Am. J. Respir. Crit. Care Med., Volume 161, Number 5, May 2000, 1698-1704

Increase of Lung Neutrophils in Hypersensitivity Pneumonitis Is Associated with Lung Fibrosis

ANNIE PARDO, ROBERTO BARRIOS, MIGUEL GAXIOLA, LOURDES SEGURA-VALDEZ, GUILLERMO CARRILLO, ANDREA ESTRADA, MAYRA MEJÍA, and MOISÉS SELMAN

Facultad de Ciencias, Universidad Nacional Autónoma de Mexico, Mexico DF, Mexico; Department of Pathology, Baylor College of Medicine, Houston, Texas; and Instituto Nacional de Enfermedades Respiratorias, Mexico DF, Mexico

Hypersensitivity pneumonitis (HP) is characterized by a T-cell-mediated alveolitis, and the putative role of other inflammatory cells in its pathogenesis remains unclear. In this study we determined whether increased quantities of neutrophils were present in HP lungs, and if they were positive for gelatinase B and collagenase-2. Fifteen nonsmoking patients with subacute/chronic active HP were included. Lung samples were analyzed using myeloperoxidase antibody, and neutrophil/total cell ratio was evaluated by digital processing. All HP tissue samples exhibited variable quantities of neutrophils located inside vessels, and in the interstitial and alveolar spaces. Lung neutrophil percentage ranged from 0.7% to 4.8% (2.1 ± 1.4%). There was a positive correlation between the percentage of lung neutrophils and the percentage of lung fibrosis (r = 0.6, p < 0.02). Tissue neutrophils showed intense immunoreactive collagenase-2 and gelatinase B staining. Additionally, gelatinolytic activities corresponding to progelatinases A and B and their activated forms, were several-fold increased in the bronchoalveolar lavage fluid (BALF) from patients with HP as compared with control subjects. These findings suggest that in HP lungs there is a persistent traffic of neutrophils loaded with gelatinase B and collagenase-2 that may play a role in the lung damage and in the fibrotic response.

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