Determinants Of Oxidant Load In Broncho Alveolar Milieu

Giuseppe Valerio M.D., Donato Lacedonia M.D., Pierluigi Bracciale M.D, Fabio Valerio

The lung is exposed to inhaled xenobiotics detemining direct damage , macrophage activation and neutrophils recruitment with an overwhelming oxidant load in broncho-alveolar milieu and alveolar macrophages leading to pulmonary damage . Our aim is to assess the biologic activity of oxygen radicals (ROS) and biologic antioxidant potential (BAP) in broncho-alveolar fluids and blood in healthy subjects and in patients affected by COPD under GOLD stage II and III and IPF and to assess the relationship between ROS and macrophage function.In thirteen healthy subjects , twenty patients affected by COPD and twenty affected by IPF we assessed pulmonary function , blood gases , ROS and BAP in blood samples , broncho-alveolar lavage(BAL), expired breath condensate and sovranatant of alveolar macrophages culture. In patients ROS were increased both in blood (474±177, 345±123 vs 192±46 U Car in COPD , IPF and healthy people respectively) , and in broncho-alveolar lavage (99±24 , 94±33 , vs77±14 )and in macrophage culture media(99 ± 37, 106±45 vs 80 ± 15). BAP were mildly decreased in blood (2162±668, 2031±562vs2553±679 mM/lt) , but they were normal in BAL(1064±432, 910±222 vs 882±241 ). ROS/BAP ratio was significantly increased in blood (0.21±03 vs0.08±.01 U Carr/mM/l) with overlap in BAL (0.09±02 vs0.08 ±.2 ) . ROS in BAL were significantly related to acid phosphatases and ROS produced by Mf in media culture . ROS load in blood is highly significant under COPD and IPF . ROS and BAP were several folds more concentrated in BAL than in blood by active secretion . Macrophages are the most important source of ROS in BAL .