Lymphocyte subsets in peripheral blood and bronchoalveolar lavage in patients with primary biliary cirrhosis

The objective of this study was to examine the hypothesis that total blood and bronchoalveolar lavage (BAL) lymphocytes and their subsets in patients with primary biliary cirrhosis (PBC) with coexistent alveolitis are different from those in patients with PBC alone. Total blood and BAL lymphocytes and their subsets were evaluated in both types of patients and compared with a control group of normal healthy subjects. 17 patients with well-documented PBC were divided into two groups: Group A--patients with coexisting alveolitis and Group B--patients with no alveolitis. Diagnosis was based on bronchoalveolar lavage. The control group consisted of healthy subjects. The lymphocyte subsets, including CD3, CD4, CD8, CD20 and CD56 were identified in blood and BAL cytospin smears using specific monoclonal antibodies. The percentage of CD3 and CD8 lymphocytes in BAL was significantly lower in a Group A, whereas the percentage of NK was significantly increased in group B as compared with the reference group. The percentage of blood CD4 lymphocytes in both subgroups of the PBC patients was significantly decreased as compared with the controls. The percentage of NK in both groups was significantly increased as compared with the controls. The relationship between the blood and BAL lymphocyte subsets in both studies groups were similar. Therefore, we suggest that PBC is a systemic disease in which lymphocytic infiltrations are not limited to the liver but may also involve lungs and probably other organs.