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In vivo studies have shown a major role for the alveolar macrophage in the killing of inhaled bacteria. This contrasted with earlier work which showed a preservation of phagocytic properties but a loss of bactericidal capacity when alveolar macrophages were studied in vitro. Recently, alveolar lining material (ALM) from rats has been shown to enhance the in vitro bactericidal capacity of alveolar macrophages from homologous animals against Staphylococcus aureus. Utilizing a similar system, we have confirmed that rat alveolar macrophages do not kill S. aureus in vitro unless the bacteria have been incubated with rat ALM (R-ALM) before phagocytosis. In addition, human ALM (H-ALM) from 7 of 11 patients assayed showed an enhancement of bactericidal capacity by rat alveolar macrophages which was not significantly different from the results utilizing R-ALM. H-ALM from the other four patients gave results which differed significantly from results with H-ALM from the first seven patients and R-ALM (P less than 0.001). Preliminary results suggest that the factor enhancing the bactericidal capacity of rat alveolar macrophages is present in the lipid fraction of the ALM. Further characterization of the ALM is warranted in an effort to explain the enhancement of the bactericidal capacity of alveolar macrophages by most, but not all, H-ALM tested.

Enhancement of bactericidal capacity of alveolar macrophages by human alveolar lining material.