Diagnostic value of bronchoalveolar lavage in interstitial lung diseases

Bronchoalveolar lavage (BAL) is currently widely applied to sample cells and proteins present in the bronchoalveolar space for subsequent studies. Moreover, this limited invasive technique is a sensitive indicator of infectious and non-infectious inflammatory disorders, such as interstitial lung diseases. The aim of this study was to investigate the clinical applications of BAL, in particular the diagnostic value of this method with a view to preventing more invasive procedures. The studies presented in this thesis are based on BAL fluid data obtained from patients during a ten-year period between 1980 and 1990. Cells and proteins, ie, albumin and immunoglobulins, determined in those BAL fluid samples, have been analyzed. Retrospectively, we searched for specific features in the data from the BAL fluid analyses, which distinguish between various interstitial lung diseases. This thesis describes the diagnostic value of BAL fluid sample analyses in patients suffering from various interstitial lung diseases. Emphasis is put on patients with sarcoidosis, extrinsic allergic alveolitis (EAA), or idiopathic pulmonary fibrosis

'Adembenemende contacten....' 'Breathtaking inspirations....'

Rede uitgesproken bij de aanvaarding van het ambt van bijzonder hoogleraar longziekten i.h.b. ‘interstitiële longaandoeningen’ aan de Universiteit Maastricht, op vrijdag 12 mei 200

Resting vs. active: a meta-analysis of the intra- and inter-specific associations between minimum, sustained, and maximum metabolic rates in vertebrates

Variation in aerobic capacity has far reaching consequences for the physiology, ecology, and evolution of vertebrates. Whether at rest or active, animals are constrained to operate within the energetic bounds determined by their minimum (minMR) and sustained or maximum metabolic rates (upperMR). MinMR and upperMR can differ considerably among individuals and species but are often presumed to be mechanistically linked to one another. Specifically, minMR is thought to reflect the idling cost of the machinery needed to support upperMR. However, previous analyses based on limited datasets have come to conflicting conclusions regarding the generality and strength of their association. Here we conduct the first comprehensive assessment of their relationship, based on a large number of published estimates of both the intra-specific (n = 176) and inter-specific (n = 41) phenotypic correlations between minMR and upperMR, estimated as either exercise-induced maximum metabolic rate (VO2max), cold-induced summit metabolic rate (Msum), or daily energy expenditure (DEE). Our meta-analysis shows that there is a general positive association between minMR and upperMR that is shared among vertebrate taxonomic classes. However, there was stronger evidence for intra-specific correlations between minMR and Msum and between minMR and DEE than there was for a correlation between minMR and VO2max across different taxa. As expected, inter-specific correlation estimates were consistently higher than intra-specific estimates across all traits and vertebrate classes. An interesting exception to this general trend was observed in mammals, which contrast with birds and exhibit no correlation between minMR and Msum. We speculate that this is due to the evolution and recruitment of brown fat as a thermogenic tissue, which illustrates how some species and lineages might circumvent this seemingly general association. We conclude that, in spite of some variability across taxa and traits, the contention that minMR and upperMR are positively correlated generally holds true both within and across vertebrate species. Ecological and comparative studies should therefore take into consideration the possibility that variation in any one of these traits might partly reflect correlated responses to selection on other metabolic parameters