102. De Garcia J, Curull V, Vidal R, Riba A, Orriols R (1988) Diagnostic value of bronchoalveolar lavage in suspected pulmonary tuberculosis. Chest 93: 329–332

    Article  Google Scholar 

  103. Xavier R, Henn L, Costa R (1990) Bronchoalveolar lavage in pulmonary tuberculosis. Chest 98: 97 (s)

    Google Scholar 

  104. Baughman RP, Dohn MN, Loudon RG, Frame PT (1991) Bronchoscopy with bronchoalveolar lavage in tuberculosis and fungal infections. Chest 99: 92–97

    Article  PubMed  CAS  Google Scholar 

  105. Peterson EM, Lu R, Floyd C, Nakasone A et al. (1989) Direct identification of Mycobacterium tuberculosis, mycobacterium avium, and mycobacterium intra-cellulare from amplified primary cultures in bactec media using DNA probes. J Clin Microbial 27: 1543–1547

    CAS  Google Scholar 

  106. Kohorst WR, Schonfeld SA, Macklin JE, Witcomb ME (1983) Rapid diagnosis of Legionnaire’s disease by bronchoalveolar lavage. Chest 84: 186–190

    Article  PubMed  CAS  Google Scholar 

  107. Edelstein PH, Meyer RD (1984) Legionnaire’s disease: a review. Chest 85: 114–120

    Article  PubMed  CAS  Google Scholar 

  108. Pasculle AW, Veto GE, Krystofiak S, McKelvey K, Vrsolovic K (1989) Labora-

    Google Scholar 

  109. S. I. Rennard et altory and clinical evaluation of a commercial DNA probe for the detection of Legionella ssp. J Clin Microbiol

    Google Scholar 

  110. Brigati DJ, Meyerson D, Leary JJ et al. (1983) Detection of viral genomes in cultured cells and paraffin-embedded tissue sections using biotin-labeled hybridization probes. Virol 126: 32–50

    Article  CAS  Google Scholar 

  111. Myerson D, Hackman RC Meyers JD (1984) Diagnosis of cytomegalovirus pneumonia by in-situ hybridization. J Infect Dis 150: 272–277

    Article  PubMed  CAS  Google Scholar 

  112. Kahn FW, Jones JM (1986) Bronchoalveolar lavage in the rapid diagnosis of lung disease. Lab Management 24: 31–35

    Google Scholar 

  113. Paik G (1980) Reagents, stains and miscellaneous test procedures. In: Lennette EH, Balows A, Hausler WJ, Traunt JP (eds) Manual of Clinical Microbiology, 3rd Ed. American Society for Microbiology, Washington DC, Chapter 98

    Google Scholar 

  114. Brinn NT (1983) Rapid metallic histological staining using the microwave oven. J Microtechnol 6: 125–129

    CAS  Google Scholar 

  115. Stover DE, White DA, Romano PA, Gellene RA (1984) Diagnosis of pulmonary disease in acquired immune deficiency syndrome (AIDS). Role of bronchoscopy and bronchoalveolar lavage. Am Rev Respir Dis 130: 659–662.

    Google Scholar 

  116. Lennette EH, Balows A, Hausler WJ et al. (1980) Manual of clinical microbiology, 3rd edn. American Society for Microbiology, Washington DC, p 1023

    Google Scholar 

  117. Richards OW, Miller DK (1941) An efficient method for the identification of tuberculosis bacteria with a simple fluorescence microscope. Am J Clin Pathol Technical [Suppl] 5: 1–8

    Google Scholar 

  118. Edelstein PH, Beer KB, Sturge JC, Watson AJ, Goldstein LC (1985) Clinical utility of a monoclonal direct fluorescent reagent specific for Legionella pneumophila: comparative study with other reagents. J Clin Microbiol 22: 419–421

    PubMed  CAS  Google Scholar 

  119. Edelstein PH, Edelstein MA (1989) Evaluation of the Meriflour-Legionella immunofluorescent reagent for identifying and detecting 21 Legionella species. J Clin Microbiol 27: 2455–2458

    PubMed  CAS  Google Scholar 

  120. Dalquen P, Bittel D, Gudat F et al. (1986) Combined immunoreaction and Papanicolaou’s stain on cytologic smears. Pathol Res Pract 181: 50–54

    Article  PubMed  CAS  Google Scholar 

  121. Drew WL, Finley T, Golde D (1977) Diagnostic lavage in occult pulmonary hemorrhage in thrombocytopenic immunocompromised patients. Am Rev Respir Dis 116: 215–221

