Alveolar cell composition in interstitial lung disease and the development of a pulmonary progressive fibrosing phenotype: a retrospective cohort study
Abstract Background Immunological bronchoalveolar lavage (iBAL) is a frequently employed diagnostic tool in interstitial lung disease (ILD). The association between iBAL cellular composition and disease progression remains elusive. We evaluated whether the alveolar cellular composition at initial di...
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BMC
2025-04-01
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| Series: | Respiratory Research |
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| Online Access: | https://doi.org/10.1186/s12931-025-03236-3 |
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| author | Iris A. Simons Bart G. Boerrigter Maud C.M. Hovestadt Kirsten A. Mooij-Kalverda Shiqi Zhang Leonoor S. Boers Anke H. Maitland– van der Zee Esther J. Nossent Jan Willem Duitman |
| author_facet | Iris A. Simons Bart G. Boerrigter Maud C.M. Hovestadt Kirsten A. Mooij-Kalverda Shiqi Zhang Leonoor S. Boers Anke H. Maitland– van der Zee Esther J. Nossent Jan Willem Duitman |
| author_sort | Iris A. Simons |
| collection | DOAJ |
| description | Abstract Background Immunological bronchoalveolar lavage (iBAL) is a frequently employed diagnostic tool in interstitial lung disease (ILD). The association between iBAL cellular composition and disease progression remains elusive. We evaluated whether the alveolar cellular composition at initial diagnosis is predictive of the development of progressive pulmonary fibrosis (PPF) in patients with ILD. Methods A retrospective analysis of 111 patients diagnosed with ILD who underwent iBAL for diagnostic purposes between January 2018 and January 2023 was conducted. The identification of PPF was based on the criteria outlined in the ATS/ERS/JRS/ALAT clinical practice guidelines. Clinical data, pulmonary function tests, radiological imaging, and BAL cellular composition were collected. Groups were compared using the non-parametric Wilcoxon rank sum test. Linear mixed-effect modelling was used to assess the association between baseline cell composition and longitudinal lung function decline. Results A total of 33.3% of patients exhibited a PPF phenotype. A significant association between baseline iBAL CD4 + and CD8 + T cell percentages and forced vital capacity (FVC) decline within the first year was observed. Other cell types were not associated with ILD progression within one-year of follow-up. Conclusions CD4 + and CD8 + T cell percentages significantly correlated with FVC changes in patients with fibrotic ILD. No further associations were found between the baseline iBAL cellular profiles and disease progression. These findings suggest that baseline iBAL cellular profiles may hold some promise in predicting fibrotic ILD disease progression. Further (prospective) studies using larger cohorts may be needed to elucidate the association between the cellular composition of iBAL fluid and pulmonary fibrosis progression. |
| format | Article |
| id | doaj-art-1ea478b7e0ee43b8ad9b3b7ff126a367 |
| institution | OA Journals |
| issn | 1465-993X |
| language | English |
| publishDate | 2025-04-01 |
| publisher | BMC |
| record_format | Article |
| series | Respiratory Research |
| spelling | doaj-art-1ea478b7e0ee43b8ad9b3b7ff126a3672025-08-20T01:47:29ZengBMCRespiratory Research1465-993X2025-04-0126111110.1186/s12931-025-03236-3Alveolar cell composition in interstitial lung disease and the development of a pulmonary progressive fibrosing phenotype: a retrospective cohort studyIris A. Simons0Bart G. Boerrigter1Maud C.M. Hovestadt2Kirsten A. Mooij-Kalverda3Shiqi Zhang4Leonoor S. Boers5Anke H. Maitland– van der Zee6Esther J. Nossent7Jan Willem Duitman8Pulmonary Medicine, Amsterdam UMC location University of AmsterdamPulmonary Medicine, Amsterdam UMC location Free UniversityPulmonary Medicine, Amsterdam UMC location University of AmsterdamPulmonary Medicine, Amsterdam UMC location University of AmsterdamInfection & Immunity, Inflammatory