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Sartorelli P, Indini S, Bianchi F, D'Alessandro M, Bergantini L, Cameli P, Mazzei MA, Scancarello G, Barabesi L, Bargagli E. Cytological analysis of bronchoalveolar lavage fluid in asbestos-exposed workers. LA MEDICINA DEL LAVORO 2020; 111:379-387. [PMID: 33124609 PMCID: PMC7809980 DOI: 10.23749/mdl.v111i5.9170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/10/2020] [Accepted: 07/24/2020] [Indexed: 11/17/2022]
Abstract
Background: Asbestos-related lung diseases are a group of heterogeneous disorders with different pathogenesis and prognosis. Very few studies investigated the BALF cell profile of asbestos exposed workers. The existence of a relationship between bronchoalveolar lavage fluid (BALF) cellular pattern and specific diagnosis and/or asbestos exposure biomarkers would allow the identification of effect biomarkers useful in the follow up of asbestos-exposed workers and in the diagnosis of asbestos-related diseases. Objectives: To assess BALF cell profile in formerly asbestos-exposed workers and its relationship with asbestos fibre (amphibole and chrysotile) and asbestos body (AB) concentrations. Methods: 113 male workers formerly exposed to asbestos underwent bronchoscopy with bronchoalveolar lavage and were retrospectively enrolled. 35 of them were affected by pleural plaques and 10 were affected by asbestosis. Pulmonary functional tests (PFT), BALF cellular pattern, BALF mineralogical analysis with asbestos fibres and AB counting were performed in each patient. A statistical analysis with a multivariate linear regression model was adopted. Results: From the statistical analysis of data a direct correlation between pack-years and BALF macrophages was found. Inversely correlation between pack-years and BALF lymphocytes was detected. There was not relationship among BALF cellular pattern, PFT values, specific diagnosis, BALF AB count or BALF asbestos fibre concentration. Discussion: BALF cellular pattern does not seem to be related to asbestos exposure biomarkers like AB and asbestos fibre concentration in BALF. Instead, smoke habit can induce an increase in BALF macrophages and a decrease of BALF lymphocytes count.
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Affiliation(s)
- Pietro Sartorelli
- Department of Medical Biotechnology, University of Siena, Unit of Occupational Health, Siena University Hospital, Viale Bracci 16, 53100 Siena, Italy.
| | - Sveva Indini
- Department of Medical Biotechnology, University of Siena, Unit of Occupational Health, Siena University Hospital, Viale Bracci 16, 53100 Siena, Italy.
| | - Francesco Bianchi
- Department of Medical, Surgical and Neurological Sciences, University of Siena, Unit of Respiratory Disease and Lung Transplant, Siena University Hospital, Viale Bracci 16, 53100 Siena, Italy.
| | - Miriana D'Alessandro
- Department of Medical, Surgical and Neurological Sciences, University of Siena, Unit of Respiratory Disease and Lung Transplant, Siena University Hospital, Viale Bracci 16, 53100 Siena, Italy.
| | - Laura Bergantini
- Department of Medical, Surgical and Neurological Sciences, University of Siena, Unit of Respiratory Disease and Lung Transplant, Siena University Hospital, Viale Bracci 16, 53100 Siena, Italy.
| | - Paolo Cameli
- Department of Medical, Surgical and Neurological Sciences, University of Siena, Unit of Respiratory Disease and Lung Transplant, Siena University Hospital, Viale Bracci 16, 53100 Siena, Italy.
| | - Maria Antonietta Mazzei
- Department of Medical Surgical and Neurological Sciences, University of Siena, Unit of Diagnostic Imaging, Siena University Hospital, Viale Bracci 16, 53100 Siena, Italy.
| | - Giuseppina Scancarello
- Unit of Occupational Hygiene and Toxicology, Laboratory of Public Health AUSL South-East Tuscany, Strada del Ruffolo 4, 53100 Siena, Italy.
| | - Lucio Barabesi
- Department of Economics and Statistics, University of Siena, Piazza San Francesco 7, 53100 Siena, Italy.
| | - Elena Bargagli
- Department of Medical, Surgical and Neurological Sciences, University of Siena, Unit of Respiratory Disease and Lung Transplant, Siena University Hospital, Viale Bracci 16, 53100 Siena, Italy.
