Evaluation of the Lungs of Individuals With Lung Disease

Patients will undergo a general medical evaluation by a pulmonary physician (and consultants
as appropriate for other organs). The typical routine medical studies to be carried out may
include: chest X-ray (posterior-anterior and lateral), non-contrast high resolution CT scan
of the chest, pulmonary function tests, electrocardiogram, echocardiogram, general
hematologic studies, general serologic studies, /immunologic studies, biochemical analyses
(including carboxyhemoglobin to measure blood carbon monoxide levels in order to accurately
evaluate the diffusion capacity in individuals who smoke since smoking increases the blood
levels of carbon monoxide), alcohol blood test, urinalysis, urine chemistries (including
blood or urine nicotine and cotinine test to evaluate urine for active or passive exposure
to nicotine), blood or urine drug screening (to evaluate use of recreational drugs and/or
mood altering medications), pregnancy test (if applicable) and HIV serology. Also, a sweat
chloride and sweat rate test may be performed by the physician to evaluate participants with
a possible diagnosis of cystic fibrosis.

The study individual will undergo fiberoptic bronchoscopy with a combination of bronchial
brushing and/or bronchoalveolar lavage and/or bronchial wall biopsy. The primary factor for
determining if an individual will have bronchial alveolar lavages (BAL) and/or brushings
and/or biopsies is the particular lung disease affecting the individual. This will depend on
the known mechanism relevant to the pathogenesis of the particular disease. For example, in
individuals with asthma, the samples may include airway brushing and airway biopsies; in
contrast, in individuals with chronic obstructive pulmonary disease (COPD), sampling may
include airway brushings, airway biopsies, and bronchoalveolar lavage. Other determining
factors include: the amount of moderate sedation (if used) and the amount of analgesia used;
the maximal dosage of topical lidocaine that is allowed per procedure; allergic reactions to
any of the medications used in the procedures; and individual's tolerance to the procedure.

Inclusion Criteria:

- Must provide informed consent

- Males and females, age 18 years and older

- Lung disease proven by at least one of the following: (1) symptoms consistent with
pulmonary disease; (2) chest X-rays consistent with lung disease; (3) pulmonary
function tests consistent with lung disease; (4) lung biopsy consistent with lung
disease; (5) family history of lung disease; and (6) diseases of organs with known
association with lung disease

- Must provide HIV informed consent

Exclusion Criteria:

- Any history of allergies to xylocaine, lidocaine, versed, valium, atropine,
pilocarpine, isoproterenol, terbutaline, aminophylline, or any local anesthetic will
not be included in the study

- Drug and/or alcohol abuse within the past six months

- Females who are pregnant or nursing

- Individuals who test positive for HIV (other than for studies directly related to the
HIV virus)