Diseases, Amsterdam UMC location University of AmsterdamInfection & Immunity, Inflammatory Diseases, Amsterdam UMC location University of AmsterdamPulmonary Medicine, Amsterdam UMC location University of AmsterdamPulmonary Medicine, Amsterdam UMC location Free UniversityPulmonary Medicine, Amsterdam UMC location University of AmsterdamAbstract Background Immunological bronchoalveolar lavage (iBAL) is a frequently employed diagnostic tool in interstitial lung disease (ILD). The association between iBAL cellular composition and disease progression remains elusive. We evaluated whether the alveolar cellular composition at initial diagnosis is predictive of the development of progressive pulmonary fibrosis (PPF) in patients with ILD. Methods A retrospective analysis of 111 patients diagnosed with ILD who underwent iBAL for diagnostic purposes between January 2018 and January 2023 was conducted. The identification of PPF was based on the criteria outlined in the ATS/ERS/JRS/ALAT clinical practice guidelines. Clinical data, pulmonary function tests, radiological imaging, and BAL cellular composition were collected. Groups were compared using the non-parametric Wilcoxon rank sum test. Linear mixed-effect modelling was used to assess the association between baseline cell composition and longitudinal lung function decline. Results A total of 33.3% of patients exhibited a PPF phenotype. A significant association between baseline iBAL CD4 + and CD8 + T cell percentages and forced vital capacity (FVC) decline within the first year was observed. Other cell types were not associated with ILD progression within one-year of follow-up. Conclusions CD4 + and CD8 + T cell percentages significantly correlated with FVC changes in patients with fibrotic ILD. No further associations were found between the baseline iBAL cellular profiles and disease progression. These findings suggest that baseline iBAL cellular profiles may hold some promise in predicting fibrotic ILD disease progression. Further (prospective) studies using larger cohorts may be needed to elucidate the association between the cellular composition of iBAL fluid and pulmonary fibrosis progression.https://doi.org/10.1186/s12931-025-03236-3Bronchoalveolar lavage (BAL)Interstitial lung disease (ILD)PrognosisProgressive pulmonary fibrosis (PPF)Pulmonary fibrosis (PF) |
| spellingShingle | Iris A. Simons Bart G. Boerrigter Maud C.M. Hovestadt Kirsten A. Mooij-Kalverda Shiqi Zhang Leonoor S. Boers Anke H. Maitland– van der Zee Esther J. Nossent Jan Willem Duitman Alveolar cell composition in interstitial lung disease and the development of a pulmonary progressive fibrosing phenotype: a retrospective cohort study Respiratory Research Bronchoalveolar lavage (BAL) Interstitial lung disease (ILD) Prognosis Progressive pulmonary fibrosis (PPF) Pulmonary fibrosis (PF) |
| title | Alveolar cell composition in interstitial lung disease and the development of a pulmonary progressive fibrosing phenotype: a retrospective cohort study |
| title_full | Alveolar cell composition in interstitial lung disease and the development of a pulmonary progressive fibrosing phenotype: a retrospective cohort study |
| title_fullStr | Alveolar cell composition in interstitial lung disease and the development of a pulmonary progressive fibrosing phenotype: a retrospective cohort study |
| title_full_unstemmed | Alveolar cell composition in interstitial lung disease and the development of a pulmonary progressive fibrosing phenotype: a retrospective cohort study |
| title_short | Alveolar cell composition in interstitial lung disease and the development of a pulmonary progressive fibrosing phenotype: a retrospective cohort study |
| title_sort | alveolar cell composition in interstitial lung disease and the development of a pulmonary progressive fibrosing phenotype a retrospective cohort study |
| topic | Bronchoalveolar lavage (BAL) Interstitial lung disease (ILD) Prognosis Progressive pulmonary fibrosis (PPF) Pulmonary fibrosis (PF) |
| url | https://doi.org/10.1186/s12931-025-03236-3 |
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