Increased levels of IL-8 in BALF from patients with Pulmonary Alveolar Proteinosis

ERNST, GLENDA; JANCIC, CAROLINA; CARO, FABIAN; VUJACICH, PATRICIA; TABAJ, GABRIELA ; GARCIA, ARTEMIO; SILVIA HAJOS, ; GEFFNER, JORGE; GRYNBLAT, PEDRO

Atlanta

Conferencia; Chest 2012; 2012

PURPOSE: Idiopathic Pulmonary Alveolar Proteinosis (PAP) is a rare illness characterized by the accumulation of phospholipids, surfactants and a high cellularity in the alveolar space as well as by the presence of antibodies anti-GM-CSF in the patient serum. The aim of this study was to determine the levels of IL-8 in bronchoalveolar lavage fluid (BALF) from patients with PAP, patients with other Interstitial Lung Diseases (ILDs), and healthy subjects. METHODS: PAP was confirmed by lung biopsies. In 3 patients we detected by ELISA the presence of antibodies anti-GM-CSF working with serum samples diluted 1:750. IL-8 was determined by ELISA in BALF from 13 healthy subjects (to whom bronchoscopy was performed as follow up for post-intubation tracheal stenosis surgery), BALF from 31 patients with ILDs with histopathology confirmation (idiopathic pulmonary fibrosis/usual interstitial pneumonia (IPF/UIP: n=6); non-specific interstitial pneumonia (NSIP: n=4); hypersensitivity pneumonitis (HP: n=12), sarcoidosis (n=6); pulmonary Langerhans cell histiocytosis (Hx: n=3), and BALF from 4 patients with PAP. RESULTS: We found a significant increase in IL-8 levels in BALF from patients with PAP compared with either healthy subjects (769.9 ± 133.2 vs 64.9 ± 28.5 pg/mL; p<0.05), or ILD patients (UIP/FPI: 111.0 ± 33.0 pg/mL; NSIP: 68.6 ± 23.3 pg/mL; HP: 59.3 ± 20.8 pg/mL; sarcoidosis: 112.6 ± 77.65 pg/mL and Hx: 93.7 ± 48.3 pg/mL, p<0.05). By contrast, we found no differences among the different groups in the BALF levels of the proinflammatory cytokines IL-1beta, IL-6 and TNF-alpha. CONCLUSIONS: We found that IL-8 levels in BALF from patients with PAP are significantly increased compared with healthy subjects and patients with others ILD. CLINICAL IMPLICATIONS: The presence of elevated levels of IL-8 may contribute to the recruitment of inflammatory cells observed in PAP.