Kumánovics Gábor, Magyarlaki Tamás, Komócsi András, Szekeres György, Czirják László
Department of Immunology and Rheumatology, Faculty of Medicine, Hungarian Brothers of St. John of God and University of Pécs, 7621 Pécs, Hungary.
Rheumatol Int. 2003 Jan;23(1):6-10. doi: 10.1007/s00296-002-0243-6. Epub 2002 Sep 11.
The proportion of cell proliferation-associated nuclear Ki-67 antigen positive alveolar macrophages was compared in the bronchoalveolar lavage fluids (BAL) of patients with dermato-/polymyositis (DM-PM), scleroderma-myositis overlap syndrome (Scl-M), systemic sclerosis (SSc), and undifferentiated connective tissue disease (UCTD).
We examined 8 patients with DM-PM, 3 with Scl-M, 11 with SSc, and 10 with UCTD. The patients were selected on the basis of their interstitial lung involvement diagnosed by non-invasive methods.
Increased Ki-67 expression in alveolar macrophages was observed in three cases of SSc (27%) and in 4 of myositis (36%). In UCTD and in healthy volunteers a low level of Ki-67 expression was detected (in both groups 5%). A positive correlation was found between the percentage of the Ki-67 positive alveolar macrophages and the percentage of granulocytes in BAL fluid of the investigated patients with different systemic autoimmune diseases and healthy controls, indicating that increased local proliferation of differentiated large alveolar macrophages can be detected in cases with neutrophil alveolitis. There was also a correlation between the extent of ground glass opacity on HRCT and elevated proportion of proliferating alveolar macrophages in BAL fluid.
比较皮肌炎/多肌炎（DM-PM）、硬皮病-肌炎重叠综合征（Scl-M）、系统性硬化症（SSc）和未分化结缔组织病（UCTD）患者支气管肺泡灌洗（BAL）液中细胞增殖相关核Ki-67抗原阳性肺泡巨噬细胞的比例。
我们检查了8例DM-PM患者、3例Scl-M患者、11例SSc患者和10例UCTD患者。这些患者是根据通过非侵入性方法诊断的间质性肺受累情况入选的。
在3例SSc患者（27%）和4例肌炎患者（36%）中观察到肺泡巨噬细胞中Ki-67表达增加。在UCTD患者和健康志愿者中检测到低水平的Ki-67表达（两组均为5%）。在患有不同系统性自身免疫性疾病的研究患者和健康对照的BAL液中，Ki-67阳性肺泡巨噬细胞的百分比与粒细胞百分比之间存在正相关，表明在中性粒细胞肺泡炎病例中可检测到分化的大肺泡巨噬细胞局部增殖增加。HRCT上磨玻璃影的范围与BAL液中增殖性肺泡巨噬细胞比例升高之间也存在相关性。
