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Query: UMLS:C0032285 (pneumonia)
 54,520 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

To investigate the morphological changes of local eosinophils in the lungs, we observed the ultrastructure of eosinophils in bronchoalveolar lavage fluid (BALF) from patients with eosinophilic pneumonia. We also measured the BALF concentration of eosinophil cationic protein (ECP) as an index of the activation of eosinophils. The eosinophils in BALF from patients with eosinophilic pneumonia showed various ultrastructural changes compared to eosinophils in BALF of the control patient. Changes included degranulation or disintegration of specific granules, cytoplasmic vacuolation, increased lipid droplets and the appearance of Charcot-Leiden crystals. These changes of BALF eosinophils were more prominent than those of peripheral blood eosinophils. ECP concentration (mean +/- SD) in BALF from patients with eosinophilic pneumonia was 12.2 +/- 7.78 micrograms/l which was significantly higher than the concentrations in patients with bronchial asthma not during an attack (1.36 +/- 2.08 micrograms/l) and in healthy control subjects (2.14 +/- 4.62 micrograms/l). These results suggest that local eosinophils in the lungs are activated and degranulated by various stimuli and undergo structural degeneration in eosinophilic pneumonia.
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PMID:[Ultrastructural observation of eosinophils in bronchoalveolar lavage fluid in eosinophilic pneumonia]. 148 34

Transbronchial biopsy specimens from ten patients with eosinophilic pneumonia were analysed to see whether the tissue contained activated eosinophils or secreted eosinophil cationic protein. The specimens showed many infiltrated tissue eosinophils in the intraalveolar spaces, and thickened alveolar septae and perivascular areas. Most of these eosinophils stained clearly with degranulation by immunohistochemical studies with monoclonal antibody EG2 (for the secreted form of eosinophil cationic protein), indicating that they were activated eosinophils. On the other hand, although pleural tissue obtained at bullectomy performed after pneumothorax showed eosinophilic infiltration, EG2-positive cells were few. Activated eosinophils may play an important role in the development of pulmonary lesions of eosinophilic pneumonia.
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PMID:[Evaluation of tissue eosinophils in eosinophilic pneumonia]. 150 82

Eosinophil cationic protein (ECP), a cytotoxic protein contained in the granules of eosinophils, has been suggested as having an important role in the pathogenesis of asthma. To determine whether ECP plays a similar role in bronchiolitis, we tested samples of nasopharyngeal secretions, obtained from a group of 47 children with various forms of illness related to respiratory syncytial virus (RSV) and from 26 children with non-RSV upper respiratory tract illness or bacterial pneumonia, for the presence of ECP by means of a double-antibody radioimmunoassay. Concentrations of ECP in children with RSV bronchiolitis were significantly higher (166.8 ng/ml) than the mean concentration of ECP in both groups of children with RSV upper respiratory tract illness (43.5 ng/ml, p less than 0.002) and RSV lower respiratory tract disease without wheezing (29.1 ng/ml; p less than 0.0002). Children with non-RSV upper respiratory tract illness or bacterial pneumonia had levels of ECP in nasopharyngeal secretions similar to those of children with RSV upper respiratory tract illness or RSV pneumonia. High ECP levels in nasopharyngeal secretions (greater than 50 ng/ml) were predictive of the development of bronchiolitis at the time of RSV infection (p less than 0.001), and the individual ECP levels correlated with severity of the disease as determined by the initial PaO2 concentrations (p less than 0.05). These data suggest that eosinophil degranulation in the respiratory tract occurs during RSV bronchiolitis and may play a significant role in the development of virus-induced airway obstruction.
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PMID:Eosinophil degranulation in the respiratory tract during naturally acquired respiratory syncytial virus infection. 173 Oct 20

An 18-year-old woman presented with coughing, fever, progressive dyspnea, and diffuse infiltrates on the chest X-ray film. Analysis of bronchoalveolar lavage fluid showed 73% eosinophils. Acute eosinophilic pneumonia was diagnosed. Methylprenisolone, 1 g per day was given for three days and her condition improved dramatically. No relapse was observed. Analysis of bronchoalveolar lavage fluid also showed lymphocytosis, abnormally high concentrations of ECP, GM-CSF, IL-5 and sICAM-1, and hypersegmentation of eosinophil nuclei. After steroid treatment almost all these findings returned to normal; only lymphocytosis remained. Precipitating antibodies against four kinds of fungi, including Trichoderma viridae, were noted in the serum, but the environmental provocation test was negative and those fungi were not detected in the environmental culture growth. Comparison of bronchoalveolar lavage findings obtained before and after steroid treatment can provide information on the mechanism of eosinophil accumulation in the lung. This case also draws attention to the relationship between acute and chronic eosinophilic pneumonia.
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PMID:[A case of acute eosinophilic pneumonia: bronchoalveolar lavage findings before and after steroid treatment]. 756

