Variability of Inflammatory Cell Counts on Bronchial Biopsies of Normal Subjects

Bronchial biopsies are currently used to study the pathophysiology of airway diseases, and comparisons are often made with biopsies from healthy volunteers. It is therefore important to evaluate the variability in each parameter analyzed in bronchial biopsies of healthy volunteers in order to be able to discriminate significant changes. We analyzed bronchial biopsies of 31 nonsmoking, nonatopic healthy subjects who volunteered as normal controls for studies on pathophysiology of asthma. Mean % epithelial desquamation was 23.7% of observed total epithelial length. No subepithelial fibrosis was observed. Inflammatory cell counts (/mm² connective tissue surface) were variable among subjects but not different between small (0.25 mm²) and large biopsies. Medians (range) of positive cells were for CD3: 20.5 (0–530.0), CD4: 6.2 (0–124.4), CD8: 1.8 (0–81.5), CD25: 0 (0–62.3), HLA-DR: 80.0 (3.5–524.2), EG1: 5.3 (0–180.6), EG2: 6.4 (0–48.8), AA1: 51.3 (0–286.4), CD45: 39.7 (0–448.5) and CD45ro: 28.6 (0–425.2). Subjects living in an urban area had significantly higher CD8-positive cell counts than those from suburban areas (p = 0.0001). The presence of an animal at home was associated with lower positive cell counts for CD4 (p = 0.02), CD45 (p = 0.02) and HLA-DR (p = 0.01). In conclusion, the variability in the number and expression of markers of activity of bronchial immune cells in normal subjects likely reflects variable host responses to environmental exposures and must be taken into account when compared to specimens obtained in subjects with airway diseases.