Highlights
- •LP in mediastinal and hilar lymph nodes involved in stage 2 sarcoidosis.
- •The LP in LNPF, BALF and PB were significantly different.
- •The main index correlated with respiratory symptoms was CD4/CD8 ratio in BALF.
- •The authors declare there is no conflict of interest existed in this study.
Abstract
Objective
To evaluate the lymphocyte profile (LP) in lymph node puncture fluid (LNPF) of mediastinal
and hilar lymph nodes, bronchoalveolar lavage fluid (BALF), and peripheral blood (PB)
involved in stage 2 sarcoidosis.
Methods
After selection, 31 patients diagnosed with stage II sarcoidosis were finally included.
Patients were further divided into symptomatic (n = 17) and asymptomatic (n = 14)
groups according to the presence or absence of respiratory symptoms. The LP in lymph
node puncture fluid (LNPF), bronchoalveolar lavage fluid (BALF), and peripheral blood
(PB) were evaluated and compared using flow cytometry. The relationship between respiratory
symptoms and LP was preliminarily analyzed.
Results
The proportions of T cells and CD4 T cells, and CD4/CD8 ratio in BALF were significantly
higher than that of LNPF with PB (all P < 0.05). The proportions of lymphocyte cells,
CD8 T cells, NK cells, and CD4/CD8 ratio in LNPF and PB were significantly different
(all P < 0.05). There were significant differences in CD4 T cells [72.40 (68.90,75.55)
vs.46.30 (38.55,52.50), P = 0.004], CD8 T cells (9.9 ± 3.9 vs. 16.8 ± 6.8, P = 0.002),
and CD4/CD8 ratio (7.9 ± 2.8 vs. 3.9 ± 1.5, P < 0.001) in BALF between the symptomatic
group and asymptomatic group (all P < 0.05). The T cells (rs = 0.447, P = 0.011),
CD4 (rs = 0.572, P = 0.002), and CD4/CD8 ratio (rs = 0.701, P < 0.001) in BALF were
positively correlated with respiratory symptoms.
Conclusion
The LP in LNPF, BALF and PB were significantly different and the main index correlated
with respiratory symptoms was CD4/CD8 ratio in BALF. The difference of LP in BALF
and LNPF may help to deeply understand the pathophysiological process and may reflect
the different degree of lung and lymph node lesion.
Keywords
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References
- Sarcoidosis: a clinical overview from symptoms to diagnosis.Cells. 2021; 10https://doi.org/10.3390/cells10040766
- Predictors of mortality in pulmonary sarcoidosis.Chest. 2018; 153: 105-113https://doi.org/10.1016/j.chest.2017.07.008
- Diagnosis and detection of sarcoidosis. An official American thoracic society clinical practice guideline.Am. J. Respir. Crit. Care Med. 2020; 201: e26-e51https://doi.org/10.1164/rccm.202002-0251ST
- Transbronchial needle aspiration in sarcoidosis: yield and predictors of a positive aspirate.J. Thorac. Cardiovasc. Surg. 2008; 135: 837-842https://doi.org/10.1016/j.jtcvs.2007.11.011
- Convex-probe endobronchial ultrasound: a decade of progress.Indian J. Chest Dis. Allied Sci. 2016; 58: 21-35
- Bronchoalveolar lavage in sarcoidosis.Semin. Respir. Crit. Care Med. 2007; 28: 486-495https://doi.org/10.1055/s-2007-991521
- Statement on sarcoidosis. Joint statement of the American thoracic society (ATS), the European respiratory society (ERS) and the world association of sarcoidosis and other granulomatous disorders (WASOG) adopted by the ATS board of directors and by the ERS executive committee, february 1999.Am. J. Respir. Crit. Care Med. 1999; 160: 736-755https://doi.org/10.1164/ajrccm.160.2.ats4-99
- Flow cytometric analysis of lymphocyte profiles in mediastinal lymphadenopathy of sarcoidosis.PLoS One. 2018; 13e0206972https://doi.org/10.1371/journal.pone.0206972
- CD4/CD8 ratio in mediastinal lymph nodes involved by sarcoidosis: analysis of flow cytometry data obtained by endobronchial ultrasound-guided transbronchial needle aspiration.J Bronchology Interv Pulmonol. 2016; 23: 288-297https://doi.org/10.1097/lbr.0000000000000311
- The CD4/CD8 ratio in BAL fluid is highly variable in sarcoidosis.Eur. Respir. J. 1997; 10: 2716-2721https://doi.org/10.1183/09031936.97.10122716
