engleski

Bronchoalveolar lavage fluid and pulmonary phisiology data relationship to prednisone therapy response and prognosis in patients with pulmonary sarcoidosis

Although bronchoalveolar lavage fluid (BALF) analysis is useful approach for study of cellular components of the lower respiratory tract, there has been considerable disagreement about its prognostic value. The aim of this study was to assess the usefulness of cyto-and immunomeasuremment in gauging disease severity and outcome. Follow-upo study population consisted of eighteen pulmonary sarcoidosis (PS) patients investigated two to six times and divided according to the onset alveolitis intensity (AI) and prednisone therapy (PT) in high AI requring PT (n=6), high AI without PT (n=5), moderate AI with PT (n=5) and low AI without PT (n=2). Patients with increased cellularity and lymphocytosis had equal chance of responding to PT as those with low counts. BALF lymphocytes were identified with monoclonals to CD3, CD4, CD8, CD16, 56, CD20, CD25, CD38, CD71 and HLA-DR using simultaneous two color standard staining procedure. CD4/CD8 ratios decreased in all patients during the course of disease, slighty more in the treated groups. CD25, CD38, CD71 and HLA-DR lymphocyte activation molecules incidence was variable, but only CD4+CD38+ and CD8+CD38+ subpopulations was associated with damaged pulmonary physiology (functional tests and radiology) and patients with elevated CD4+CD38+ were (1) less likely to recover spontaneously and (2) more likely to retain functional impairement after PT.

bronchoalveolar lavage; Immunophenotypisation; pulmonary sarcoidosis

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