Inflammatory cytokines in BAL fluid and pulmonary hemodynamics in high-altitude pulmonary edema |
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| Affiliation: | 1. First Department of Internal Medicine, Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto, 390, Japan;2. Department of Clinical Laboratories, Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto, 390, Japan;1. Department of Laboratory Medicine, Kochi Medical School, Kochi University, Japan;2. Department of Hematology and Respiratory Medicine, Kochi Medical School, Kochi University, Japan;3. Center of Medical Information Science, Kochi Medical School, Kochi University, Japan;4. Clinical Laboratory, Kochi Medical School, Kochi University, Japan;1. Department of Veterinary Clinical Studies, Faculty of Veterinary Medicine, Universiti Putra Malaysia, 43400, Serdang, Selangor, Malaysia;2. Research Centre for Ruminant Disease, Faculty of Veterinary Medicine, Universiti Putra Malaysia, 43400, Serdang, Selangor, Malaysia;3. Department of Preclinical Studies, Faculty of Veterinary Medicine, Universiti Putra Malaysia, 43400, Serdang, Selangor, Malaysia;1. Department of Urology, College of Medicine, Seoul National University, Seoul, Korea;2. Department of Urology, College of Medicine, Chonnam National University, Gwangju, Korea;3. Department of Urology, College of Medicine, Korea University, Seoul, Korea;4. Department of Urology, College of Medicine, Catholic University, Seoul, Korea;5. Department of Urology, National Cancer Center, Goyang, Korea;6. Department of Urology, College of Medicine, Kyungpook National University, Daegu, Korea;7. Department of Urology, College of Medicine, Chungbuk National University, Cheongju, Korea;8. Department of Urology, College of Medicine, Hallym University, Chuncheon, Korea;1. School of Software, Xiamen University, Xiamen, PR China;2. School of Computer Science, Fudan University, Shanghai, PR China;1. Departamento de Ecología y Geología (Área de Paleontología), Facultad de Ciencias, Campus Universitario de Teatinos, 29071 Málaga, Spain;1. Department of Clinical Radiation Oncology, Ernst von Bergmann Medical Center, Academic Teaching Hospital of Humboldt University Berlin (Charité), Potsdam, Germany;2. National Cancer Institute (NCI), Radiation Oncology Department, Cairo University, Cairo, Egypt;3. Interdisciplinary Brachytherapy Unit, University of Luebeck/UKSH-CL, Lubeck, Germany;4. Department of Thoracic Surgery, Ernst von Bergmann Medical Center, Academic Teaching Hospital of Humboldt University Berlin (Charité), Potsdam, Germany |
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| Abstract: | To evaluate the pathogenesis of high-altitude pulmonary edema (HAPE), we performed bronchoalveolar lavage (BAL) and pulmonary hemodynamic studies in seven patients with HAPE at its early stage. We measured cell counts, biochemical contents, and concentrations of pro-inflammatory cytokines including interleukin (IL)-1, IL-6, IL-8 and tumor necrosis factor (TNF)-α and of anti-inflammatory cytokines including IL-1 receptor antagonist (ra) and IL-10 in the BAL fluid (BALF). All patients showed increased counts for total cells, alveolar macrophages, neutrophils and lymphocytes, and markedly elevated concentrations of proteins, lactate dehydrogenase, IL-1β, IL-6, IL-8, TNF-α and IL-1ra. The levels of IL-1α and IL-10 were not increased. Patients also showed pulmonary hypertension with normal wedge pressure. Both the driving pressure obtained as pulmonary arterial pressure minus wedge pressure and the PaO2 under room air were significantly correlated with the concentrations of IL-6 and TNF-α in the BALF. These findings suggest that the inflammatory cytokines play a role at the early stage of HAPE and might be related to pulmonary hypertension. |
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