The aim of this study was the evaluation of cytological, immunocytological and cytochemical tests efficiency in describing the pulmonary alveoli cells activity in people chronically exposed to the polluted air. The detailed analysis of bronchoalveolar lavage (BAL) obtained by rinsing of pulmonary alveoli in 36 cases of prolonged exposure to silica and asbestos dust, divided into non-smokers and smokers, was performed. The control were the patients free of any pathological pulmonary symptoms, in this number the inhabitants of Cracow. The BAL cells contribution and activity was evaluated by following methods: routine cytology (the number and percentage of cells), computer cytomorphometry (for assessment macrophage area), nitro-blue-tetrazolium (NBT) reduction test (macrophage activity) and indirect immunofluorescence with use of monoclonal antibodies (macrophage subsets) and FACS-star-PLUS flow cytometer (lymphocyte subsets). In the individuals chronically exposed to the different forms of air pollution we found the changes in number and proportions of bronchoalveolar space cells, the alterations in cell activity (especially pulmonary macrophages) and decrease in CD4/CD8 lymphocyte ratio, that could indicate the apparent disturbances in the local cell resistance. According to our observation there is a synergistic action of tobacco smoking and air pollution. Finally, we may conclude, that BAL, was a non-invasive, repeatable method, useful for monitoring pulmonary changes due to dust exposure.
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