- Enhanced CD8(+) cytolytic T cell responses in the peripheral circulation of patients with sarcoidosis and non-Löfgren's disease.Respir. Med. 2018; 138s: S38-s44https://doi.org/10.1016/j.rmed.2017.10.006
- Biomarkers in sarcoidosis.Expet Rev. Clin. Immunol. 2016; 12: 1191-1208https://doi.org/10.1080/1744666x.2016.1196135
- Bronchoalveolar lavage fluid characteristics of patients with sarcoidosis and nonsarcoidosis interstitial lung diseases: ten-year experience of a single center in Turkey.Iran. Red Crescent Med. J. 2015; 17e31103https://doi.org/10.5812/ircmj.31103
- Value of s-ACE, BAL lymphocytosis, and CD4+/CD8+ and CD103+CD4+/CD4+ T-cell ratios in diagnosis of sarcoidosis.Eur. Respir. J. 2012; 39: 1037-1039https://doi.org/10.1183/09031936.00144311
- T-cell phenotypes in bronchoalveolar lavage fluid, blood and lymph nodes in pulmonary sarcoidosis--indication for an airborne antigen as the triggering factor in sarcoidosis.J. Intern. Med. 2012; 272: 465-471https://doi.org/10.1111/j.1365-2796.2012.02543.x
- Multidisciplinary approach and long-term follow-up in a series of 640 consecutive patients with sarcoidosis: cohort study of a 40-year clinical experience at a tertiary referral center in Barcelona, Spain.Medicine (Baltim.). 2017; 96e7595https://doi.org/10.1097/md.0000000000007595
- Predictors of objective cough frequency in pulmonary sarcoidosis.Eur. Respir. J. 2016; 47: 1461-1471https://doi.org/10.1183/13993003.01369-2015
- BAL fluid cells in newly diagnosed pulmonary sarcoidosis with different clinical activity.Ups. J. Med. Sci. 2009; 114: 26-31https://doi.org/10.1080/03009730802579729
- Relationship between presentation of sarcoidosis and T lymphocyte profile. A study in bronchoalveolar lavage fluid.Chest. 1993; 104: 795-800https://doi.org/10.1378/chest.104.3.795
- Study of immune complexes in bronchoalveolar lavage fluids.Respiration. 1988; 54: 36-41https://doi.org/10.1159/000195495
- Rituximab in the treatment of refractory pulmonary sarcoidosis.Eur. Respir. J. 2014; 43: 1525-1528https://doi.org/10.1183/09031936.00224513
- Imbalance in B cell and T Follicular helper cell subsets in pulmonary sarcoidosis.Sci. Rep. 2020; 10: 1059https://doi.org/10.1038/s41598-020-57741-0
- Rituximab in refractory sarcoidosis: a single centre experience.Clin. Mol. Allergy. 2015; 13: 19https://doi.org/10.1186/s12948-015-0025-9
- NK and NKT-like cells in granulomatous and fibrotic lung diseases.Clin. Exp. Med. 2019; 19: 487-494https://doi.org/10.1007/s10238-019-00578-3
- NK and NKT cells in the diagnosis of diffuse lung diseases presenting with a lymphocytic alveolitis.BMC Pulm. Med. 2019; 19: 39https://doi.org/10.1186/s12890-019-0802-1
- Mouse hypersensitivity pneumonitis: depletion of NK cells abrogates the spontaneous regression phase and leads to massive fibrosis.Exp. Lung Res. 1992; 18: 761-773https://doi.org/10.3109/01902149209031706
- Prognostic value of neutrophils and NK cells in bronchoalveolar lavage of sarcoidosis.Cytometry B Clin Cytom. 2006; 70: 416-422https://doi.org/10.1002/cyto.b.20120
- Impaired IFN-gamma production of Valpha24 NKT cells in non-remitting sarcoidosis.Int. Immunol. 2004; 16: 215-222https://doi.org/10.1093/intimm/dxh020
- Comparison of the T cell patterns in leprous and cutaneous sarcoid granulomas. Presence of Valpha24-invariant natural killer T cells in T-cell-reactive leprosy together with a highly biased T cell receptor Valpha repertoire.Am. J. Pathol. 2000; 157: 509-523https://doi.org/10.1016/s0002-9440(10)64562-2
- Deficiency of a subset of T-cells with immunoregulatory properties in sarcoidosis.Lancet. 2005; 365: 1062-1072https://doi.org/10.1016/s0140-6736(05)71143-0
Article info
Publication history
Published online: November 08, 2022
Accepted:
November 3,
2022
Received in revised form:
October 30,
2022
Received:
September 5,
2022
Identification
Copyright
© 2022 Elsevier Ltd. All rights reserved.
