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Markers of activity in clinically recovered human leukocyte antigen-DR17-positive sarcoidosis patients

Dept of Respiratory Medicine, Karolinska Hospital, Stockholm, Sweden

CORRESPONDENCE: A. Planck, Dept of Respiratory Medicine, Karolinska Hospital, S-171 76, Stockholm, Sweden. Fax: 46 8312705. E-mail: anders.planck@ks.se

Keywords: bronchoalveolar lavage, follow-up studies, human leukocyte antigen-DR-antigens, sarcoidosis, T-lymphocytes

Received: July 5, 2002
Accepted August 5, 2002

This study was supported by the Swedish Medical Research Council (K2002-74X-14182-01A), the Swedish Heart-Lung Foundation, the King Oscar II Jubilee Foundation and the Karolinska Institutet.

Scandinavian human leukocyte antigen-DR17-positive (DR17+) sarcoidosis patients are characterised by a good prognosis. They also reveal an accumulation in bronchoalveolar lavage fluid of T-lymphocytes expressing the T-cell receptor V gene segment AV2S3 at disease onset. The authors of this study wished to establish whether AV2S3 T-lymphocyte accumulation changes from disease onset to clinically resolved disease and how this relates to other activity parameters.

Bronchoalveolar lavage fluid and serum from nine DR17+ sarcoidosis patients were examined at disease onset and after spontaneous resolution of clinical and radiographical signs of disease.

Nine DR17+ patients with lung accumulated CD4+ AV2S3+ T-cells were investigated after clinically recovery. At re-examination the percentage of CD4+ AV2S3+ lymphocytes in bronchoalveolar lavage fluid was normalised (29 versus 5.4%). A significant reduction in lymphocyte percentage (14 versus 4.4%) and a decrease in cellular concentration (179x10⁶·L^–1 versus 111x10⁶·L^–1) and CD4/CD8 ratio (5.2 versus 2.4) were also seen. In serum, the activity of angiotensin-converting enzyme (24.9 versus 14.0 U·mL^–1) as well as the levels of neopterin (7.8 versus 5.3 nmol·L^–1) decreased significantly after recovery.

These results indicate that the locally accumulated AV2S3 positive T-lymphocytes in bronchoalveolar lavage are involved in the pathogenic process of sarcoidosis in this patient group.

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