Planck A, Eklund A, Grunewald J
Dept of Respiratory Medicine, Karolinska Hospital, Stockholm, Sweden.
Eur Respir J. 2003 Jan;21(1):52-7. doi: 10.1183/09031936.03.00059103.
Scandinavian human leukocyte antigen-DR17-positive (DR17+) sarcoidosis patients are characterised by a good prognosis. They also reveal an accumulation in bronchoalveolar lavage fluid of T-lymphocytes expressing the T-cell receptor V gene segment AV2S3 at disease onset. The authors of this study wished to establish whether AV2S3 T-lymphocyte accumulation changes from disease onset to clinically resolved disease and how this relates to other activity parameters. Bronchoalveolar lavage fluid and serum from nine DR17+ sarcoidosis patients were examined at disease onset and after spontaneous resolution of clinical and radiographical signs of disease. Nine DR17+ patients with lung accumulated CD4+ AV2S3+ T-cells were investigated after clinically recovery. At re-examination the percentage of CD4+ AV2S3+ lymphocytes in bronchoalveolar lavage fluid was normalised (29 versus 5.4%). A significant reduction in lymphocyte percentage (14 versus 4.4%) and a decrease in cellular concentration (179x10(6) x L(-1) versus 111x10(6) x L(-1)) and CD4/CD8 ratio (5.2 versus 2.4) were also seen. In serum, the activity of angiotensin-converting enzyme (24.9 versus 14.0 U x mL(-1)) as well as the levels of neopterin (7.8 versus 5.3 nmol x L(-1)) decreased significantly after recovery. These results indicate that the locally accumulated AV2S3 positive T-lymphocytes in bronchoalveolar lavage are involved in the pathogenic process of sarcoidosis in this patient group.
斯堪的纳维亚人类白细胞抗原-DR17阳性（DR17+）结节病患者的特点是预后良好。他们还显示，在疾病发作时，表达T细胞受体V基因片段AV2S3的T淋巴细胞在支气管肺泡灌洗液中积聚。本研究的作者希望确定从疾病发作到临床治愈，AV2S3 T淋巴细胞的积聚是否发生变化，以及这与其他活动参数有何关系。在疾病发作时以及临床和影像学症状自发缓解后，对9名DR17+结节病患者的支气管肺泡灌洗液和血清进行了检查。对9名临床康复后肺部积聚CD4+ AV2S3+ T细胞的DR17+患者进行了调查。复查时，支气管肺泡灌洗液中CD4+ AV2S3+淋巴细胞的百分比恢复正常（29%对5.4%）。淋巴细胞百分比也显著降低（14%对4.4%），细胞浓度降低（179×10⁶×L⁻¹对111×10⁶×L⁻¹），CD4/CD8比值降低（5.2对2.4）。血清中，恢复后血管紧张素转换酶活性（24.9对14.0 U×mL⁻¹）以及新蝶呤水平（7.8对5.3 nmol×L⁻¹）显著降低。这些结果表明，支气管肺泡灌洗液中局部积聚的AV2S3阳性T淋巴细胞参与了该患者组结节病的致病过程。
