POSSIBLE ALTERATION OF SURFACTANT IN BRONCHOALVEOLAR LAVAGE FLUID FROM HEALTHY SMOKERS COMPARED TO NONSMOKERS AND PATIENTS WITH SARCOIDOSIS

In disorders affecting the alveoli and lung interstitium an altered co mposition of the epithelial lining fluid, i.e. the surfactant, may aff ect the outcome of the disease. The phospholipid composition in bronch oalveolar lavage (BAL) fluid was determined in healthy non-smoking (n = 8) and smoking (n = 12) volunteers, and in non-smoking patients with clinically active sarcoidosis (n = 7). The total amount of phosphatid ylcholines (median +/- SD) were in the non-smoking control group (21.8 +/- 5.7 mu mol/L) and in the non-smoking sarcoidosis group (26.1 +/- 9.1 mu mol/L), while healthy smokers had significantly (p < 0.05 for b oth) lower amounts (14.6 +/- 5.6 mu mol/L). The composition of phospha tidylcholines was similar in all three groups with one exception. Palm itoylmyristoyl-phosphatidylcholine constituted a significantly higher fraction among the smokers (12.7 +/- 2.1 mol%) compared to the non-smo king control group (10.6 +/- 1.4 mol%; p < 0.05) and the sarcoidosis g roup (10.6 +/- 0.6 mol%; p < 0.01). In conclusion, no quantitative or qualitative differences in phosphatidylcholines were observed between non-smoking healthy volunteers and non-smoking patients with clinicall y active sarcoidosis. However, in smoking healthy volunteers the total amount of phosphatidylcholines was reduced and their composition alte red. Earlier reported conflicting results may be due to the fact that the smoking habits have not been considered.