Analysis of the relationship between bronchoalveolar lavage lymphocyte fraction and detailed autoimmune features in patients with idiopathic interstitial pneumonia
Abstract Bronchoalveolar lavage (BAL) is crucial for the diagnosis of interstitial lung disease (ILD). Although BAL lymphocytosis is found in patients with connective tissue disease (CTD)-related ILD, the effects of CTD-associated features on BAL lymphocytosis have not been elucidated. To identify C...
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2025-07-01
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| author | Noriyuki Enomoto Masayuki Watanuki Shogo Nakai Shusuke Yazawa Yasutaka Mochizuka Atsuki Fukada Yuko Tanaka Hyogo Naoi Yusuke Inoue Hideki Yasui Masato Karayama Yuzo Suzuki Hironao Hozumi Kazuki Furuhashi Mikio Toyoshima Masato Kono Shiro Imokawa Masato Fujii Taisuke Akamatsu Naoki Koshimizu Koshi Yokomura Hiroyuki Matsuda Yusuke Kaida Yutaro Nakamura Masahiro Shirai Kazutaka Mori Masafumi Masuda Tomoyuki Fujisawa Naoki Inui Hiroaki Sugiura Hiromitsu Sumikawa Masashi Kitani Kazuhiro Tabata Noriyoshi Ogawa Takafumi Suda |
| author_facet | Noriyuki Enomoto Masayuki Watanuki Shogo Nakai Shusuke Yazawa Yasutaka Mochizuka Atsuki Fukada Yuko Tanaka Hyogo Naoi Yusuke Inoue Hideki Yasui Masato Karayama Yuzo Suzuki Hironao Hozumi Kazuki Furuhashi Mikio Toyoshima Masato Kono Shiro Imokawa Masato Fujii Taisuke Akamatsu Naoki Koshimizu Koshi Yokomura Hiroyuki Matsuda Yusuke Kaida Yutaro Nakamura Masahiro Shirai Kazutaka Mori Masafumi Masuda Tomoyuki Fujisawa Naoki Inui Hiroaki Sugiura Hiromitsu Sumikawa Masashi Kitani Kazuhiro Tabata Noriyoshi Ogawa Takafumi Suda |
| author_sort | Noriyuki Enomoto |
| collection | DOAJ |
| description | Abstract Bronchoalveolar lavage (BAL) is crucial for the diagnosis of interstitial lung disease (ILD). Although BAL lymphocytosis is found in patients with connective tissue disease (CTD)-related ILD, the effects of CTD-associated features on BAL lymphocytosis have not been elucidated. To identify CTD-associated features that affect BAL lymphocyte fraction in patients with idiopathic interstitial pneumonia (IIP). This post hoc analysis of a prospective, multicentre cohort study was conducted between 2015 and 2020. Overall, 222 patients newly diagnosed with IIP were consecutively enrolled, and 74 autoimmune features were comprehensively analysed during IIP diagnosis. The median age was 71 years, and the median observation period was 36 months. The clinical characteristics related to a significant increase in BAL lymphocyte fraction were consolidation opacity on high-resolution computed tomography (HRCT), morphologic domain of interstitial pneumonia with autoimmune features (IPAF), serum CXCL10 concentration, and acute/subacute onset (all p < 0.05). In contrast, presence of joint lesion/mucocutaneous lesion/dry symptoms, autoantibodies, or other CTD-like features on HRCT and surgical lung biopsy did not affect the BAL lymphocyte fraction (all p ≥ 0.05). Furthermore, a high BAL lymphocyte fraction (≥ 8.5%) was related to a low proportion of progressive pulmonary fibrosis (p < 0.001) and favourable survival (log-rank, p = 0.020) in patients with non-idiopathic pulmonary fibrosis (IPF). IPAF morphologic domain especially with consolidation opacity on HRCT and high CXCL10 concentration, but not CTD-like symptoms, autoantibodies, or CTD-like features on lung biopsy, were related to a high BAL lymphocyte fraction with favourable survival in patients with non-IPF. |
| format | Article |
| id | doaj-art-6ad8d94e68424600bccab1541e68dcc0 |
| institution | Kabale University |
| issn | 2045-2322 |
| language | English |
| publishDate | 2025-07-01 |
| publisher | Nature Portfolio |
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| series | Scientific Reports |
