Tsiligianni Joanna, Tzanakis Nikolaos, Kyriakou Despina, Chrysofakis George, Siafakas Nikolaos, Bouros Demosthenes
Department Pneumonology, Medical School University of Crete and University Hospital, Heraklion, Greece.
Sarcoidosis Vasc Diffuse Lung Dis. 2002 Oct;19(3):205-10.
Induced sputum (IS) has been proposed as a useful non-invasive method mainly for the assessment of airway diseases. The aim of this study was to evaluate IS cellular composition and T-lymphocyte subpopulations and to compare them with those of bronchoalveolar lavage fluid (BALF) in patients with sarcoidosis.
We studied prospectively 20 patients (12 female, 8 male) of median age 46 yr (range 25-65) with sarcoidosis and 10 normal subjects (5 female, 5 male) of median age 39 yr (range 26-60). IS was performed with hypertonic saline solution using an ultrasonic nebulizer (De Vilbis 2000). BALF was performed by conventional procedure using fiberoptic bronchoscopy. May-Giemsa-Grunewald stained preps were differentially counted and T-lymphocyte subsets were analyzed by flow activated cell sorter (FACS).
The percentage of macrophages was significantly lower in IS than in BALF (p < 0.0001), the percentage of neutrophils was significantly lower in BALF than in IS (p < 0.0001), while there was no difference in the percentage of lymphocytes (p = 0.693) and eosinophils (p = 0.25) in IS vs BALF in patients with sarcoidosis. A significant correlation was found between BALF and IS lymphocyte counts (r = 0.61, p = 0.004), macrophages (r = 0.51, p = 0.02), and CD4+/CD8+ ratio (r = 0.700, p = 0.001).
These results suggest that the inflammation in sarcoidosis could be effectively and non-invasively determined by the analysis of cell differential counts and T-lymphocyte subsets in IS. Further studies are needed to explore the role of IS vs BALF in the follow-up of these patients.
诱导痰（IS）已被提议作为一种主要用于评估气道疾病的有用的非侵入性方法。本研究的目的是评估结节病患者诱导痰的细胞组成和T淋巴细胞亚群，并将其与支气管肺泡灌洗（BALF）的细胞组成和T淋巴细胞亚群进行比较。
我们前瞻性地研究了20例结节病患者（12例女性，8例男性），中位年龄46岁（范围25 - 65岁），以及10名正常受试者（5例女性，5例男性），中位年龄39岁（范围26 - 60岁）。使用超声雾化器（德维比斯2000）用高渗盐溶液进行诱导痰操作。通过常规纤维支气管镜检查方法进行支气管肺泡灌洗。对May - Giemsa - Grunewald染色涂片进行分类计数，并通过流式细胞分选仪（FACS）分析T淋巴细胞亚群。
诱导痰中巨噬细胞的百分比显著低于支气管肺泡灌洗（p < 0.0001），支气管肺泡灌洗中中性粒细胞的百分比显著低于诱导痰（p < 0.0001），而结节病患者诱导痰与支气管肺泡灌洗中淋巴细胞百分比（p = 0.693）和嗜酸性粒细胞百分比（p = 0.25）无差异。在支气管肺泡灌洗和诱导痰的淋巴细胞计数（r = 0.61，p = 0.004）、巨噬细胞（r = 0.51，p = 0.02）以及CD4+/CD8+比值（r = 0.700，p = 0.001）之间发现显著相关性。
这些结果表明，通过分析诱导痰中的细胞分类计数和T淋巴细胞亚群，可以有效且非侵入性地确定结节病中的炎症情况。需要进一步研究以探讨诱导痰与支气管肺泡灌洗在这些患者随访中的作用。
