ArticleChest2024
Flow Cytometry as an Alternative to Microscopy for the Differentiation of BAL Fluid Leukocytes.
Article in Chest, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.
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Who cites it
10 citing papers in PubMed, 10 citations in OpenAlex.
- Label-free Raman spectroscopic imaging enables high-content molecular phenotyping of respiratory diseases from bronchoalveolar lavage fluid.Journal of translational medicine · 2026Article
- Bronchoalveolar lavage for supporting acute cellular rejection in lung transplant recipients: A retrospective analysis.JHLT open · 2026Article
- Deep learning-based 3D leukocyte differentiation using label-free higher harmonic generation microscopy.Journal of translational medicine · 2026Article
- Protocol for single-use Ambu aScope-based minimally invasive bronchoalveolar lavage collection in pigs.STAR protocols · 2026Article
- Eleutheroside E Attenuates Hypobaric Hypoxia-Induced High Altitude Pulmonary Edema by Regulating Ferritinophagy-Mediated Ferroptosis via Keap1-Nrf2 Regulatory Axis.Journal of inflammation research · 2026Article
- Article
- Diagnostic Utility of Bronchoalveolar Lavage Flow Cytometric Leukocyte Profiling in Interstitial Lung Disease and Infection.Biomolecules · 2025Article
- Predictive Value of Flow Cytometry Quantification of BAL Lymphocytes and Neutrophils in ILD.Cells · 2024Article
- Article
- Epigenetic mechanisms of alveolar macrophage activation in chemical-induced acute lung injury.Frontiers in immunology · 2024Review
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Authors and funding
5 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundMicroscopy is currently the gold standard to differentiate BAL fluid (BALF) leukocytes. However, local expertise for microscopic BALF leukocyte differentiation is often unavailable in clinical practice. RESEARCH QUESTION: Can automated flow cytometry be used instead of microscopy to differentiate BALF leukocytes? STUDY DESIGN AND
methodsA new automated flow cytometric method for BALF leukocyte differentiation, using four antibodies (anti-CD45, anti-CD66b, anti-HLA-DR, anti-CD52) given to human BALF in one tube, was developed and prospectively validated in 745 unselected subsequent BALF samples from patients with interstitial lung diseases (455 patients), infectious diseases (196 patients), and other diseases (94 patients). Flow cytometry and traditional microscopy were performed by separate investigators in a double-anonymized fashion. Results were compared using Spearman correlation, Deming regression, and Bland-Altman analysis.
resultsThere was a strong correlation between flow cytometric and microscopic results regarding macrophage/monocyte, lymphocyte, eosinophil, and neutrophil percentages in BALF (P < .001 for all leukocyte subpopulations). Bland-Altman analyses showed that the mean differences between the methods were ≤ 2% for all four cell types. Flow cytometric results differed less than 20% from microscopic results in more than 95% of all samples. Subgroup analyses confirmed that these results were independent from total leukocyte counts in BALF.
interpretationWe report, to our knowledge, the first validated flow cytometric method for BALF leukocyte differentiation, which can be used in clinical settings where local expertise for microscopic analysis is unavailable and which can be combined easily with lymphocyte surface marker analysis.
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