Abstract
The diagnosis of lung sarcoidosis relies in part on the observation of alveolar CD4+ cells and the demonstration of an increased CD4/CD8 ratio. This ratio has been proposed as a diagnostic tool for pulmonary sarcoidosis. But this anomaly is also found in other lung diseases too. The search for other pathognomonic criteria allowing the discrimination of sarcoidosis patients (pts.) from patients with CD4+ alveolar lymphocytosis has been disappointing.
We investigated CD103 molecules on the T lymphocytes subpopulations. The expression of these molecules was examined on BAL lymphocytes from sarcoid patients with different radiologycal stages (Ist. – 23 pts; II – 16 pts: III – 9 pts.) and Lefgren's sindrome (25 pts) and patients with other lung disemination (17 pts.). For all patients, the expression of CD3, CD4, CD8 and CD103 was assessed by flow cytometry.
We found that CD4+/CD8+ ratio in I stage was 6,5±4,1; II st. – 4,5±2,3, III st. – 4,1±3,3, Lefgren's sindrome – 8,6±4,9 and other lung disemination – 1,9±1,7. CD4+CD103+/CD4+ ratio in I st. – 0,2±0,1; 0,2±0,1; 0,2±0,1; 0,1±0,1 and 0,4±0,2 respectively. CD4+CD103+/CD4+ ratio differ significally (p< 0,05) in all stages of sarcoidosis compared with other lung disemination while CD4+/CD8+ not.
Our findings demonstrate that the combined use of CD4+/CD8+ and CD4+CD103+/CD4+ ratios provides a highly sensitive indicator of lung sarcoidosis in patients with other CD4+ BAL lymphocytosis.
- © 2011 ERS