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Keskitalo E, Varis L, Bloigu R, Kaarteenaho R. Bronchoalveolar cell differential count and the number of asbestos bodies correlate with survival in patients with asbestosis. Occup Environ Med 2019; 76:765-771. [DOI: 10.1136/oemed-2018-105606] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2018] [Revised: 06/12/2019] [Accepted: 06/30/2019] [Indexed: 11/04/2022]
Abstract
ObjectivesTo determine cell differential counts and the number of asbestos bodies (ABs) in bronchoalveolar lavage (BAL) fluid obtained from patients with asbestosis, and to correlate the results with their survival.MethodsThe BAL cell differential counts and ABs from 91 patients with asbestosis were determined. The BAL cell differential counts were analysed in relation to smoking status. BAL cell differential counts and the number of ABs were correlated with the patients’ survivals.ResultsA neutrophilic cell pattern was observed independently of smoking habits with both Papanicolau (8.4%) and May-Grunwald-Giemsa (6.5%) staining. Smoking and a high number of ABs (>2 AB/mL) were associated with high total cell counts and high macrophage and low lymphocyte differential counts. The median survival of the patients was 131.8 months. Shortened survival was associated with high numbers of ABs (78 vs 165 months; p=0.042) and low lymphocyte (77 vs 179 months; p=0.005), high neutrophil (102 vs 180 months; p=0.016) and high eosinophil (104 vs170 months; p=0.007) differential counts.ConclusionA neutrophilic cell pattern was evident in BAL from patients with asbestosis. Smoking and ABs both affected the total cell count and the macrophage and lymphocyte differential counts. Several BAL parameters associated with patient survival, suggesting that BAL cell count analyses could be used in the estimation of the prognosis of patients with asbestosis.
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Hostetter SJ, Clark SK, Gilbertie JM, Wiechert SA, Jones DE, Sponseller BA. Age-related variation in the cellular composition of equine bronchoalveolar lavage fluid. Vet Clin Pathol 2017; 46:344-353. [PMID: 28346682 PMCID: PMC10629498 DOI: 10.1111/vcp.12473] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND Previous reports reveal variation in the cellular composition of equine bronchoalveolar lavage fluid (BALF). OBJECTIVES The purpose of this study was to compare the profiles of BALF from horses to assess age-related differences. Serial BALF samples were collected from the same individuals over a one-year period to identify changes in individual animals as they aged. METHODS Collection of BALF was performed on horses aged one week and one, 2, 6, and 12 months. Total nucleated cell count (TNCC), protein concentration, and cytology were assessed. Longitudinal analysis was performed and compared to healthy adults. RESULTS Foals at one week and 6 months of age had significantly higher TNCC than adults (medians: 320/μL, 285/μL, and 90/μL, respectively); no differences in total protein were found. Foals at one month had the highest proportion of macrophages (median: 87.3%), differing significantly from both yearlings and adults (medians: 45.5% and 48.7%, respectively). Foals aged one week and one month had significantly lower proportions of lymphocytes than yearlings and adults (medians: 3.2% and 4.7% vs 43.2% and 45.8%, respectively). Eosinophil percentage was lowest in foals aged one week, one month, and 2 months (median: 0.0%) and highest in foals aged 6 months (median: 2.2%). Mast cell percentages were highest in yearlings and adults (medians: 2.2% and 3.3%, respectively) and neutrophil percentage was highest in foals aged one week (13.7%). CONCLUSIONS Cytologic profiles of BALF from foals and adult horses differed considerably. Significant changes in TNCC and percentages of lymphocytes, macrophages, and eosinophils occurred with age.
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Affiliation(s)
| | - Sandra K Clark
- Departments of Veterinary Microbiology and Preventive Medicine, Iowa State University, Ames, IA, USA
| | - Jessica M Gilbertie
- Departments of Veterinary Microbiology and Preventive Medicine, Iowa State University, Ames, IA, USA
| | - Sarah A Wiechert
- Departments of Veterinary Microbiology and Preventive Medicine, Iowa State University, Ames, IA, USA
| | - Doug E Jones
- Departments of Veterinary Pathology, Iowa State University, Ames, IA, USA
| | - Brett A Sponseller
- Departments of Veterinary Microbiology and Preventive Medicine, Iowa State University, Ames, IA, USA
- Departments of Veterinary Clinical Sciences, Iowa State University, Ames, IA, USA
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Cruz MJ, Curull V, Pijuan L, Álvarez-Simón D, Sánchez-Font A, de Gracia J, Culebras M, Ferrer J. Utility of Bronchoalveolar Lavage for the Diagnosis of Asbestos-Related Diseases. Arch Bronconeumol 2016; 53:318-323. [PMID: 27914752 DOI: 10.1016/j.arbres.2016.08.016] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2016] [Revised: 08/14/2016] [Accepted: 08/16/2016] [Indexed: 10/20/2022]
Abstract
INTRODUCTION Bronchoalveolar lavage (BAL) analysis has been proposed as an objective technique for confirming asbestos exposure. However, the reliability and diagnostic yield of this procedure has not been studied in Spain. The aim of this study was to assess the usefulness of the analysis of asbestos bodies (AB) in bronchoalveolar lavage (BAL) for the diagnosis of asbestos-related diseases (ARD). METHODS BAL samples from 72 patients (66 male, mean age 66 years) undergoing bronchoscopy were analyzed. Lung tissue from 23 of these patients was also analyzed. Asbestos exposure was assessed by anamnesis and a review of the patient's medical records. BAL and lung samples were processed and AB count was determined by light microscopy. The accepted threshold value to diagnose asbestos-related diseases was 1 AB/ml BAL or 1000 AB/gr dry tissue. RESULTS Thirty-nine patients reported exposure to asbestos. Of these, 13 (33%) presented AB values above 1 AB/ml BAL. In the 33 non-exposed patients, 5 (15%) presented AB values above 1 AB/ml BAL. There was a significant difference between the AB levels of exposed and non-exposed patients (P=.006). The ROC curve showed that a value of 0.5 AB/ml BAL achieved the most satisfactory sensitivity, 46%, and a specificity of 83%. The correlation between AB levels in BAL and lung was 0.633 (P=.002). CONCLUSIONS BAL study provides objective evidence of exposure to asbestos. The good correlation between the AB counts in BAL and lung tissue indicates that both techniques are valid for the analysis of asbestos content.
