Abstract
Persensitivity pneumonitis (HP) is an immunologically induced lung disease caused by inhalation of a variety of environmental agents. HP is not a uniform disease but rather a complex syndrome characterized by varying intensities of responsiveness to different antigens leading to an immunopathology with variable clinical presentation and natural history. we studied the association between serum TNF-alpha and CD4/CD8 ratio on chest computed tomography findings and steroid responsiveness in patients with HP
methods: The study included46 patients with chronic hypersensitivity pneumonitis, 22 (47.8%) male and 24 (52.8%) female. mean age 49±8 years. All patients underwent high resolution chest computed tomography, TNF-alpha ELIZA assay, and cd3, cd4, cd8, CD4/CD8 by flow cytometry .
Results: The TNF-alpha level was (mean±SD) 299±427 pg/ ml, CD4/CD8 ratio (84±36). With regard to steroid responsiveness ( 26) 57% patients were steroid responder while 20 (43%) were non-responder
TNF-alpha level was significantly lower in patients with predominant ground glass in their chest computed tomography (p= 0.014), however CD3, CD4, CD8, CD4/CD8 levels showed insignificant difference between patients with groud glass and those with fibrosis in their chest computed tomography.
Finally, TNF-alpha level was significantly lower in patients with good steroid response (p= 0.014), on the other hand CD4/CD8 ratio was significantly higher in those with good steroid response(P= 0.011).
Conclusion: Low TNF-alpha and high CD4/CD8 ratio could be used as a predictor of steroid responsiveness in CHP patients.
- Copyright ©the authors 2016