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Abstract
Bronchoalveolar lavage (BAL) is becoming a common procedure for research into infectious disease immunology. Little is known about the clinical factors which influence the main outcomes of the procedure. In research participants who underwent BAL according to guidelines, the BAL volume yield, and cell yield, concentration, viability, pellet colour and differential count were analysed for association with important participant characteristics such as active tuberculosis (TB) disease, TB exposure, HIV infection and recent SARS-CoV-2 infection. In 337 participants, BAL volume and BAL cell count were correlated in those with active TB disease, and current smokers. The right middle lobe yielded the highest volume. BAL cell and volume yields were lower in older participants, who also had more neutrophils. Current smokers yielded lower volumes and higher numbers of all cell types, and usually had a black pellet. Active TB disease was associated with higher cell yields, but this declined at the end of treatment. HIV infection was associated with more bloody pellets, and recent SARS-CoV-2 infection with a higher proportion of lymphocytes. These results allow researchers to optimise their participant and end assay selection for projects involving lung immune cells.
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1 Stellenbosch University, DSI-NRF Centre of Excellence for Biomedical Tuberculosis Research, Cape Town, South Africa (GRID:grid.11956.3a) (ISNI:0000 0001 2214 904X); Stellenbosch University, South African Medical Research Council Centre for Tuberculosis Research, Cape Town, South Africa (GRID:grid.11956.3a) (ISNI:0000 0001 2214 904X); Stellenbosch University, Division of Molecular Biology and Human Genetics, Biomedical Research Institute, Faculty of Medicine and Health Sciences, Cape Town, South Africa (GRID:grid.11956.3a) (ISNI:0000 0001 2214 904X)
2 Stellenbosch University, DSI-NRF Centre of Excellence for Biomedical Tuberculosis Research, Cape Town, South Africa (GRID:grid.11956.3a) (ISNI:0000 0001 2214 904X); Stellenbosch University, South African Medical Research Council Centre for Tuberculosis Research, Cape Town, South Africa (GRID:grid.11956.3a) (ISNI:0000 0001 2214 904X); Stellenbosch University, Division of Molecular Biology and Human Genetics, Biomedical Research Institute, Faculty of Medicine and Health Sciences, Cape Town, South Africa (GRID:grid.11956.3a) (ISNI:0000 0001 2214 904X); Stellenbosch University, South African Tuberculosis Bioinformatics Initiative, Cape Town, South Africa (GRID:grid.11956.3a) (ISNI:0000 0001 2214 904X)
3 Stellenbosch University, DSI-NRF Centre of Excellence for Biomedical Tuberculosis Research, Cape Town, South Africa (GRID:grid.11956.3a) (ISNI:0000 0001 2214 904X); Stellenbosch University, South African Medical Research Council Centre for Tuberculosis Research, Cape Town, South Africa (GRID:grid.11956.3a) (ISNI:0000 0001 2214 904X); Stellenbosch University, Division of Molecular Biology and Human Genetics, Biomedical Research Institute, Faculty of Medicine and Health Sciences, Cape Town, South Africa (GRID:grid.11956.3a) (ISNI:0000 0001 2214 904X); Stellenbosch University, South African Tuberculosis Bioinformatics Initiative, Cape Town, South Africa (GRID:grid.11956.3a) (ISNI:0000 0001 2214 904X); Stellenbosch University, Centre for Bioinformatics and Computational Biology, Stellenbosch, South Africa (GRID:grid.11956.3a) (ISNI:0000 0001 2214 904X)
4 University of Cape Town, South African Tuberculosis Vaccine Initiative (SATVI), Institute of Infectious Disease and Molecular Medicine and Division of Immunology, Department of Pathology, Cape Town, South Africa (GRID:grid.7836.a) (ISNI:0000 0004 1937 1151)
5 Oregon Health and Science University, and Portland Veterans Administration Medical Center, Division of Pulmonary and Critical Care Medicine, Department of Medicine, Portland, USA (GRID:grid.5288.7) (ISNI:0000 0000 9758 5690)
6 Oregon Health and Science University, Division of Infectious Disease, Department of Paediatrics, Portland, USA (GRID:grid.5288.7) (ISNI:0000 0000 9758 5690)
7 University of Washington School of Medicine, Seattle Children’s Research Institute and Departments of Paediatrics and Immunology, Washington, Seattle, USA (GRID:grid.34477.33) (ISNI:0000000122986657)
8 The Research Institute of the McGill University Health Centre, Program in Infectious Diseases and Immunity in Global Health, Montreal, Canada (GRID:grid.63984.30) (ISNI:0000 0000 9064 4811); McGill University, McGill International TB Centre and Departments of Medicine, Biochemistry and Human Genetics, Faculty of Medicine and Health Sciences, Montreal, Canada (GRID:grid.14709.3b) (ISNI:0000 0004 1936 8649)
9 Case Western Reserve University, Department of Medicine, Cleveland, USA (GRID:grid.67105.35) (ISNI:0000 0001 2164 3847)
10 Harvard T. H. Chan School of Public Health, Department of Immunology and Infectious Disease, Boston, USA (GRID:grid.38142.3c) (ISNI:000000041936754X)