1,721,103 research outputs found
The role of bronchoalveolar lavage in diffuse lung diseases [Ruolo del BAL nello studio delle interstiziopatie polmonari diffuse]
No full textThe application of bronchoalveolar lavage (BAL) to the study of diffuse interstitial lung diseases (DLD) provided very important information about the complex reactions present at alveolar level in the various forms. The data till now obtained allowed to improve our understanding of the pathogenetic mechanisms and to contribute to the diagnosis and to the disease activity evaluation. The evaluation of cell pattern often associated with cell phenotype is widely used in clinical practice to distinguish the various forms and may be of diagnostic value in some cases, when the clinical picture is compatible or can aid to exclude other diseases. More sophisticated investigations such as the analysis of cytokine patterns to identify the type of immune response (Th1/Th2) and of mediators with different functions (profibrotic, proinflammatory etc.) or the identification of disease markers by new methods (genomic or proteomic studies) are research tools with future clinical application for diagnosis, prognosis and new treatment indication. Standardized protocols and guidelines are needed for correct clinical use of BAL. The recent literature on the role of BAL in DLD is reviewed
Serum chitotriosidase activity in sarcoidosis patients
No full textChitotriosidase as a potential biomarker of sarcoidosi
Omalizumab treatment associated with Churg-Strauss vasculitis
No full textReport on Churg- Strauss vasculitis in a patient treated with omalizumab, due to streoids taperin
Human chitotriosidase: a potential new marker of sarcoidosis severity
No full textSarcoidosis is a multisystemic granulomatous disorder of unknown etiology. The unpredictable clinical course of the disease has prompted research into biomarkers useful for predicting outcome. Among the potential markers of sarcoidosis, a recently proposed indicator was chitotriosidase, a chitinase produced by activated macrophages. Chitotriosidase is involved in the defense against pathogens containing chitin. Increased concentrations of chitotriosidase have been observed in a number of lysosomal storage diseases including Gaucher disease and more recently also in sarcoidosis. In 2004, significantly higher serum chitotriosidase activity was reported for the first time in sarcoidosis patients with respect to controls (p < 0.01); a similar increase was subsequently observed in bronchoalveolar lavage of these patients. In 2007, an increase in enzyme activity was described in juvenile sarcoidosis. Chitotriosidase activity was found to be correlated with angiotensin-converting enzyme levels in serum, radiological stages and quantitative high-resonance CT score for sarcoidosis, suggesting that this enzyme could be a potential marker of disease severity worthy of further study. To evaluate the sensitivity and specificity of this marker, further analysis was done in other granulomatous and diffuse lung diseases. Here, we review the principal literature and the recent evidence of chitotriosidase as a possible marker of sarcoidosis
Is bronchoalveolar lavage obsolete in the diagnosis of interstitial lung disease?
No full textThis review considers the literature on bronchoalveolar lavage in the diagnosis of interstitial lung disease published during the last 12 months with the aim of clarifying the role bronchoalveolar lavage can have in diagnostic work-up on the basis of current knowledge and expert opinion. Recent research findings with possible future clinical applications are presented. Various information, useful for research and clinical applications, can be obtained from performing bronchoalveolar lavage in patients with interstitial lung diseases. Indeed, evaluation of cell pattern associated with cell phenotype is used widely in clinical practice to distinguish the various forms and may be of diagnostic value in some interstitial lung diseases, as already known, when the clinical picture is compatible. Bronchoalveolar lavage may also be complementary to high-resolution CT or at least useful for diagnosis by exclusion. A major advance in the last year is recognition of a role for bronchoalveolar lavage in the diagnostic workup of idiopathic interstitial pneumonias, albeit as an auxiliary procedure. It may be useful to exclude infections and tumors, may help to decide whether to do surgical biopsy, and may aid in distinguishing different forms of interstitial lung disease. Although it is not diagnostic for idiopathic interstitial pneumonias, in the presence of cell patterns considered "typical" of the various forms, it can support clinical diagnosis in the absence of biopsy. Because further studies following standardized protocols and guidelines will presumably find new parameters for bronchoalveolar lavage in the diagnostics of interstitial lung diseases, it would be a mistake to consider bronchoalveolar lavage an obsolete tool
Markers of inflammation in sarcoidosis: blood, urine, BAL, sputum, and exhaled gas
No full textSarcoidosis is characterized by intense inflammation at the different sites of localization. Many different mediators, such as cytokines, chemokines, and other proteins with various functions, that participate in its complex pathogenesis have been proposed as markers of inflammation. This article examines the principal literature on these different markers analyzed in serum, bronchoalveolar lavage, expired breath, and urine. After many years of research, no single marker sufficiently sensitive and specific for diagnosis of sarcoidosis has yet been found. Greater correlation with clinical parameters is needed and proper validation.
[PubMed - indexed for MEDLINE
Studies on bronchoalveolar cells in human diseases. II General morphology and ultrastructure of pulmonary macrophages and small mononuclear cells in sarcoidosis
No full textData are presented from light and electron microscopic studies on bronchoalveolar lavage (BAC) in sarcoidosis, with particular emphasis on the ultrastructural morphology and functional characteristics of pulmonary macrophages (PM) and small mononuclear cells (SMC). Light microscopy showed an average of over 77% of the BAC to be PM, range 99-51%. SMC populations were also extremely variable. These variations may relate directly to the degree of disease activity. Electron microscopy demonstrated a wide range of morphological and implied functional (biosynthetic and phagocytic) characteristics of PM. Some of these are morphologically comparable to cells found in tissue granulomata. Our ultrastructural study has shown that the SMC population is made up of lymphocytes, monocytes and cells with intermediate characteristics (precursors).
[PubMed - indexed for MEDLINE
Hypersensitivity to pets in Italy
No full textEight hundred and two consecutive symptomatic outpatients (with asthma and rhinitis) were studied to evaluate the incidence of prick test positivity to cat and dog danders and the association of exposure to these animals in the home, as revealed by a standard questionnaire. 14.3% were found to be skin positive to cat and/or dog danders. The incidence of cutaneous hypersensitivity to cat and/or dog danders was 25% in the 216 subjects who kept animals, significantly higher (p less than 0.0005) than the 10.4% of 586 subjects who did not keep animals. In the 57 subjects who owned both dogs and cats, a significantly higher incidence of skin hypersensitivity was found compared to the other subjects. Our data does not demonstrate a greater incidence in sensitivity to cat danders compared to dog danders, or increased sensitization to dermatophagoides pteronyssinus, nor a different incidence of clinical manifestations (asthma and rhinitis) between those with animals in the house and those without.
[PubMed - indexed for MEDLINE
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