Analysis of bronchoalveolar lavage in XXXX : divergent responses of antigen-specific antibodies and total IgE.

@entity1 @entity54 @entity3460 @entity5929
Bronchoalveolar lavage (BAL) was performed in eight @entity1 with @entity5929 ( @entity5929 ) at a time when chest roentgeongraphy did not reveal an infiltrate, and respiratory status was stable. BAL was tolerated well by all @entity1 with only one @entity1 experiencing mild wheezing. BAL fluid recovery averaged 40%, and total cells/lavage were 22.3 x 10(6) (range 3.5 to 49.5 x 10(6)). Cell viability, as determined by @entity3460 exclusion, averaged 48% (range 34% to 60%). Mean values for cellular elements were macrophages, 62%; epithelial cells, 12%; lymphocytes, 16%; neutrophils (PMN), 4%; and eosinophils, 6%. Isotypic antibodies to @entity54 (Af) in BAL and serum were detected by an amplified indirect ELISA. Antibodies to Af in BAL expressed as optical density/albumin (milligrams per milliliter) were compared to BAL from six nonatopic @entity1 . IgE-Af and IgA-Af in BAL were elevated in @entity1 with @entity5929 compared with six nonatopic @entity1 . The ratios of Ig-Af in BAL to peripheral blood in @entity1 with @entity5929 were 48 (range 18 to 75) for IgE-Af, 96 (range 37 to 159) for IgA-Af, and 0.94 (range 0.24 to 1.40) for IgG-Af, suggesting local production of IgE-Af and IgA-Af in the bronchoalveolar compartment. Total serum IgE correlated directly with IgE-Af in BAL (rs = 0.67; p less than 0.02). However, the ratio of total BAL IgE/albumin divided by total serum IgE/albumin was 0.93 +/- 0.94, suggesting that the bronchoalveolar compartment is not the source of the significant elevations in total serum IgE in @entity5929 .
