Am. J. Respir. Crit. Care Med., Volume 162, Number 3, September 2000, 1162-1168

Increased Levels of Interleukin-6 Are Associated with Lymphocytosis in Bronchoalveolar Lavage Fluids of Idiopathic Nonspecific Interstitial Pneumonia

CHOON S. PARK, SUNG W. CHUNG, SHIN Y. KI, GUNE-IL LIM, SOO-TAEK UH, YONG H. KIM, DEUK I. CHOI, JAI S. PARK, DONG W. LEE, and MASANORI KITAICHI

Division of Allergy and Respiratory Medicine, Department of Internal Medicine, Radiology, and Anatomic Pathology, Soonchunhyang University Hospital, Seoul, Korea; and Laboratory of Anatomic Pathology, Kyoto University Hospital, Kyoto, Japan

Local overexpression of interleukin-6 (IL-6) experimentally induces lymphocytic infiltration in the bronchial tree of rat. Among idiopathic interstitial pneumonia (IIP), nonspecific interstitial pneumonia/fibrosis (NSIP) has an increased number of lymphocytes in bronchoalveolar lavage (BAL) fluid when compared with usual interstitial pneumonia (UIP). To reveal a relation of IL-6 with the lymphocyte infiltration of NSIP, IL-6 was measured in BAL fluids of idiopathic NSIP (n = 7), idiopathic UIP (n = 16), and normal control subjects (n = 45). IL-6-producing sites were assessed by IL-6 protein stain on biopsy specimens of NSIP, UIP, and normal lung of mediastinal tumors. Lymphocyte numbers and IL-6 levels in BAL fluids were higher in NSIP than those in UIP (p < 0.01, respectively), which were also higher when compared with those of normal control subjects (p < 0.01, respectively). In NSIP, the levels of IL-6 correlated with the number of lymphocytes (r = 0.93, p < 0.01). UIP cases were divided into two groups: high-UIP (n = 7) or low-UIP (n = 9) according to IL-6 levels greater than or within the 95 percentile of normal control subjects, respectively. The high-UIP group had BAL lymphocytosis when compared with the low-UIP group (p < 0.05). IL-6 stained on epithelial cells of the bronchial tree and on alveolar macrophages of NSIP and UIP. In conclusion, the lymphocytosis in BAL fluid of patients with NSIP and a subgroup of UIP is associated with the high levels of IL-6 and its sources are the epithelial cells of the small airway and the alveolar macrophages.

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