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Query: UMLS:C0019621 (Langerhans cell histiocytosis)
 3,250 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Respiratory tract fluid, produced from an enormous area spanning the mucosa of the nose to the alveolar surface, is a complex mixture of serum transudate and locally secreted proteins and glycomucoproteins and of inflammatory and immune effector cells intermingled. Its analysis is important in understanding the pathogenesis of respiratory diseases and remains essential for the clinical diagnosis of most lung disorders. Many basic facts about the formation and composition of this fluid remain unknown, and little information exists about absorptive mechanisms along the airways. Respiratory fluid is not homogeneous but has unique regional characteristics that are becoming better appreciated as more selective sampling methods are devised. Above all, it is a dynamic substance in healthy airways and diseased ones, and any specimen is just a point-in-time sample that can change in composition, often making serial analysis and comparisons necessary. Nasal fluids currently have limited diagnostic application except in allergic rhinitis. Expectorant (sputum) telescopes fluid and cells from all areas and is not from a specific locale, so the trend is to retrieve more selective and regional specimens of airways fluids. Technology largely does not exist to collect area specimens, except for bronchoalveolar lavage, which generally samples the alveolar surface. Clearly, bronchoalveolar lavage fluid analysis has been the favored way to characterize the peripheral air-spaces for the past 10 years or so, and most of this monograph has been devoted to normal data derived from lavage specimens and to a few examples of lung disease that reflect this burgeoning application. In many respects, results obtained from lavage fluid are virtually in catalogue form at present, and it remains to the future to know how some of the observations will help make diagnosis better or elucidate pathogenic mechanisms. Generally, bronchoalveolar lavage fluid analysis has led to better concepts of immunopathology of many diseases and provided new ways to monitor the evolution of certain diseases, especially the diffuse interstitial lung disorders, but development of specific criteria for diagnosis has been less rewarding. However, certain patterns of lymphocyte-predominant alveolitis, suggesting sarcoidosis or hypersensitivity diseases, recognition of specific T lymphocyte defects and opportunistic microorganisms as in AIDS, and the use of microprobe electron analysis to identify cellular particulates all point to more precision of diagnosis. Alveolar proteinosis and histiocytosis X may be detected from lavage fluid components. The prospects are truly exciting.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:Respiratory tract fluids: analysis of content and contemporary use in understanding lung diseases. 636 22

Histological features of tuberculosis are caseation necrosis and epithelioid cell granuloma formation. Both phenomena are interpreted as expression of cellular immunity. Caseation necrosis is thought to be immunopathology and epithelioid cell granuloma formation is considered to be expression of protective immunity. Recently roles of cytokines for granuloma formation are gradually elucidated. In this symposium, mechanisms and functions of necrosis and granuloma formation Dr. Akagawa reported differentiation of two types of phenotypically different macrophages from human monocytes by GM (granulocyte-macrophage)-CSF or M (macrophage)-CSF. Interestingly such a basic differentiation induced by CSF was affected by IL-4 (interleukin-4). Langerhans-like dendritic cells were generated by cooperation of GM-CSF and IL-4, and multinucleated cells were generated by cooperation of IL-4 and M-CSF. Dr. Fukuda reported human Langerhans cell granulomatosis (LCG) from the pathological and immunohistochemical standpoints. In situ proliferation of LCs in the LCG was demonstrated by immunohistochemistry using antibody to PCNA (proliferating cell nuclear antigen) which is used to detect proliferating cells. In the course of granuloma formation, damage and disruption of lung structure such as alveolar basement membrane and elastic tissue framework, and reactive intraluminar fibrosis was observed. Mechanism of cystic dilation was also reported. Cytokines might play important roles in these events. Dr. Ina demonstrated experimental epithelioid cell granuloma formation. Extract (granuloma inducing factor, GIF) from Schistosoma mansoni Egg-induced granuloma, TNF -alpha, or IL-1 beta were coated, individually on the surface of beads, then these beads were inoculated to rat's skins or cultured with rat's monocytes. Four weeks later, epithelioid cell granuloma was demonstrated histologically and electronmicroscopically around beads in vitro and in vivo. GIF-induced granuloma was more organized than cytokine-induced ones. In vitro using human monocytes, activated macrophages accumulated around beads of which cytokines or GIF were coated. It was suspected that many cytokines or other factors are needed to make epithelioid cell granuloma. Dr. Sakamoto showed the presence of acid fast bacilli and various inflammatory cells including lymphocytes and macrophages in the tuberculous caseous necrosis after exudative reaction (E-necrosis) by immunohistochemistry. But no acid fast bacilli or inflammatory cells were found in the caseous necrosis after productive reaction (P-necrosis). TNF-alpha (tumor necrosis factor-alpha) and IL-4 were stained in the E-necrosis and IL-4 and ICAM-1 (intercellular adhesion molecule-1) were positively stained in the cytoplasm of epithelioid cells by immunohistochemistry. It was suspected that many cells and cytokines were involved in epithelioid cell granuloma formation and caseous necrosis formation.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:[The 69th annual meeting symposium. II: Mechanism of necrotizing granuloma formation and its function]. 779 74