Nguyen D M, Mulder D S, Shennib H
McGill University Lung Transplant Program, Montreal, Quebec, Canada.
Ann Thorac Surg. 1991 Jan;51(1):76-80. doi: 10.1016/0003-4975(91)90454-x.
Pulmonary atelectasis is common and may predispose the lung to infection. We have previously shown that atelectasis impairs alveolar macrophage antibacterial function. This study examines the effect of atelectasis on the cytotoxic function of lymphocytes harvested from the bronchoalveolar space of atelectatic lung segments by bronchoalveolar lavage. Specifically, we studied natural killer and lectin-dependent cell-mediated cytotoxicity in peripheral blood and bronchoalveolar lavage lymphocytes from the atelectatic lower lobes and contralateral normal lobes in a group of 8 dogs. We observed a decline of natural killer and lectin-dependent cell-mediated cytotoxicity to 62.7% and 61.5%, respectively, of preatelectasis control values in the affected lung lobes (p less than 0.01). Simultaneous measurements of cytotoxic activity of bronchoalveolar lavage lymphocytes harvested from the unaffected contralateral normal lungs were comparable with control values. On the other hand, natural killer and lectin-dependent cell-mediated cytotoxicity activities in peripheral blood lymphocytes were significantly increased in animals having right lower lobe atelectasis (166.7% and 154.7% of pretreated normal control, respectively, p less than 0.01). Atelectasis was also associated with an influx of polymorphonuclear leukocytes into the bronchoalveolar compartment. These findings confirm the presence of natural killer cells and cytotoxic lymphocytes in the bronchoalveolar compartment and demonstrate an atelectasis-induced impairment of local bronchoalveolar lymphocyte function. Such a dysfunction of local lung cellular host defenses may render the atelectatic lung susceptible to infection.
肺不张很常见，可能使肺部易发生感染。我们之前已经表明，肺不张会损害肺泡巨噬细胞的抗菌功能。本研究通过支气管肺泡灌洗，检测肺不张对从肺不张肺段的支气管肺泡腔中采集的淋巴细胞细胞毒性功能的影响。具体而言，我们研究了一组8只犬的肺不张下叶和对侧正常肺叶的外周血及支气管肺泡灌洗淋巴细胞中的自然杀伤细胞活性和凝集素依赖性细胞介导的细胞毒性。我们观察到，在受影响的肺叶中，自然杀伤细胞活性和凝集素依赖性细胞介导的细胞毒性分别降至肺不张前对照值的62.7%和61.5%（p<0.01）。同时测量从未受影响的对侧正常肺采集的支气管肺泡灌洗淋巴细胞的细胞毒性活性，其与对照值相当。另一方面，右下叶肺不张动物外周血淋巴细胞中的自然杀伤细胞活性和凝集素依赖性细胞介导的细胞毒性活性显著增加（分别为预处理正常对照的166.7%和154.7%，p<0.01）。肺不张还与多形核白细胞流入支气管肺泡腔有关。这些发现证实了支气管肺泡腔中存在自然杀伤细胞和细胞毒性淋巴细胞，并表明肺不张可导致局部支气管肺泡淋巴细胞功能受损。局部肺细胞宿主防御功能的这种失调可能使肺不张的肺易发生感染。
