INHALATION CHALLENGE IN PIGEON-BREEDERS DISEASE - BAL FLUID CHANGES AFTER 6 HOURS

The purpose of this study was to determine the cellular events occurri ng 6 h after bronchial inhalation challenge, in a group of pigeon bree ders. Twelve subjects agreed to undergo challenge, either with nebuliz ed pigeon serum (Ps) (n=10), or with saline (n=2). The development of characteristic symptoms was used to detect a positive response in comb ination with monitoring tests (white blood cell count (WBC), body temp erature, and spirometry). An initial bronchoalveolar lavage (BAL) was performed before inhalation challenge, and a further BAL on the previo usly spared right middle lobe subsegment or lingula 6 h after challeng e. Paired bronchoalveolar lavage fluid (BALF) samples were analysed fo r urea, albumin, total and differential WBC, interleukin-1 and interle ukin-2. There was a significant increase in total cells, lymphocytes, T-lymphocytes, and neutrophils; numbers.ml-1 of BALF in responders. A monitoring score reflecting severity of patient response correlated wi th an increase in all cell types (p<0.05). In conclusion, responders d eveloped both a BALF lymphocytic and neutrophilic ''alveolitis'' follo wing inhalation challenge, the degree of BALF ''alveolitis'' correlati ng with the severity of patient response.