BibTex format
@article{Kaenmuang:2026,
author = {Kaenmuang, P and Barnett, JL and Maher, TM and Quint, JK and Adamson, A and Wu, Z and Smith, DJF and Rawal, B and Nair, A and Walsh, SLF and Desai, SR and George, PM and Kokosi, M and Kouranos, V and Renzoni, EA and Rice, A and Nicholson, AG and Chua, F and Wells, AU and Molyneaux, PL and Devaraj, A and Jenkins, G and Stewart, ID},
journal = {BMJ Open Respiratory Research},
title = {Association of bronchoalveolar lavage cellular analysis and radiological findings in fibrotic interstitial lung diseases},
year = {2026}
}
RIS format (EndNote, RefMan)
TY - JOUR
AB - Background and aims: Inflammation may play a role in driving interstitial lung diseases (ILD). Radiological ground-glass opacity (GGO) may not reliably distinguish fine intralobular fibrosis from inflammatory processes in fibrotic ILD. We therefore investigated the relationship between GGO, fibrosis and leukocytes in bronchoalveolar lavage (BAL).Methods: We recruited patients with fibrotic ILD at a single centre between May 2014 and February 2018. The extent of GGO and fibrosis were evaluated by two radiologists. Linear regression examined the association between leukocyte numbers in BAL obtained from the right middle lobe (RML) and GGO/fibrosis extent in whole lung, adjusting for age, sex, and smoking. Z-test was used to compare the association between BAL and GGO/fibrosis.Results: 316 patients were included. Adjusting analyses for covariates, only BAL eosinophil and eosinophil-to-macrophage ratio were positively associated with GGO involvement (0.23 [95%CI 0.03 to 0.42] p = 0.023 and 11.21[1.33, 21.08] p = 0.026). Lymphocyte percentages (fibrosis -0.17 vs. GGO -0.02 p = 0.046); neutrophil percentages (fibrosis 0.38 vs. GGO 0.06 p 0.002); neutrophil-to-lymphocyte ratio (fibrosis 0.63 vs. GGO -0.05 p 0.027); neutrophil-to-macrophage ratio (Fibrosis 14.08 vs. GGO 2.57 p = 0.015), and neutrophilia (fibrosis 6.81 vs. GGO -0.31 p = 0.002) all demonstrated a significantly stronger associations with fibrosis than GGO. Conclusions: Lack of relationships between radiological GGO and BAL leukocyte counts in fibrotic lung disease indicates that GGO may not always be inflammatory in nature. Higher levels of neutrophil were associated with more extensive fibrosis.
AU - Kaenmuang,P
AU - Barnett,JL
AU - Maher,TM
AU - Quint,JK
AU - Adamson,A
AU - Wu,Z
AU - Smith,DJF
AU - Rawal,B
AU - Nair,A
AU - Walsh,SLF
AU - Desai,SR
AU - George,PM
AU - Kokosi,M
AU - Kouranos,V
AU - Renzoni,EA
AU - Rice,A
AU - Nicholson,AG
AU - Chua,F
AU - Wells,AU
AU - Molyneaux,PL
AU - Devaraj,A
AU - Jenkins,G
AU - Stewart,ID
PY - 2026///
SN - 2052-4439
TI - Association of bronchoalveolar lavage cellular analysis and radiological findings in fibrotic interstitial lung diseases
T2 - BMJ Open Respiratory Research
ER -