Am. J. Respir. Crit. Care Med., Vol 153, No. 4, 04 1996, 1437-1441.
Cytokine production at the site of disease in chronic eosinophilic pneumonitis
H Kita, S Sur, LW Hunt, ES Edell, DA Weiler, MC Swanson, RW Samsel, JS Abrams and GJ Gleich
Department of Medicine, Mayo Clinic and Mayo Foundation, Rochester, Minnesota, USA.
Chronic eosinophilic pneumonitis (CEP) is characterized by longstanding
respiratory symptoms accompanied by a massive pulmonary eosinophil
infiltration. We hypothesized that cytokine(s) produced in the disease
sites are implicated in the pathophysiology of CEP. We studied peripheral
blood and bronchoalveolar lavage fluids (BALF) obtained from two lung
segments of a patient with CEP. Seventy times more eosinophils were found
in the BALF from an involved lung segment (showing patchy opacification on
a chest roentgenogram) than from an uninvolved segment. The
eosinophil-active cytokines interleukin-5 (IL-5), IL-6, and IL-10 were
strikingly elevated in the BALF from the involved lung segment, whereas no
or minimal levels of these cytokines were detectable in the BALF from the
uninvolved segment or serum, respectively. Leukocytes in the involved lung
segment, but not those in peripheral blood, expressed messenger ribonucleic
acid (mRNA) for IL-5, IL-6, and IL-10. In contrast, IL-2, IL-3, IL-4,
interferon-gamma (IFN- gamma), granulocyte-macrophage colony-stimulating
factor (GM-CSF), and tumor necrosis factor-alpha (TNF-alpha) were not
detected in any sample. These findings suggest that increased production of
several cytokines, such as IL-5, IL-6, and IL-10, in the involved lung
segment, but not in the uninvolved lung segment or peripheral blood, is a
critical pathophysiologic feature of CEP.
