[Comparison of immunological aspects in diffuse panbronchiolitis and cystic bronchiectasis].

We examined immunological parameters in 35 patients with diffuse panbronchiolitis (DPB) and 20 patients with cystic bronchiectasis (CBE) to analyze the relation between local immune responses and subsequent clinical courses. Patients with DPB showed more impaired cell-mediated immunity than those with CBE. On analysis of peripheral blood lymphocytes from DPB and CBE, the significant increase in CD4 positive T-cells and Fc alpha R positive T-cells and decrease in Leu-11 positive cells were recognized. The observation of humoral immunity revealed a tendency for local immunity to be accelerated such as increases of IgA and IgG2 in both diseases. The titer of serum cold agglutinin and rheumatoid factor were elevated in DPB. However, these fluctuations of immunological factors were normalized according to improvement of inflammatory processes by chemotherapy. The analysis of the distribution of lymphocyte subsets in lung tissues taken from DPB showed that CD4 positive T-cells always overwhelmed CD8-positive T-cells and that secretary IgA-positive B-cells were abundant in bronchioles. On the other hand, bronchiolitis was recognized in about 80% of cases with CBE, although to a less striking degree than DPB. Lymphocyte subsets were similarly distributed in the respiratory tract. DPB and CBE could be considered as the same disease entity in the spectrum of chronic respiratory tract infection based on mucociliary disorder. Sinusitis and immunological abnormalities are often complicated by both diseases. However, precise analysis demonstrated that there are some obvious differences of systemic and local immune responses between DPB and CBE, probably due to the conditions of each diseases such as primary focus, severity and causative microorganism.