Many healthy subjects who have had no exposure to cotton textile dusts will experience significant reductions in expired flow rate following an inhalational challenge with an aqueous extract of cotton bracts (CBE). Differences noted among individuals in the magnitude of the bronchial response to a standardized preparation of CBE suggest variable airway reactivity. The mechanism of this response and the reasons for its variability among these naive subjects are unknown. We have studied this problem by performing bronchoalveolar lavage on 13 volunteer subjects with no history of textile dust exposure. Two to three months later, a bronchial provocation with aqueous CBE was performed by an investigator blinded to the lavage results. Subjects with greater than 20 percent drop in flow rate at 40 percent of vital capacity during a partial forced expiration (MEF 40 percent [P]) following CBE had a reduction in total recoverable alveolar macrophages, with a resultant increase in the percentage of recoverable lymphocytes. The magnitude of response (MEF 40 percent [P]) correlated directly with the measured lymphocyte percentage (r = 0.69 p less than 0.01) and inversely with the total numbers of recovered cells.
