engleski

Bronchoalveolar T cell subsets in pulmonary sarcoidosis. Correlation with disease activity and effect of steroid treatment

Background and purpose: This is a prospective study aimed to determine the usefulness of bronchoalveolar lavage immunophenotyping as an aid in evaluarting the intensity of alveolitis in pulmonary sarcoidosis. Patients and methods: Nineteen patients were examined at diagnosis and followed .up over a 5-30 months period. Alveolitis intensity was determined by clinical (CR, DLCO, 67 GA and ACE) and bronchoalveolar lavage (cyto- and immunomeasurement ) parameters. Activation phenotype was identified by two-color labelling (i.e. T lymphocytes bearing HLA-DR, CD25, CD38 and CD71 activation molecules). Results: Generally, bronchoalveolar lavage in active alveolitis shows elevated cellularity with lymphocyte predominance of various activation degree. At the onset of the disease T subset analysis revealed highly activated cells. As a rule, the majority of those were T lmphocytes bearing CD38 activation marker (i e CD4+CD38+). Moreover elevated CD4+CD38+ subset was associated with severe pulmonary function impairment, whereas CD3+HLA-DR+, CD4++CD38+ and CD4+CD71+ were not of greater importance for the disease activity assessment. Conclusion: Our results suggest thar CD38 level on bronchoalveolar lavage lymphocytes is a reporesentative indicator of effector populations able to induce alveolitis. As only CD38 level on CD4 bronchoalveolar lavage lymphocytes correlated with disease activity, maybe by CD4+CD3+ subset monitoring, it might be possible to predict disease severity and its outcome. Close positive correlation between CD38 expression and alveolitis activity provide further evidence in the pathogenesis of pulmonary sarcoidosis. However, definite conclusions with the respect to action mechanism and the predictive usefulness of CD38 in bronchoalveolar larger patients group within a longer folow-up study,

BAL; T lymphocytes; immunophenotypisation

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