ArticleRespiratory research2021
Impact of bronchoalveolar lavage lymphocytosis on the effects of anti-inflammatory therapy in idiopathic non-specific interstitial pneumonia, idiopathic pleuroparenchymal fibroelastosis, and unclassifiable idiopathic interstitial pneumonia.
Article in Respiratory research, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers, 2 of them syntheses that pooled it.
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Who cites it
12 citing papers in PubMed, 2 syntheses or guidelines pooled it, 16 citations in OpenAlex.
- BAL lymphocytosis as a predictive marker for drug response and long-term outcome in fibrotic ILD: systematic review.BMJ open respiratory research · 2026Pooled it
- Bronchoalveolar lavage lymphocyte patterns in hypersensitivity pneumonitis and nonspecific interstitial pneumonia: a systematic review.Frontiers in medicine · 2026Pooled it
- Secondary pulmonary lymphoma diagnosed by minimal residual disease detected in bronchoalveolar lavage fluid: A case report.Experimental and therapeutic medicine · 2026Article
- [What is certain in the treatment of interstitial lung diseases?]Innere Medizin (Heidelberg, Germany) · 2025Review
- Analysis of the relationship between bronchoalveolar lavage lymphocyte fraction and detailed autoimmune features in patients with idiopathic interstitial pneumonia.Scientific reports · 2025Article
- Alveolar cell composition in interstitial lung disease and the development of a pulmonary progressive fibrosing phenotype: a retrospective cohort study.Respiratory research · 2025Article
- Neutrophils and Lymphocytes: Yin and Yang of Lung Fibrosis and Patient Outcome in Diffuse Interstitial Lung Diseases.Biomedicines · 2024Article
- Corticosteroid therapy in fibrotic interstitial lung disease: a modified Delphi survey.ERJ open research · 2024Article
- The Role of Inflammation and Fibrosis in Interstitial Lung Disease Treatment Decisions.American journal of respiratory and critical care medicine · 2024Article
- Correlation of high-resolution computed tomography and immunological bronchoalveolar lavage in interstitial lung disease at the onset of inflammatory rheumatic diseases: implications for diagnosis and therapeutic strategies.Arthritis research & therapy · 2024Article
- Clinical implications of bronchoalveolar lavage fluid cellular analysis in fibrotic interstitial lung disease combined with CT quantification.Therapeutic advances in respiratory diseaseArticle
- Clinical characteristics and prognostic factors of fibrotic nonspecific interstitial pneumonia.Therapeutic advances in respiratory diseaseArticle
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Authors and funding
12 authors at 7 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundIdiopathic non-specific interstitial pneumonia (iNSIP), idiopathic pleuroparenchymal fibroelastosis (iPPFE), and unclassifiable idiopathic interstitial pneumonia (IIP) are IIPs with chronic fibrotic phenotypes, and unlike idiopathic pulmonary fibrosis, they have often been treated with anti-inflammatory drugs, including corticosteroids and immunosuppressants. However, the impact of bronchoalveolar lavage (BAL) lymphocytosis on the effects of anti-inflammatory therapy has never been evaluated. This study aimed to elucidate whether BAL lymphocytosis can be used to predict the efficacy of anti-inflammatory drugs for iNSIP, iPPFE, and unclassifiable IIP.
methodsJapanese patients diagnosed with iNSIP, iPPFE, and unclassifiable IIP by multidisciplinary discussion were identified using the nationwide registry. Eligible patients were stratified into four groups with and without BAL lymphocytosis and anti-inflammatory therapy to compare overall survival (OS) and changes in lung function. BAL lymphocytosis was defined as a lymphocyte differential count > 15%, and the cut-off was corroborated by survival classification and regression tree analysis.
resultsOverall, 186 patients (37 iNSIP, 16 iPPFE, and 133 unclassifiable IIP) were analyzed. Limited to patients treated with anti-inflammatory drugs (n = 123), patients with BAL lymphocytosis had a better prognosis [hazard ratio (HR), 0.26; 95% confidence interval (CI), 0.11-0.63; P = 0.003], higher slope of forced vital capacity (FVC) % predicted for 2 years, and longer OS (log-rank test, P = 0.012) than those without BAL lymphocytosis. On multivariate analysis, BAL lymphocytosis (HR 0.31; 95% CI 0.13-0.75; P = 0.009) was a prognostic factor for OS, along with age and FVC % predicted. Conversely, for patients managed without anti-inflammatory therapy (n = 63), the presence or absence of BAL lymphocytosis had no prognostic value.
conclusionsBAL lymphocytosis is associated with good outcomes in patients treated with anti-inflammatory drugs, but has no prognostic value when anti-inflammatory drugs are not used. BAL lymphocytosis may provide a predictive biomarker for identifying patients with iNSIP, iPPFE and unclassifiable IIP who are likely to benefit from anti-inflammatory drugs.
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