Pulmonary Alveolar Proteinosis: Origin of Proteins in Pulmonary Washings

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Abstract
Alveolar material was obtained from 3 cases of alveolar proteinosis by broncho -pulmonary irrigation and compared by means of immunoelectrophoresis with material obtained in a similar manner from cases of alveolar cell carcinoma and bronchitis. Antisera were produced to the protein fraction of the soluble phase of these materials and to the subjects'' sera by hyper immunizing rabbits. The following components were demonstrated in each of the preparations by reaction of the pulmonary washing antigens with antihuman sera or their homologous antisera: albumin, gammaA-globulin (gamma1A), and gammaG-globulin (7Sgamma). Transferrin and [alpha]1-acid glycoprotein were also detected. Identification of the above components was confirmed by the use of antisera to the individual purified plasma proteins. Additional precipitin bands were observed when antisera to the pulmonary washings from all subjects reacted with human sera, indicating the presence in the alveolar material of other serum proteins not specifically identified. No soluble antigenic proteins other than plasma proteins were found. The results of this study support the concept that the soluble proteins in the substance which fills the alveolar spaces in alveolar proteinosis are derived primarily from the plasma.

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