Chest
Volume 90, Issue 1, July 1986, Pages 39-44
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Alterations in Immunoregulatory T-Cell Subsets in Cigarette Smokers: A Phenotypic Analysis of Bronchoalveolar and Blood Lymphocytes

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Abnormalities in the proportions of immunoregulatory T-lymphocytes in bronchoalveolar lavage fluid have been reported in interstitial pulmonary diseases, yet the effect of cigarette smoking on T-cell subsets in bronchoalveolar lavage fluid from normal subjects has not been investigated. We applied an immunoperoxidase technique performed on glass slides using the monoclonal antibodies, OKT3, OKT4, OKT8, OKIa, and Leu-7 to study T-cell subsets in bronchoalveolar lavage fluid and blood of 11 normal nonsmokers and 12 smokers. In the bronchoalveolar lavage fluid of smokers, a decrease in the percentage of OKT4+ helper/inducer and an increase in OKT8+ suppressor/cytotoxic cells resulted in a markedly decreased OKT4/OKT8 ratio (0.9±0.4) compared with nonsmokers (1.9±0.8) (p<0.005). These abnormalities of lymphocyte subsets in bronchoalveolar lavage fluid correlated with the cumulative pack-years of smoking history but were not reflected in the peripheral blood. These results suggest that cellular immunoregulation is disturbed in the lungs of cigarette smokers. This may play a role in pulmonary defense mechanisms and tumor immunity.

Section snippets

Population under Study

Our population under study consisted of 11 normal nonsmokers (five men and six women; mean age, 37±15 years) and 12 asymptomatic cigarette smokers (nine men and three women; mean age, 34±16 years). No subject had serious illness or acute viral syndrome in the preceding three months. The smokers had a mean smoking history of 14±9 pack-years. All subjects had normal results of pulmonary function tests, except one smoker, who had mild central airway obstruction. There was no difference in average

General Characteristics of Bronchoalveolar Lavage Fluid and Cells

The total number of cells recovered was significantly increased in smokers compared with that in nonsmokers, as is well known from prior studies (Table 1). This was due to an increase in the proportion and absolute number of macrophages recovered from the lungs of smokers. In absolute numbers, smokers had 516±459 and nonsmokers had 126±62×l03 macrophages per milliliter of bronchoalveolar lavage fluid (p<0.05).

The absolute numbers of lymphocytes in the bronchoalveolar lavage fluid were not

DISCUSSION

Immunologic alterations due to cigarette smoking include an increase in leukocyte counts in the peripheral blood,8, 16, 18 a decrease in levels of circulating immunoglobulins,14, 15 and the formation of serum precipitins against tobacco antigens.9, 10 Studies of the peripheral blood lymphocyte responsiveness to mitogens are conflicting, indicating enhancement,28 no effect,12, 13 or suppression17 in cigarette smokers.

A reversible decrease in the ratio of OKT4+ to OKT8+ lymphocytes in the

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    Supported in part by grant Co 118/2-1 from the Deutsche Forschungsgemeinschaft.

    Manuscript received October 28; revision accepted January 10.

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