Immunobiochemical evaluation of bronchoalveolar lavage (BAL) in atopic bronchial asthma, chronic bronchitis and bronchiectasis.

The protease-antiprotease balance and concentration of immunoglobulin was evaluated in some respiratory tract diseases. Analysis was carried out on 24 patients with atopic bronchial asthma, 21 with chronic bronchitis, 27 with bronchiectasis and 18 healthy smokers volunteers. In examination of BAL fluid some selective changes of proteolytic enzymes activities and concentrations of their natural inhibitors were documented. In atopic bronchial asthma the increased activity of acid protease, acid phosphatase and concentration of alpha-2-macroglobulin was the most characteristic. In chronic bronchitis there was an increase of acid protease, alkaline phosphatase and concentration of alpha-1-antitrypsin, haptoglobin, but in bronchiectasis the increase of neutral and acid proteases activities and concentration of all examined natural inhibitors was noted. The changes in concentration of IgA and IgG confirmed their participation in local defense response. All examined BAL enzyme activities and concentrations of inhibitors and immunoglobulins were compared with the results of the parameters in serum, mentioned above. The obtained finding supports the suggestion that the proteolytic enzymes, their natural inhibitors and immunoglobulins play an important role in the respiratory tract pathology. Immunobiochemical analysis of BAL in atopic bronchial asthma, chronic bronchitis and bronchiectasis may be useful for clinical prognosis and pharmacological treatment.