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A4779 - Bronchoalveolar Lavage Cytokine Analysis in Deployment-Related Chronic Respiratory Symptoms
Author Block: J. Anderson1, M. J. Morris2, A. B. Holley3, M. Cabellero4, S. Valtier5, G. Chaudry5; 1Pulmonary/Critical Care, San Antonio Military Medical Center, San Antonio, TX, United States, 2Brooke Army Medical Ctr, San Antonio, TX, United States, 3Pulmonary / Sleep / CCM, Walter Reed National Military Med Ctr, Bethesda, MD, United States, 4Center for Advanced Molecular Detection, 59th Medical Wing JBSA-Lackland TX, San Antonio, TX, United States, 5Center for Advanced Molecular Detection, 59th Medical Wing, JBSA-Lackland, San Antonio, TX, United States.
Introduction: Chronic respiratory symptoms are frequently reported after military deployment to Southwest Asia in support of combat operations. STAMPEDE III is an ongoing clinical study providing a comprehensive pulmonary evaluation to include bronchoscopy. The current study aimed to analyze 37 cytokines and other secreted proteins in the bronchoalveolar lavage (BAL) samples from enrolled patients and healthy non-deployed controls. Methods: Samples from 38 healthy subjects and 193 subjects with chronic pulmonary symptoms were collected by the standard methods for BAL fluid collection. The analysis employed the Luminex bead-based high-throughput approach to simultaneously analyze the level of each of the 37 secreted cytokines and other proteins. Total protein concentration in each sample was determined by a fluorescence method using the Qubit 3.0 fluorescence spectrometer. Bio-Plex ProTM Human Inflammation Panel I, 37-Plex Assay kit was used for analysis of 37 proteins in BAL samples. Results: The proteins whose levels were about 1.5 to nearly 4 times higher in the lung disease samples compared to normal controls were the sIL-6 receptor, BAFF, MMP1 and IL-8. The proteins that showed higher levels in the control samples than the disease samples were APRIL (1.5 fold) and INF-beta (2 fold). Of the proteins with higher levels in the patient group, MMP1 exhibited the most dramatic difference with nearly 10-fold higher in the patient group. The remainder of the 37 proteins analyzed exhibited little or no difference between the two populations. There is ongoing subanalysis of cytokine findings with BAL cell counts and clinical diagnoses. Conclusions: These results suggest the possibility that secreted protein profile in these patients in comparison to the healthy individuals may help distinguish the lung conditions due to exposure in the war theater. Further analysis based on clinical evaluation, pulmonary function testing, and cytologic studies may better define subgroups in whom these cytokines are elevated.