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Reduced Th1 response in the lungs of HLA-DRB1*0301 patients with pulmonary sarcoidosis

¹ Dept of Medicine, Division of Respiratory Medicine, ³ Immune and Gene Therapy Laboratory, Cancer Center Karolinska, ² Dept of Oncology and Pathology, Karolinska University Hospital, Stockholm, Sweden.

CORRESPONDENCE: F. Idali, Dept of Medicine, Division of Respiratory Medicine, Lung Research Laboratory, L4:01, Karolinska University Hospital, Solna, 171 76 Stockholm, Sweden. Fax: 46 851775451. E-mail: Farah.Idali{at}medks.ki.se

Keywords: Bronchoalveolar lavage, cytokine, interferon-, tumour necrosis factor-, sarcoidosis

Received: June 8, 2005
Accepted November 22, 2005

To investigate why human leukocyte-associated antigen-DRB1*0301 (HLA-DRB1*0301) positive Scandinavian patients have a better prognosis than HLA-DRB1*0301 negative patients, the present authors examined patterns of cytokine expression in bronchoalveolar lavage (BAL) cells and BAL fluid (BALF) from patients with pulmonary sarcoidosis and controls.

Using real-time PCR, the mRNA expression of selected cytokines in BAL cells from newly diagnosed, untreated nonsmoking patients (n = 25) and controls (n = 11) was quantified. Cytokine protein levels in BALF from patients (n = 34) and controls (n = 11) were assessed using cytometric bead array. The patients were evaluated and stratified into two subgroups: HLA-DRB1*0301 positive (all with an acute onset) and HLA-DRB1*0301 negative (all with an insidious onset).

When comparing patients and controls, BAL cells of the patients expressed significantly higher levels of interferon (IFN)- and interleukin (IL)-10 mRNA. There were significantly decreased IFN- and tumour necrosis factor (TNF)- mRNA levels, and a tendency toward higher levels of transforming growth factor-ß1 mRNA in HLA-DRB1*0301 positive compared with HLA-DRB1*0301 negative patients. Protein levels of IL-1ß, IL-2, IL-6, IL-12p70 and TNF- in BALF were significantly higher in patients. HLA-DRB1*0301 positive patients exhibited tendencies to lower levels of most cytokines in BALF.

In conclusion, the present data show a reduced expression of T-helper cell type-1 cytokines in human leukocyte-associated antigen-DRB1*0301 positive patients, which may relate to their good prognosis.

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