Performance and immune characteristics of bronchoalveolar lavage by research bronchoscopy in pulmonary tuberculosis and other lung diseases in the Western Cape, South Africa
Date
2019-06-01
Journal Title
Journal ISSN
Volume Title
Publisher
BMC (part of Springer Nature)
Abstract
Background: Tuberculosis (TB) remains a debilitating, deadly disease that warrants innovative research tools to fully
understand the pathogenesis and host immune responses, particularly at the site of infection and disease. In this
regard, bronchoscopies with bronchoalveolar lavage (BAL) serve as a valuable technique for site of disease sample
retrieval for further clinical- and basic research. Here we investigate the feasibility of research bronchoscopies in a
low/middle-income area, where TB remains rife, and assess the value of retrieved BAL cells (BALC) for downstream
fluorescent-based cellular evaluations.
Methods: Using quantitative and qualitative methods, we evaluate the outcomes, safety, tolerability, participant
-perception and -experience, while also providing insight into participant recruitment and screening processes of
our study. Using light microscopy differential counting for BALC analysis, we evaluate the cellular composition of
BAL fluid (BALF) from TB patients, healthy community controls and patients with other lung diseases. We also use
flow cytometry to describe the challenges associated with fluorescence-based phenotypic analysis of
autofluorescent BALC.
Results: Our findings suggest that research bronchoscopies are safe, acceptable procedures for research
participants and are indeed a feasible technique for future study design. We also suggest that the majority of
participants are receptive to the proposition of a second research bronchoscopy. This poses an important avenue
for research entailing follow-up investigations of the same study participant. Furthermore, our results show that
smoking is characterized by retrieval of BALC containing particulate matter, that interferes with fluorescence-based
flow cytometry data analysis. Based on light microscopy differential cell counting, our findings suggest that there
are differences in the cell yields and cellular composition of the BALF between TB patients, healthy community
controls and patients with other lung diseases. We also report on subject characteristics and demographic factors,
namely gender and age, that have the potential to affect cell yields and cellular data of BALF.
Conclusions: These findings will serve as a valuable reference for appropriate planning and design of studies
involving clinical bronchoscopies for TB and lung disease research.
Description
CITATION: Young, C., et al. 2019. Performance and immune characteristics of bronchoalveolar lavage by research bronchoscopy in pulmonary tuberculosis and other lung diseases in the Western Cape, South Africa. Translational Medicine Communications, 4:7, doi:10.1186/s41231-019-0039-2.
The original publication is available at https://transmedcomms.biomedcentral.com
The original publication is available at https://transmedcomms.biomedcentral.com
Keywords
Tuberculosis, Bronchoalveolar lavage, Bronchoscopy, Pulmonary tuberculosis, Lungs -- Diseases
Citation
Young, C., et al. 2019. Performance and immune characteristics of bronchoalveolar lavage by research bronchoscopy in pulmonary tuberculosis and other lung diseases in the Western Cape, South Africa. Translational Medicine Communications, 4:7, doi:10.1186/s41231-019-0039-2