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Am. J. Respir. Crit. Care Med., Volume 160, Number 1, July 1999, 283-290

Antibacterial Components in Bronchoalveolar Lavage Fluid from Healthy Individuals and Sarcoidosis Patients

BIRGITTA AGERBERTH, JOHAN GRUNEWALD, ESMERALDA CASTAÑOS-VELEZ, BERIT OLSSON, HANS JÖRNVALL, HANS WIGZELL, ANDERS EKLUND, and GUDMUNDUR H. GUDMUNDSSON

Department of Medical Biochemistry and Biophysics, and Microbiology and Tumorbiology Center, Karolinska Institutet; Department of Medicine and Immunopathology Laboratory, Karolinska Hospital, Stockholm, Sweden

Antibacterial peptides and proteins are an integral part of the epithelial defense barrier that provides immediate protection against bacterial invasion. In humans, alpha -defensins are mainly bactericidal effectors in circulating granulocytes, beta -defensin-1 is synthesized in epithelial cells, and LL-37 is produced in granulocytes but is also induced in skin epithelia during inflammation. To investigate the importance of these defense effectors in disease, we analyzed bronchoalveolar lavage fluid (BALF) for bactericidal activity. Antibacterial activity was found in BALF material from healthy individuals and sarcoidosis patients, with enhanced activity in BALF from the patients. The activity was present as several antibacterial components, of which we have so far characterized LL-37, lysozyme, alpha -defensins, and antileukoprotease. In addition, the antibacterial peptide LL-37 was located in alveolar macrophages, bronchial epithelial cells, and bronchial glands, suggesting that it has a defensive role in airway mucosa. In conclusion, the airway epithelium is protected by a complex antibacterial defense system. This is activated in sarcoidosis, and may explain why these patients seldom develop severe respiratory tract infections.




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Copyright © 1999 American Thoracic Society