Bronchoalveolar Lavage in Interstitial Lung Diseases to Characterization of Specific Inflammatory Cellular Infiltrate in Different Interstitial Lung Diseases
For patients and families
In plain language
An automatic summary of structured registry data. It is an orientation aid, not a substitute for the official protocol or a physician assessment.
- What is being studied
- The protocol lists: bronchoscopy.
- Who it may be relevant to
- Registry conditions: Interstitial Lung Diseases. Basic parameters: from 18 years · All.
- What needs checking
- Age, condition and sex are only basic indicators. Prior treatment, laboratory values and other mandatory requirements appear in the eligibility criteria below.
- Where it takes place
- Center list to be confirmed — check the primary protocol.
- Next step
- Save the trial, show it to the treating physician, and confirm current recruitment with the study center. Costs, documents and travel →
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Official title
Clinical Utility of Bronchoalveolar Lavage in Interstitial Lung Diseases
Overview
Interstitial lung disease (ILD) represents a various group of disorders characterized by inflammation and fibrosis within the lung parenchyma.\[1\] ILD refers to a group of diffuse parenchymal lung disorders, including a spectrum of conditions such as idiopathic pulmonary fibrosis (IPF), sarcoidosis, and connective tissue disease-associated ILD (CTD-ILD) characterized by inflammation and fibrosis of the interstitium. ILD results in Impaired lung function and, in severe cases, respiratory failure.\[1\] Diagnosing ILD is a complex task due to the heterogeneous nature of these disorders. Distinguishing between different ILD subtypes and identifying disease progression present ongoing challenges in clinical practice. .\[2\] BAL emerges as a key investigative tool , allowing for the collection of bronchoalveolar fluid. The cellular and molecular composition of BAL fluid provides valuable insights into the underlying pathology, aiding in the differential diagnosis of ILD subtypes. The gold standard in BAL analysis is cytological examination by microscopy.\[3\] Flow cytometry is an updated method of BAL analysis which can provide quicker and more objective results and, with the appropriate design of antibody panels, accurately quantify the main leukocyte subsets. Several studies have described the usefulness of flowcytometry for the discrimination of sarcoidosis from other lymphocytic pathologies or even to perform leukocyte subset counting in diverse ILDs.\[4\]\[5\] Both microscopic and flowcytometric examination of BAL in ILD are complementary tools that provide comprehensive information about the cellular landscape of the lower respiratory tract ,conclusive for: Accurate diagnosis Primary aim: Characterization of specific inflammatory cellular infiltrate in different interstitial lung diseases. \- Secondary aims: 1. Correlation between clinical ,radiological and inflammatory cellular pattern as regards BAL findings of different interstitial lung diseases 2. Assessment of impact on outcome, prognosis and survival of the disease as regards management modification after BAL characterization
Interventions
- Procedure bronchoscopy
BAL is performed with the fiberoptic bronchoscope in a wedge position within the selected bronchopulmonary segment. The total instilled volume of normal saline should be no less than 100 ml and should not exceed 300 ml. Three to five sequentially instilled aliquots are generally withdrawn after each aliquot instillation. For optimal sampling of distal airspaces, the total volume (pooled aliquots) retrieved should be greater than or equal to 30% of the total instilled volume. A total volume o
Primary outcome measures
- description of pattern and percentage of specific inflammatory cellular infiltrate in different interstitial lung diseases in bronchoalveolar lavage . [Time frame: 2 years]
Eligibility criteria
Inclusion criteria
- Age ≥ 18 years
- Clinical suspicion of ILD based on symptoms, clinical examination, and radiological findings or newly diagnosed cases .
- HRCT findings consistent with ILD
- Willingness to undergo bronchoscopy with BAL and provide informed consent
Exclusion criteria
- Hemodynamic instability or ICU admission at time of evaluation
- Oxygen saturation < 88% on room air or < 92% on oxygen therapy
- Absolute contraindications to bronchoscopy (e.g., uncorrected bleeding diathesis, recent myocardial infarction)
- Associated chronic chest diseases other than ILD (COPD. bronchial asthma and lung cancer )
- Known active pulmonary infection or recent antibiotic treatment (< 2 weeks)
- Pregnancy
Criteria are shown verbatim from the registry (in English). Final eligibility is always assessed by the study center.
Healthy volunteers: No
Study design
- Observational model
- Other
Study locations
Center list to be confirmed — check the primary protocol.
Identifiers
NCT: NCT07208201 · BAL in ILD