T lymphocyte activation in bronchoalveolar lavage of patients with interstitial lung disease.

To study the role of T-lymphocytes in the patients with alveolitis due to interstitial lung disease (ILD), we have examined T cell populations in bronchoalveolar lavage (BAL) and peripheral blood (PB) of ten patients with ILD and six normal-controls via flow cytometry. The percentages of T-lymphocytes bearing the activation markers of HLA-DR (p < 0.01) and CD25 (p < 0.05) were significantly higher in BAL of ILD patients. There was no correlation between T lymphocytes subtypes and pulmonary functions and diffusion capacity (p > 0.05). In PB of ILD patients had less CD4+ T lymphocytes and CD19 cells (B lymphocytes) than controls (p < 0.05). This increased T-lymphocyte activation in BAL in contrast to PB suggested to have a role in the pathogenesis of the lung involvement in ILD.

Fluticasone propionate and budesonide do not influence bone metabolism in the long term treatment of asthma.

BACKGROUND: Inhaled corticosteroids (ICS) are recommended in the treatment of asthmatic patients. They have been said to be efficacious in the treatment of asthma in respect to cortisol and bone metabolism. METHODS: The effects of the two inhaled corticosteroid, budesonide (BUD) and fluticasone propionate (FP) on bone metabolism, morning cortisol and their effects on the clinical parameters (FEV1, diurnal variation of peak expiratory flow rate = PEFR and log PC20) were examined in a group of 16 asthmatic patients. Eight patients used 800 micrograms/daily BUD and 8,400 micrograms/daily FP during 6 months period. RESULTS: Both BUD and FP improved clinical parameters as determined by FEV1 (p < 0.05) and PEFR (p < 0.01). There was no difference in respect to log PC20 values in either group (p > 0.05). Both treatments didn't change morning cortisol (p < 0.05). Both FP and BUD didn't change any indices of bone formation as determined by serum alkaline phosphatase, bone alkaline phosphatase, osteocalcin and carboxyterminal propeptide of type 1 procollagen and bone resorption as determined by urinary calcium and deoxypyridinoline (p > 0.05). In addition there was no significant effect on calcium and phosphate metabolism (serum calcium, phosphate and parathyroid hormone). CONCLUSION: As a result, having no adverse effect on bone metabolism and adrenal function, in the regard to clinical efficacy, FP is as effective as the double dose of BUD on PEFR and FEV1.