Characterization of the inflammatory and immune effector cells in the lung parenchyma of patients with interstitial lung disease.
The pathogenesis of the interstitial lung disorders is intimately related to the number, type, and state of activation of inflammatory and immune effector cells (the alveolitis) within the alveolar structures. To directly characterize the type and status of the cells comprising the alveolitis of various interstitial lung disorders, a method was developed to isolate inflammatory and immune effector cells from open lung biopsies of patients with idiopathic pulmonary fibrosis (n = 9) and sarcoidosis (n = 6). The cells isolated from these biopsies were compared with effector cells obtained from normal lung (n = 3). The effector cell populations in normal lung contained alveolar macrophages (84 ± 17%), lymphocytes (16 ± 4%), and rare polymorphonuclear leukocytes (<1%); of the lymphocytes present, 73 ± 4% were T-lymphocytes, 7 ± 2% were “activated” T-lymphocytes, and 9 ± 2% were B-lymphocytes. In contrast, a characteristic feature of the alveolitis of idiopathic pulmonary fibrosis was the presence of increased ...