    PubMed  CAS  Google Scholar 

  122. Mallory RF (1938) Pathological technique. Saunders, Philadelphia, pp 118–121

    Google Scholar 

  123. Warr GA, Martain RR, Sharp PM, Rossen RD (1977) Normal human bronchial immunoglobulin and proteins: effects of cigarette smoking. Am Rev Respir Dis 116: 25–30

    PubMed  CAS  Google Scholar 

  124. Merrill WW, Goodenberger D, Strober W, Matthay RA, Naegel GP, Reynolds HY (1980) Free secretory component and other proteins in human lung lavage. Am Rev Respir Dis 122: 156–161

    PubMed  CAS  Google Scholar 

  125. Merrill WW, Naegel GP, Reynolds HY (1980) Reagenic antibody in the lung lining fluid: analysis of normal human bronchoalveolar lavage IgE and comparison to immunoglobulins G and A. J Lab Clin Med 96: 494–500

    PubMed  CAS  Google Scholar 

  126. Bell DY, Haseman JA, Spock A, McLennan G, Hook GER (1981) Plasma protein of the bronchoalveolar surface of the lungs of smokers and nonsmokers. Am Rev Respir Dis 124: 72–79

    PubMed  CAS  Google Scholar 

  127. Merrill WW, Naegel GP, Olchowski JJ, Reynolds HY (1985) Immunoglobulin G subclass proteins in serum and lavage fluid of normal subjects: quantitation and comparison with immunoglobulin A and E. Am Rev Respir Dis 131: 584–587

    CAS  Google Scholar 

  128. Olsen GN, Harris JO, Castle JR, Waldman RA, Karmgard HJ (1975) Alpha-1antitrypsin content in the serum, alveolar macrohages and alveolar lavage fluid of smoking and non-smoking normal subjects. J Clin Invest 55: 427–430

    Article  PubMed  CAS  Google Scholar 

  129. Villiger B, Brockelmann T, Kelly D, Heymach GJ, McDonald JA (1981) Bronchoalveolar fibronectin in smokers and nonsmokers. Am Rev Respir Dis 124: 652–654

    PubMed  CAS  Google Scholar 

  130. Lam S, LeRiche JC, Kijek K (1985) Effect of filtration and concentration on the composition of bronchoalveolar lavage fluid. Chest 87: 740–742

    Article  PubMed  CAS  Google Scholar 

  131. Hook GER, Bell DY, Gilmore LB, Nadeau D, Reasor MJ, Talley FA (1978) Composition of bronchoalveolar lavage effluents from patients with pulmonary alveolar poteinasis. Lab Invest 39: 342–356

    PubMed  CAS  Google Scholar 

  132. Hunninghake GW, Gadek JE, Kawanani O, Ferrans VJ et al. (1979) Inflammatory and immune processes in the human lung in health and disease: evaluation by bronchoalveolar lavage. Am J Pathol 97: 149–206

    PubMed  CAS  Google Scholar 

  133. Davis WG, Rennard SI, Bitterman P et al. (1983) Pulmonary oxygen toxicity: early reversible changes in human alveolar structures induced by hyperoxia. N Engl J Med 309: 878–883

    Article  PubMed  CAS  Google Scholar 

  134. Buchalter S, Rennard SI, Fulmer J et al. (1984) Evidence for alveolar edema and capillary leak in the lower respiratory tract of patients with sarcoidosis and idiopathic pulmonary fibrosis. Am Rev Respir Dis 129 (2): (A)64

    Google Scholar 

  135. Rossman MD, McDonald JA, Broekelman T, Dauber JH, Daniele RB (1983) Protein leak in pulmonary sarcoidosis: assessment of bronchoalveolar lavage fluid and plasma albumin and fibronectin. Am Rev Respir Dis 127 (2): 90 (A)

    Google Scholar 

  136. Daniele RP, Elias JA, Epstein PE et al. (1985) Bronchoalveolar lavage: role in the pathogenesis, diagnosis and management of interstitial lung disease. Ann Intern Med 102: 93–108

    PubMed  CAS  Google Scholar 

  137. Shasby DM, Shasby SS (1985) Active transendothelial transport of albumin• interstitium to lumen. Circ Res 57: 903–908

    PubMed  CAS  Google Scholar 

  138. Peterson MW, Stone P, Shasby DM (1987) Cationic neutrophil proteins increase transendothelial albumin movement. J Appl Physiol 62: 1521–1530

    Article  PubMed  CAS  Google Scholar 

  139. Bonomo L, D’Addabbo A (1964)131I albumin turnover and loss of protein into the sputum of chronic bronchitis. Clin Chim Acta 10: 214–222

    Google Scholar 

  140. Jacquot J, Dupuit F, Benali R, Spilmont C, Puchele E (1990) Modulation of albumin-like protein and lysozyme production by bovine tracheal gland serous cells: dependence on culture conditions. FEBS Lett 269 (1): 65–68