We describe an acute eosinophilic pneumonia (AEP) patient with bronchoalveolar lavage fluid (BALF). Eosinophil cell number (47%), content of interleukin (IL)-5 (8.22 x 10(2) pg/ml) and eosinophil cationic protein (9.25 micrograms/ml) were high in BALF. No eosinophilia was seen in peripheral blood on admission; however, content of IL-5 was 9.47 x 10(2) pg/ml. After methylprednisolone pulse therapy, he improved rapidly with a reduction in eosinophil cell number (7%) and the content of IL-5 (< 100 pg/ml) in BALF. However, a high content of IL-5 (6.9 x 10(2) pg/ml) and transient eosinophilia (17.5%) were seen in peripheral blood. It is important to distinguish between AEP and infectious pneumonia, because of the differing treatments. If the diagnosis of AEP is doubtful, BALF should be performed early.
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PMID:IL-5 predominant in bronchoalveolar lavage fluid and peripheral blood in a patient with acute eosinophilic pneumonia. 771 86

Eosinophil cationic protein (ECP) was assayed in nasopharyngeal secretion (NPS) and serum from 42 infants, hospitalized with acute lower respiratory infection, in El Salvador and the results analyzed in relation to etiology of the infection. ECP concentrations were high in NPS, at an average 50 times higher than those found in serum. Exceedingly high levels of ECP (> 1000 micrograms/L) were found more frequently in wheezing than in non-wheezing children (30% vs 7%) and, accordingly, were more commonly found in children hospitalized with bronchiolitis than in those with pneumonia. Excessive levels were significantly more common in girls than in boys. Of the 42 cases, 28 were found to be caused by respiratory syncytial virus (RSV) subgroup A, and 3 by RSV-B, by means of detection of RSV antigen in nasopharyngeal cells. ECP serum levels were moderately elevated during the acute phase of the respiratory infection and increased slightly but significantly, in cases with RSV antigen-positive bronchiolitis, but not in those with pneumonia. The ECP levels in NPS from patients in Sweden who, by antigen detection in NPS cells, were diagnosed as either RSV or para-influenza 3 infection or none of these, were similar. These results indicate that elevation of ECP in NPS is associated with acute lower respiratory infection in general, but particularly pronounced in cases of bronchiolitis. Elevation of ECP is not an exclusive consequence of RSV infection, but may occur to an equal extent in infections caused by other agents.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Eosinophil cationic protein in nasopharyngeal secretions and serum of infants infected with respiratory syncytial virus. 808 88

Infants and young children with acute viral respiratory illness were studied to determine the association of peripheral blood eosinophil counts and concentrations of eosinophil cationic protein (ECP) in nasopharyngeal secretions with the development and severity of bronchiolitis. Subjects included those with upper respiratory illness (URI) alone, pneumonia or bronchiolitis. Controls consisted of healthy infants, and those hospitalized with non-respiratory illnesses. While peripheral blood eosinophil counts were suppressed in all infected infants greater than two months of age, eosinophil counts in patients with bronchiolitis were significantly greater than in those with URI alone. ECP concentrations were significantly greater among individuals with bronchiolitis than other infected infants. For bronchiolitis cases with detectable peripheral blood eosinophils, eosinophil counts correlated weakly and inversely with oxygen saturations. In contrast, ECP concentrations were strongly inversely correlated with initial oxygen saturation. ECP concentrations were also significantly correlated with peripheral blood eosinophil counts. Viral infections suppress peripheral blood eosinophil counts in infants greater than two months of age, although the effect is somewhat overcome in patients with bronchiolitis. The form and severity of bronchiolitis is much more strongly related to degranulation of eosinophils in the respiratory tract than to peripheral blood eosinophil counts.
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PMID:Peripheral blood eosinophil counts and eosinophil cationic protein content of respiratory secretions in bronchiolitis: relationship to severity of disease. 808 90

