We examined the
interleukin-1 (IL-1) and
tumor necrosis factor alpha (
TNF alpha) releasability of alveolar macrophages and the natural killer (NK) cell activity in the bronchoalveolar lavage (BAL) cells of 11 patients with
Farmer's lung at different stages of the disease. Although there were some variations in the levels of monokine release, macrophages of patients with
acute disease secreted significantly higher spontaneous levels of
TNF alpha than did a nonfarming control group (p = 0.0002). Conversely,
TNF alpha release stimulated by bacterial
lipopolysaccharide (LPS) was similar in patients with
acute disease when compared with that in normal control subjects.
IL-1 was also spontaneously secreted in significantly greater amounts by patients with acute
Farmer's lung than by subjects in a control group (p = 0.0001). However, LPS-induced
IL-1 release was significantly diminished in BAL macrophages from patients with acute manifestations of the disease when compared with that in control subjects (p = 0.001). Treating
hypersensitivity pneumonitis with
corticosteroids or by contact avoidance resulted in very significant decrease in spontaneous and LPS-stimulated
IL-1 production by BAL macrophages (p = 0.0001 and p = 0.03, respectively), as well as in a decrease in spontaneous
TNF alpha release that was also significant (p = 0.01). In addition, BAL cells of patients in the acute phase had a significant NK cell activity (mean +/- SEM of 18.33 +/- 2.65%). Treatment of these patients resulted in an increase in NK cell activity (mean of 40.17 +/- 7.86%), which was significantly different from values of patients with
acute disease (p = 0.037).(ABSTRACT TRUNCATED AT 250 WORDS)