T-cell alveolitis in lung lavage of asbestos-exposed subjects

Our plain-English summary of T-cell alveolitis in lung lavage of asbestos-exposed subjects, by N.L. Sprince, L.C. Oliver, T.C. McLoud, et al (American Journal of Industrial Medicine, 1992).

The study

• Authors: N.L. Sprince, L.C. Oliver, T.C. McLoud, L.C. Ginns
• Journal: American Journal of Industrial Medicine
• Published: 1992;21(3):311-9
• Cited by: 3 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

In sarcoidosis and idiopathic pulmonary fibrosis, it has been reported that lymphocyte proportions in lung lavage predict the subsequent clinical course. Recent evidence has suggested that lymphocytes are important in the alveolitis of asbestosis. We hypothesized that a greater relative proportion of T-lymphocytes in lung lavage of asbestos-exposed subjects is associated with immune activation and may predict the subsequent clinical course. We assessed lymphocyte subsets in lung lavage and peripheral blood (PB) of 97 asbestos-exposed subjects and 10 unexposed normal, using flow cytometry analysis of monoclonal antibody-treated cells. T-cell alveolitis was defined as follows: [%lymphocytes in lavage x %CD3 in lavage] greater than 2 SD above that product in normals. Eighteen subjects had T-cell alveolitis (group 1) and 79 did not (group 2). There were no significant differences between the groups in age, smoking status, duration of exposure, lung function results, or frequency of plaques or profusion greater than or equal to 1/0. Percent CD2 was higher in lavage of group 1 compared with group 2. There was a trend for higher %Ia in lavage of group 1 compared with group 2. These results identify a subgroup of asbestos-exposed subjects with T-cell alveolitis but no present excess of asbestos-related disease who may be at risk for future asbestos-related disease.

In plain English

This study compared cells rinsed from the lungs (bronchoalveolar lavage) and blood cells in 97 men with past workplace asbestos exposure in building construction trades, such as pipecoverers, plumbers, pipefitters and boilermakers, and in 10 unexposed healthy non-smoking volunteers. The authors defined "T-cell alveolitis" as lavage in which the percentage of lymphocytes multiplied by the percentage of CD3 T-cells was more than 2 standard deviations above that value in the unexposed volunteers. Eighteen exposed men (18.6%) met this definition and 79 did not. These two exposed groups did not differ significantly in age, smoking status, exposure duration, lung function, or chest X-ray findings. Pleural plaques alone were seen in 9 of the 18 and 33 of the 79. Blood results did not differ significantly between them. In lavage, the T-cell alveolitis group had a higher percentage of CD2 cells. A trend toward a higher percentage of Ia cells in that group did not reach statistical significance (p = 0.06). The authors concluded that this subgroup, with no present excess of asbestos-related disease, may be at risk for future disease, and called for follow-up studies. They advised caution with p-values because many comparisons were made.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: Cross-sectional comparison of lung lavage and blood lymphocyte subsets in asbestos-exposed volunteers and unexposed volunteers (the article does not name its design; no follow-up was done)
• Who was studied: Men who volunteered. 97 of 122 asbestos-exposed volunteers were analysed; 25 were excluded for missing lavage CD3 data. There were also 10 unexposed healthy non-smoking volunteers recruited through hospital notices. Authors were based at Massachusetts General Hospital, Boston, and the University of Iowa. Study dates were not given.
• Exposure: Workplace asbestos exposure in building construction trades: pipecoverer, plumber and pipefitter, boilermaker, sheetmetal worker, and cement mason. Fiber types were not specified.
• Main results:
  • 18 of the 97 exposed subjects (18.6%) had T-cell alveolitis (group 1); 79 (81.4%) did not (group 2)
  • No significant differences between group 1 and group 2 in age, smoking status, duration of exposure, lung function, or frequency of plaques or of small irregular opacities at profusion 1/0 or greater
  • Pleural plaques alone: 9 (50%) in group 1 and 33 (41.8%) in group 2
  • In blood, no statistically significant differences between groups 1 and 2
  • In lavage, group 1 had a higher CD2 percentage than group 2, beyond the differences expected from the group definition
  • Higher Ia percentage in lavage of group 1 was a trend that was not statistically significant (p = 0.06)
  • Asbestos exposure within 1 year of testing: 14 of 18 (77.8%) in group 1 vs 50 of 79 (63.3%) in group 2. The difference was not significant (p = 0.24).
• The authors' conclusion: The authors concluded that the results identify a subgroup of asbestos-exposed subjects with T-cell alveolitis but no present excess of asbestos-related disease, who may be at risk for future asbestos-related disease
• Limitations the authors state:
  • Multiple comparisons were performed, so p-values should be interpreted with caution
  • A larger sample might have shown a significant difference in Ia cells
  • Other measures of T-cell activation, such as soluble IL-2 receptor, were not assessed
  • The unexposed comparison group, used to define T-cell alveolitis, differed from exposed subjects in age and smoking status. The authors believed any resulting bias would tend to reduce the number meeting the definition.
  • The definition might not identify a group at risk for future disease; follow-up studies are needed

Topics

Medical terms in this study, explained in our Lexicon: Idiopathic, Pulmonary Fibrosis, Monoclonal Antibody.

Related studies

• Bronchoalveolar lavage in occupational lung diseases — C.R. Cordeiro, J.C. Jones, et al. (2007)
• Multinuclear giant cells in bronchoalveolar lavage in interstitial lung diseases — C. Agustí, A. Xaubet, et al. (1987)
• Two dimensional protein patterns of bronchoalveolar lavage fluid from non-smokers, smokers, and subjects exposed to asbestos — M. Lindahl, T. Ekström, et al. (1996)
• Inorganic particles in bronchoalveolar lavage fluids from nonoccupationally exposed subjects — M. Falchi, L. Biondo, et al. (1996)
• Detection of lipid peroxidation in lung and in bronchoalveolar lavage cells and fluid — J.M. Petruska, S.H. Wong, et al. (1990)
• Bronchoalveolar lavage cell and lymphocyte phenotype profiles in healthy asbestos-exposed shipyard workers — J.M. Wallace, J.S. Oishi, et al. (1989)

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