Idiopathic pulmonary fibrosis (IPF) is characterized by a chronic inflammatory process in the lower respiratory tract of unknown etiology and poor prognosis. There is evidence that cytotoxic mediators released by neutrophils and eosinophils, such as myeloperoxidase (MPO) and eosinophil cationic protein (ECP) play a central role in the pathogenesis of this disease. The aim of this study was to assess disease activity in patients with IPF by measuring MPO and ECP concentrations in bronchoalveolar lavage (BAL). 14 patients with IPF had significantly higher concentrations of BAL-MPO and ECP (median = 117.2 micrograms/l, range: 4-217 micrograms/l and median = 16 micrograms/l, range: 4-34 micrograms/l, respectively) than patients with sarcoidosis (n = 9) (median = 6.5 micrograms/l, range: 4-12 micrograms/l and median = 7.1 micrograms/l, range: 2-13 micrograms/l, respectively) or pneumonia (n = 13) (median = 10.8 micrograms/l, range: 5-14 micrograms/l and median = 7.6 micrograms/l, range: 3-10 micrograms/l, respectively) (p < 0.01). Follow-up of MPO and ECP concentrations in BAL was performed in 8 patients with IPF before and after 4 weeks high-dose and 12 months low-dose corticosteroid therapy. Changes in MPO and ECP levels paralleled the clinical course and successful treatment resulted in a significant decrease of both MPO and ECP concentrations (p < 0.05), while clinical deterioration or treatment failure was associated with an increase of BAL-MPO and ECP levels. Increased MPO and ECP concentrations in BAL seem to reflect ongoing disease activity and may be useful prognostic markers in the management of patients with IPF.
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PMID:[Diagnostic value of secretory products of eosinophils and neutrophils in bronchoalveolar lavage in patients with idiopathic lung fibrosis]. 839 88

A 64-year-old women presented with a dry cough. The common cold was diagnosed and she was given medication, but the symptom did not resolve. She came to our hospital, and multiple patchy shadows were seen on a chest X-ray film. Bronchoalveolar lavage fluid contained an abnormally high percentage of eosinophils. Microscopic examination of transbronchial lung biopsy specimens showed infiltration of eosinophils into the alveoli and alveolar septa. Chronic eosinophilic pneumonia was diagnosed. Analysis of bone marrow cells showed high percentages of mature eosinophilic cells, and blood serum had a high concentration of eosinophil cationic protein. An inhalation challenge test with methacholine revealed bronchial hypersensitivity and hyperresponsiveness. Prednisolone (30 mg/day) was given and the symptoms resolved. After steroid treatment, the patient was asymptomatic, although airway hyperresponsiveness remained. The concentration of eosinophil cationic protein in serum and the results of the methacholine inhalation test reflected the degree of chronic eosinophilic pneumonia, and the production of eosinophils in bone marrow was suppressed by steroid medication.
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PMID:[Chronic eosinophilic pneumonia involving eosinophil cationic protein and bone marrow cells]. 895 6

In chronic eosinophilic pneumonia (CEP), histopathological evidence exists for the degranulation of eosinophils and the release of various toxic proteins. In vitro studies have demonstrated the degranulation of eosinophils in response to aggregated and complexed immunoglobulins. The aims of this study were to investigate: 1) whether the eosinophil cationic protein (ECP) and immunoglobulin (Ig) levels in bronchoalveolar lavage (BAL) fluid from patients with CEP are increased compared to those of healthy controls; 2) and whether a relationship is present between immunoglobulin levels and ECP levels in BAL fluid from patients with CEP. The BAL from 12 patients with CEP was selected, retrospectively, from all BAL analyses performed in our centre between 1986 and 1992. ECP levels were measured using a radioimmunoassay in BAL fluid of patients with CEP and 10 healthy controls. ECP levels and immunoglobulin levels in BAL fluid from patients with CEP were found to be elevated compared to controls (p < 0.001). A relationship was found between IgA levels and ECP levels in BAL fluid from patients with CEP (r = 0.72; p = 0.043). In conclusion, eosinophil cationic protein and immunoglobulin levels were found to be increased in bronchoalveolar lavage fluid from patients with chronic eosinophilic pneumonia. The relationship found between immunoglobulin A levels and eosinophil cationic protein levels may suggest that immunoglobulin A could be involved in the degranulation of eosinophils in chronic eosinophilic pneumonia.
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PMID:Eosinophil cationic protein and immunoglobulin levels in bronchoalveolar lavage fluid obtained from patients with chronic eosinophilic pneumonia. 898 Sep 49


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