Tomichi N, Yagawa K, Takayama K, Moori T, Tamura M
Arerugi. 1989 Jun;38(6):508-12.
The purpose of this study was to ascertain the immunological abnormality of hypersensitivity pneumonitis. The relationship between T cell subsets of lymphocytes in transbronchial lung biopsy (TBLB) specimens and in bronchoalveolar lavage fluid (BALF) were studied in 3 cases of farmer's lung disease (FLD). The lung specimens were examined by immunoperoxidase staining (ABC method) and the cells in BALF by the immunofluorescence method on the flowcytometry. All cases of FLD were diagnosed according to the following criteria: 1) history of exposure to FLD antigen, 2) clinical symptoms (cough, fever, breathlessness), 3) radiologic feature (diffuse small nodular pattern) and functional pattern of interstitial lung disease and 4) evidence of antibodies against Micropolyspora faeni. Histologically, granulomatous interstitial pneumonitis was revealed in all cases. Immunohistochemically, the number of positive lymphocytes was as follows: for Leu 4 (pan T cell) 8.6 cells/15.6 x 10(-3) mm2; Leu 3a (helper/inducer T cell) 5.1 cells; Leu 2a(suppressor/cytotoxic T cell) 1.2 cells on average, respectively. The Leu 3a+ cells were larger in number than the Leu 2a+ cells and the Leu 3a+/Leu 2a+ ratio was 4.76. In the BALF, the percentage of OKT3+ cells (pan T cell) was increased. The percentage of OKT4+ cells (helper/inducer T cell) was higher than that of OKT8+ cells (suppressor/cytotoxic T cell). The OKT4+/OKT8+ ratio was 6.65 in the BALF. The result of this study revealed the close relationship between the numerical distribution of T cell subsets in the lung tissue and in the BALF. It is suggested that the immuno-reaction in the lung tissue of patients with FLD is a type of helper-T cell alveolitis.
本研究的目的是确定过敏性肺炎的免疫异常情况。对3例农民肺疾病（FLD）患者的经支气管肺活检（TBLB）标本和支气管肺泡灌洗液（BALF）中的淋巴细胞T细胞亚群之间的关系进行了研究。通过免疫过氧化物酶染色（ABC法）对肺标本进行检查，通过流式细胞术的免疫荧光法对BALF中的细胞进行检查。所有FLD病例均根据以下标准诊断：1）有接触FLD抗原的病史；2）临床症状（咳嗽、发热、呼吸困难）；3）放射学特征（弥漫性小结节型）和间质性肺疾病的功能模式；4）有针对嗜热放线菌的抗体证据。组织学上，所有病例均显示为肉芽肿性间质性肺炎。免疫组织化学检查显示，阳性淋巴细胞数量如下：Leu 4（全T细胞）平均为8.6个细胞/15.6×10⁻³mm²；Leu 3a（辅助/诱导性T细胞）平均为5.1个细胞；Leu 2a（抑制/细胞毒性T细胞）平均为1.2个细胞。Leu 3a⁺细胞数量多于Leu 2a⁺细胞，Leu 3a⁺/Leu 2a⁺比值为4.76。在BALF中，OKT3⁺细胞（全T细胞）的百分比增加。OKT4⁺细胞（辅助/诱导性T细胞）的百分比高于OKT8⁺细胞（抑制/细胞毒性T细胞）。BALF中OKT4⁺/OKT8⁺比值为6.65。本研究结果揭示了肺组织和BALF中T细胞亚群数量分布之间的密切关系。提示FLD患者肺组织中的免疫反应是一种辅助性T细胞肺泡炎。