    Article  PubMed  CAS  Google Scholar 

  141. Baughman RP, Bosken CH, Loudon RG, Hurtubise P, Wesseler T (1983) Quantitation of bronchoalveolar lavage with Methylene Blue. Am Rev Respir Dis 128: 226–270

    Google Scholar 

  142. Rennard S, Basset G, Lecossier D, O’Donnell K, Martain P, Crystal RG (1986) Estimations of the absolute volume of epithelial lining fluid recovered by bronchoalveolar lavage using urea as an endogenous marker of dilution. J Appl Physiol 60: 532–638

    PubMed  CAS  Google Scholar 

  143. Peterson BT, Idell S, McCarthur C, Gray LD, Cohen AB (1990) A modified bronchoalveolar lavage procedure that allows measurement of lung epithelial lining fluid volume. Am Rev Respir Dis 141: 314–320

    PubMed  CAS  Google Scholar 

  144. DeMonchy JGR, Kauffman HF, Venge P et al. (1985) Bronchoalveolar eosinophils during allergen-induced late asthmatic rections. Am Rev Respir Dis 131: 373–376

    CAS  Google Scholar 

  145. Fabri LM, Baschetto P, Zacca E, Milani G, Piverotto F, Plebani M, Burlina A, Licata B, Mapp CE (1987) Bronchoalveolar neutrophilia during late asthmatic reactions induced by Toluene Diisocyanate. Am Rev Respir Dis 136: 36–42

    Article  Google Scholar 

  146. Calhoun WJ, Bush RJ et al. (1990) Enhanced reactive oxygen species metabolism of air space cells and airway inflammation follow antigen challenge in human asthma. J Allergy Clin Immunol 86: 306–13.

    Article  PubMed  CAS  Google Scholar 

  147. Rossi GA, Crimi E, Lauterno S, Gianiorio P, Oddera S et al. (1991) Late-phase asthmatic reaction to inhaled allergen is associated with early recruitment of eosinophils in the airways. Am Rev Respir Dis 144: 379–383

    Article  PubMed  CAS  Google Scholar 

  148. Murray JJ, Tonnel Ab, Brash AR (1986) Release of prostaglandin DZ into human airways during acute allergen challenge. N Engl J Med 315: 800–804

    Article  PubMed  CAS  Google Scholar 

  149. Lam S, Chan H, LeRiche JC, Chan-Yeung M, Salari H (1988) Release of leukotrienes in patients with bronchial asthma. J Allergy Clin Immunol 81: 711–717

    Article  PubMed  CAS  Google Scholar 

  150. Wenzel SE, Fowler AA, Schwartz LB (1988) Activation of pulmonary mast cells by bronchoalveolar allergen challenge: in vivo release of histamine and tryptase in atopic subjects with and without asthma. Am Rev Respir Dis 137: 1002–1008

    PubMed  CAS  Google Scholar 

  151. Chan-Yeung M, Chan H, Tse KS, Salari H, Lam S (1989) Histamine and leukotrienes release in bronchoalveolar fluid during plicatic acid-induced bronchoconstriction. J Allergy Clin Immunol 84: 762–768

    Article  PubMed  CAS  Google Scholar 

  152. Casale TB, Wood D, Richerson HB, Trapp S, Metzger WJ et al. (1987) Elevated bronchoalveolar fluid histamine levels in allergic asthmatics are associated with methacholine bronchial hyperresponsiveness. J Clin Invest 79: 1197–1203

    Article  PubMed  CAS  Google Scholar 

  153. Wardlaw AJ, Dunnette S, Gleich GJ, Colli NS et al. (1988) Eosinophils and mast cells in bronchoalveolar lavage in subjects with mild asthma. Relationship to bronchial hyperreactivity. Am Rev Respir Dis 137: 62–69

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 1993 Springer-Verlag Berlin Heidelberg

About this chapter

Cite this chapter

Rennard, S.I., Floreani, A.A., Linder, J., Thompson, A.B., McGranaghan, S., Spurzem, J.R. (1993). Bronchoalveolar Lavage in Asthma. In: Allegra, L., Braga, P.C., Dal Negro, R. (eds) Methods in Asthmology. Springer, Milano. https://doi.org/10.1007/978-88-470-2263-8_24

Download citation

  • DOI: https://doi.org/10.1007/978-88-470-2263-8_24

  • Publisher Name: Springer, Milano

  • Print ISBN: 978-88-470-2265-2

  • Online ISBN: 978-88-470-2263-8

  • eBook Packages: Springer Book Archive

Publish with us

Policies and ethics