Stéphan F, Bernaudin J F, Cesari D, Fajac A, Grenet D D, Caubarrere I, Stern M
Laboratoire d'Histologie-Biologie Tumorale, AP-HP Hôpital Tenon, 4 rue de la Chine 75020 Paris, France.
BMC Infect Dis. 2001;1:15. doi: 10.1186/1471-2334-1-15. Epub 2001 Sep 17.
Cytomegalovirus (CMV) pneumonitis has been shown to be associated with lymphocytic alveolitis after lung transplantation. In the present study, we investigated a series of bronchoalveolar (BAL) and blood samples, collected in the absence of rejection or acute infectious episodes. in order -1: to evaluate intra-alveolar cell population changes concomitant with CMV replication and -2: to reappraise the value of cell population analysis in the management of patients after lung transplantation.
We used flow cytometry to investigate modifications of lymphocyte subpopulations related to pulmonary cytomegalovirus infections in blood and BAL samples from a series of 13 lung transplant recipients. After exclusion of samples obtained during pulmonary rejection, bronchiolitis obliterans or acute bacterial infection, 48 blood and BAL samples were retained for analysis: 17 were CMV positive by shell-vial assay and 31 were CMV negative in blood and BAL.
Our results demonstrate that pulmonary CMV infection is associated with a significant increase in the total lymphocyte population in BAL samples, but with minor modifications of the various lymphocyte subpopulations and a significantly higher absolute number of B lymphocytes in blood samples.
Cytomegalovirus pulmonary infection is accompanied by only minor changes in BAL lymphocyte subpopulations. The study of BAL lymphocyte subpopulations therefore appears to be of limited clinical value in the diagnosis of pulmonary CMV infection. However, increased blood B-lymphocytes seems to be a clinical feature associated with CMV infection.
巨细胞病毒(CMV)肺炎已被证明与肺移植后的淋巴细胞性肺泡炎有关。在本研究中,我们调查了一系列在无排斥反应或急性感染发作情况下采集的支气管肺泡(BAL)和血液样本。目的如下:1. 评估与CMV复制相伴的肺泡内细胞群体变化;2. 重新评估细胞群体分析在肺移植患者管理中的价值。
我们使用流式细胞术研究了13例肺移植受者的血液和BAL样本中与肺巨细胞病毒感染相关的淋巴细胞亚群的变化。在排除肺排斥、闭塞性细支气管炎或急性细菌感染期间获得的样本后,保留48份血液和BAL样本进行分析:17份通过空斑试验检测为CMV阳性,31份血液和BAL样本CMV阴性。
我们的结果表明,肺部CMV感染与BAL样本中淋巴细胞总数的显著增加有关,但各淋巴细胞亚群变化较小,且血液样本中B淋巴细胞的绝对数量显著更高。
巨细胞病毒肺部感染仅伴有BAL淋巴细胞亚群的微小变化。因此,BAL淋巴细胞亚群的研究在肺部CMV感染的诊断中似乎临床价值有限。然而,血液中B淋巴细胞增多似乎是与CMV感染相关的临床特征。