| spelling | doaj-art-6ad8d94e68424600bccab1541e68dcc02025-08-20T03:42:27ZengNature PortfolioScientific Reports2045-23222025-07-011511910.1038/s41598-025-12180-7Analysis of the relationship between bronchoalveolar lavage lymphocyte fraction and detailed autoimmune features in patients with idiopathic interstitial pneumoniaNoriyuki Enomoto0Masayuki Watanuki1Shogo Nakai2Shusuke Yazawa3Yasutaka Mochizuka4Atsuki Fukada5Yuko Tanaka6Hyogo Naoi7Yusuke Inoue8Hideki Yasui9Masato Karayama10Yuzo Suzuki11Hironao Hozumi12Kazuki Furuhashi13Mikio Toyoshima14Masato Kono15Shiro Imokawa16Masato Fujii17Taisuke Akamatsu18Naoki Koshimizu19Koshi Yokomura20Hiroyuki Matsuda21Yusuke Kaida22Yutaro Nakamura23Masahiro Shirai24Kazutaka Mori25Masafumi Masuda26Tomoyuki Fujisawa27Naoki Inui28Hiroaki Sugiura29Hiromitsu Sumikawa30Masashi Kitani31Kazuhiro Tabata32Noriyoshi Ogawa33Takafumi Suda34Second Division, Department of Internal Medicine, Hamamatsu University School of MedicineSecond Division, Department of Internal Medicine, Hamamatsu University School of MedicineSecond Division, Department of Internal Medicine, Hamamatsu University School of MedicineSecond Division, Department of Internal Medicine, Hamamatsu University School of MedicineSecond Division, Department of Internal Medicine, Hamamatsu University School of MedicineSecond Division, Department of Internal Medicine, Hamamatsu University School of MedicineSecond Division, Department of Internal Medicine, Hamamatsu University School of MedicineSecond Division, Department of Internal Medicine, Hamamatsu University School of MedicineSecond Division, Department of Internal Medicine, Hamamatsu University School of MedicineSecond Division, Department of Internal Medicine, Hamamatsu University School of MedicineSecond Division, Department of Internal Medicine, Hamamatsu University School of MedicineSecond Division, Department of Internal Medicine, Hamamatsu University School of MedicineSecond Division, Department of Internal Medicine, Hamamatsu University School of MedicineSecond Division, Department of Internal Medicine, Hamamatsu University School of MedicineDepartment of Respiratory Medicine, Hamamatsu Rosai HospitalDepartment of Respiratory Medicine, Seirei Hamamatsu General HospitalDepartment of Respiratory Medicine, Iwata City HospitalDepartment of Respiratory Medicine, Shizuoka City Shizuoka HospitalDepartment of Respiratory Medicine, Shizuoka General HospitalDepartment of Respiratory Medicine, Fujieda Municipal General HospitalDepartment of Respiratory Medicine, Respiratory Disease Center, Seirei Mikatahara General HospitalDepartment of Respiratory Medicine, Japanese Red Cross Shizuoka HospitalDepartment of Respiratory Medicine, Enshu HospitalRespiratory and Allergy Medicine, National Hospital Organization Tenryu HospitalRespiratory and Allergy Medicine, National Hospital Organization Tenryu HospitalRespiratory Medicine, Shizuoka City Shimizu HospitalRespiratory Medicine, Shizuoka City Shimizu HospitalSecond Division, Department of Internal Medicine, Hamamatsu University School of MedicineSecond Division, Department of Internal Medicine, Hamamatsu University School of MedicineDepartment of Radiology, National Defense Medical CollegeDepartment of Radiology, National Hospital Organization Kinki-Chuo Chest Medical CenterDepartment of Pathology, NHO Tokyo National HospitalDepartment of Pathology, Kagoshima University Graduate School of Medical and Dental SciencesDivision of Immunology and Rheumatology, Department of Internal Medicine 3, Hamamatsu University School of MedicineSecond Division, Department of Internal Medicine, Hamamatsu University School of MedicineAbstract Bronchoalveolar lavage (BAL) is crucial for the diagnosis of interstitial lung disease (ILD). Although BAL lymphocytosis is found in patients with connective tissue disease (CTD)-related ILD, the effects of CTD-associated features on BAL lymphocytosis have not been elucidated. To identify CTD-associated features that affect BAL