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Affiliation(s)
- María Jesús Cruz
- Servicio de Neumología, Hospital Universitario Vall d'Hebron, Barcelona, España; Ciber Enfermedades Respiratorias (CibeRes), Barcelona, España
| | - Victor Curull
- Ciber Enfermedades Respiratorias (CibeRes), Barcelona, España; Departament de Medicina, Universitat Autònoma de Barcelona, Barcelona, España; Servicio de Neumología, Hospital del Mar, IMIM, Barcelona, España
| | - Lara Pijuan
- Servicio de Neumología, Hospital del Mar, IMIM, Barcelona, España
| | - Daniel Álvarez-Simón
- Servicio de Neumología, Hospital Universitario Vall d'Hebron, Barcelona, España; Ciber Enfermedades Respiratorias (CibeRes), Barcelona, España
| | - Albert Sánchez-Font
- Ciber Enfermedades Respiratorias (CibeRes), Barcelona, España; Departament de Medicina, Universitat Autònoma de Barcelona, Barcelona, España; Servicio de Neumología, Hospital del Mar, IMIM, Barcelona, España
| | - Javier de Gracia
- Servicio de Neumología, Hospital Universitario Vall d'Hebron, Barcelona, España; Ciber Enfermedades Respiratorias (CibeRes), Barcelona, España
| | - Mario Culebras
- Servicio de Neumología, Hospital Universitario Vall d'Hebron, Barcelona, España; Ciber Enfermedades Respiratorias (CibeRes), Barcelona, España
| | - Jaume Ferrer
- Servicio de Neumología, Hospital Universitario Vall d'Hebron, Barcelona, España; Ciber Enfermedades Respiratorias (CibeRes), Barcelona, España; Departament de Medicina, Universitat Autònoma de Barcelona, Barcelona, España.
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Alexopoulos EC, Bouros D, Dimadi M, Serbescu A, Bakoyannis G, Kokkinis FP. Comparative analysis of induced sputum and bronchoalveolar lavage fluid (BALF) profile in asbestos exposed workers. J Occup Med Toxicol 2011; 6:23. [PMID: 21838922 PMCID: PMC3170282 DOI: 10.1186/1745-6673-6-23] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2010] [Accepted: 08/14/2011] [Indexed: 11/17/2022] Open
Abstract
Background Biological monitoring of healthy workers exposed to hazardous dusts lack validated screening tools. Induced sputum (IS) cellular profile was compared with bronchoalveolar lavage fluid (BALF) profile in asbestos exposed workers in order to assess its usefulness in monitoring workers exposed to asbestos for a long period of time. Methods IS and BALF analysis was performed in 39 workers of a car brakes and clutches factory that uses chrysotile asbestos. Selection criteria were an employment history of > 15 years and the absence of a diagnosis of pneumonoconiosis. The type of cells, the existence of dust cells, of iron laden macrophages and of asbestos bodies were assessed and compared between IS and BALF samples. Results 35 IS samples (90%) had dust cells, 34 (87%) iron laden macrophages and in 8 samples (21%) asbestos bodies were found. In most samples neutrophils were dominated. Samples with asbestos bodies (ABs) had significantly higher lymphocytes and lower neutrophils count compared with the samples without ABs. Macrophages and neutrophils in IS and BALF exhibited significant inter-relations (Spearman's rho: 0.26-0.29, p < 0.05) while IS lymphocytes count showed an inverse relation with BALF neutrophils (Spearman's rho: -0.36). Neutrophils and dust cells were highly correlated between the samples (Spearman's rho: 0.35, p < 0.05) while IS dust cells and lymphocytes were inversely related (Spearman's rho: -0.36, p < 0.05). More years of employment in the company was related with more neutrophils (Spearman's rho: 0.26) and less lymphocytes (Spearman's rho: -0.33) count. In multivariate analysis the presence of AB in IS samples was strongly related to the presence of asbestos bodies and lymphocytes count in BALF samples. Conclusions IS and BALF analysis showed a similar cellular profile indicating that IS sampling in exposed workers to asbestos as a less invasive and expensive method may be useful in providing an insight both for inhalation of dusts and inflammatory processes in the lung.
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Affiliation(s)
- Evangelos C Alexopoulos
- Occupational Health Unit, Department of Public Health, Medical School, University of Patras, GR-26500 Rio Patras, Greece.
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