Bronchoalveolar lavage procollagen-111-peptide in recent onset hypersensitivity pneumonitis: correlation

Bronchcalveolar lavage procollagen-/11-peptide in recent onset hypersensitivity pneumonitis: co"elation with extracellular matrix components. H. Teschler, A.B. Thompson, W.R. Pohl, N. Konietz}co, S.l. Rennard, U. Costabel. ©ERS Journtlls Ltd 1993. ABSTRACT: Hypersensitivity pneumonitis (HP) is characterized by the accumulation of inflammatory cells in the lung parenchyma, and may progress to fibrosis. The content of the fibroblast derived collagen metabolite procoUagen-ID-peptide (PCP-ill) in bronchoalveolar lavage (BAL) fluid of HP patients has been found to be increased. Previous studies have shown elevation of the fibroblast adhesion molecules, vitronectin and fibronectin in the BAL fluid of recent onset HP. In view of these observations, it was hypothesized that increases in PCP-ID would be associated with increases in vitronectin and fibronectin in the BAL fluid of subjects with untreated recent onset HP. BAL was performed in 14 patients with HP and nine normal controls. The aminoterminal domain of PCP-IIl was measured by radioimmunoassay, and vitronectin and fibronectin by enzyme-linked immunosorbent assay. Detectable amounts of BAL PCP-ID were seen in all HP patients but not in the normal controls (mean±sEM 5.1±1.2 versus <0.2 ng·ml"; i.e. below the limit of detection of the PCP-ID assay). The BAL fluid concentration of PCP-ID correlated well with the amount of vitronectin (r-0.638) and fibronectin (r=0.710). Except for PCP-m and mast cells, no significant correlations were found between PCP-m, vitronectin, fibronectin and the cellular parameters. The fmdings suggest that an increased turnover of collagens and proteoglycans is present in the lower respiratory tract of patients with recent onset HP, possibly reflecting remodelling of the extracellular matrix. Eur Respir J., 1993, 6, 709-714. • Ruhrlandklinik, Dept of Pneumology, Medical Faculty, University of Essen, Gennany. u Dept of Internal Medicine, University of Nebraska Medical Center, Omaha, NE, USA.