Oxidized BAL fluid proteins in patients with interstitial lung diseases

Oxygen-derived free radicals, released by phagocytic cells, have been postulated to contribute to lung tissue damage. We therefore investigated oxidative damage to proteins from bronchoalveolar lavage fluid (BALF) as an indicator of oxidative stress and to assess antioxidant defences in the lungs. We examined BAL fluids from patients with interstitial lung diseases, such as idiopathic pulmonary fibrosis (IPF, nonsmokers (NS) and smokers (S)), sarcoidosis (SARC, nonsmokers), and asbestosis (ASB, ex-smokers (EXS)). The oxidation of BALF proteins is accompanied by the introduction of carbonyl groups into their amino acid side-chains and can be quantitated by labelling these groups with tritiated borohydride. The total lung content of oxidized proteins recovered by bronchoalveolar lavage (BAL) was 0.3+/-0.07 nmol carbonyl . mL BALF (mean+/-SEM) in the NS control group (n=9) and tended to be increased, in the asymptomatic S group (m=8; 0.59+/-0.14 nmol . mL(-1)). This parameter was significantly elevated both in IPF-NS (n=14; 0.84+/-0.2 nmol carbonyl . mL(-1) BALF) and SARC-NS (n=15; 0.73+/-0.16 nmol . mL(-1)) as compared with NS control. On the contrary, in smoking patients with IPF (n=6; 0.41+/-0.1 nmol carbonyl . mL(-1) BALF) and also in ASB-EXS (n=6; 0.73+/-0.16 nmol . mL(-1)) it was not different from NS controls. The total amount of oxidized proteins correlated positively with the absolute number of eosinophils (EOS) in IPF-NS, IPF-S and SARC and also with absolute polymorphonuclear neutrophil (PMN) numbers in IPF-NS and IPF-S. In conclusion, oxidative damage of BALF proteins occurred in nonsmoking patients with IPF and SARC. The amount of oxidized bronchoalveolar lavage fluid protein may provide a quantitative assessment of oxygen burden, a balance between oxidant stress and antioxidant defences.