lymphocyte fraction in patients with idiopathic interstitial pneumonia (IIP). This post hoc analysis of a prospective, multicentre cohort study was conducted between 2015 and 2020. Overall, 222 patients newly diagnosed with IIP were consecutively enrolled, and 74 autoimmune features were comprehensively analysed during IIP diagnosis. The median age was 71 years, and the median observation period was 36 months. The clinical characteristics related to a significant increase in BAL lymphocyte fraction were consolidation opacity on high-resolution computed tomography (HRCT), morphologic domain of interstitial pneumonia with autoimmune features (IPAF), serum CXCL10 concentration, and acute/subacute onset (all p < 0.05). In contrast, presence of joint lesion/mucocutaneous lesion/dry symptoms, autoantibodies, or other CTD-like features on HRCT and surgical lung biopsy did not affect the BAL lymphocyte fraction (all p ≥ 0.05). Furthermore, a high BAL lymphocyte fraction (≥ 8.5%) was related to a low proportion of progressive pulmonary fibrosis (p < 0.001) and favourable survival (log-rank, p = 0.020) in patients with non-idiopathic pulmonary fibrosis (IPF). IPAF morphologic domain especially with consolidation opacity on HRCT and high CXCL10 concentration, but not CTD-like symptoms, autoantibodies, or CTD-like features on lung biopsy, were related to a high BAL lymphocyte fraction with favourable survival in patients with non-IPF.https://doi.org/10.1038/s41598-025-12180-7Bronchoalveolar lavageInterstitial pneumonia with autoimmune featuresIdiopathic interstitial pneumoniaNon-specific interstitial pneumoniaOrganizing pneumonia |
| spellingShingle | Noriyuki Enomoto Masayuki Watanuki Shogo Nakai Shusuke Yazawa Yasutaka Mochizuka Atsuki Fukada Yuko Tanaka Hyogo Naoi Yusuke Inoue Hideki Yasui Masato Karayama Yuzo Suzuki Hironao Hozumi Kazuki Furuhashi Mikio Toyoshima Masato Kono Shiro Imokawa Masato Fujii Taisuke Akamatsu Naoki Koshimizu Koshi Yokomura Hiroyuki Matsuda Yusuke Kaida Yutaro Nakamura Masahiro Shirai Kazutaka Mori Masafumi Masuda Tomoyuki Fujisawa Naoki Inui Hiroaki Sugiura Hiromitsu Sumikawa Masashi Kitani Kazuhiro Tabata Noriyoshi Ogawa Takafumi Suda Analysis of the relationship between bronchoalveolar lavage lymphocyte fraction and detailed autoimmune features in patients with idiopathic interstitial pneumonia Scientific Reports Bronchoalveolar lavage Interstitial pneumonia with autoimmune features Idiopathic interstitial pneumonia Non-specific interstitial pneumonia Organizing pneumonia |
| title | Analysis of the relationship between bronchoalveolar lavage lymphocyte fraction and detailed autoimmune features in patients with idiopathic interstitial pneumonia |
| title_full | Analysis of the relationship between bronchoalveolar lavage lymphocyte fraction and detailed autoimmune features in patients with idiopathic interstitial pneumonia |
| title_fullStr | Analysis of the relationship between bronchoalveolar lavage lymphocyte fraction and detailed autoimmune features in patients with idiopathic interstitial pneumonia |
| title_full_unstemmed | Analysis of the relationship between bronchoalveolar lavage lymphocyte fraction and detailed autoimmune features in patients with idiopathic interstitial pneumonia |
| title_short | Analysis of the relationship between bronchoalveolar lavage lymphocyte fraction and detailed autoimmune features in patients with idiopathic interstitial pneumonia |
| title_sort | analysis of the relationship between bronchoalveolar lavage lymphocyte fraction and detailed autoimmune features in patients with idiopathic interstitial pneumonia |
| topic | Bronchoalveolar lavage Interstitial pneumonia with autoimmune features Idiopathic interstitial pneumonia Non-specific interstitial pneumonia Organizing pneumonia |
| url | https://doi.org/10.1038/s41598-025-12180-7 |
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