Tsiligianni Ioanna, Antoniou Katerina M, Kyriakou Despina, Tzanakis Nikolaos, Chrysofakis George, Siafakas Nikolaos M, Bouros Demosthenes
Department of Pneumonology, University of Crete, Heraklion, Greece.
BMC Pulm Med. 2005 Jun 24;5:8. doi: 10.1186/1471-2466-5-8.
Sarcoidosis is thought to be a T-helper type 1 cytokine (Th2 cytokine) mediated disorder. Induced sputum (IS) has been proposed as a useful non-invasive method, mainly for the assessment of the airway diseases. The aim of this study was to explore induced sputum (IS) CD4+ Th1 T-lymphocyte subpopulation and to compare them with those of bronchoalveolar lavage fluid (BALF) in patients with sarcoidosis.
We studied prospectively 21 patients (12 female, 9 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. BALF was performed within 10 days of IS. After stimulation of sputum lymphocytes with phorbol-myristate-acetate, we used double immunocytochemical methods to identify CD4+ IFN-gamma positive and IL-4 positive cells (Th1 and Th2, respectively).
Sarcoidosis patients had an increased number of CD4+ -IFN-gamma producing cells in IS (p = 0.003) and BALF (p = 0.01) in comparison with normal subjects. No significant differences were detected between CD4+ -IL-4 cells in BALF (p = 0.053, NS) and IS (p = 0.46, NS) between sarcoidosis patients and healthy controls. The ratio of Th1 to Th2 cells in BALF and IS was statistically different in sarcoidosis when compared with normal subjects (p = 0.007 in BALF and IS). A significant correlation was found between CD4+ IFN-gamma positive cells in IS and those in BALF in sarcoidosis patients (r = 0.685, p = 0.0006).
These data suggests that a Th1-like cytokine pattern can be observed in CD4+ T-lymphocytes in IS in patients with pulmonary sarcoidosis. Further studies are needed to explore the value of IS vs BALF in the follow-up of these patients.
结节病被认为是一种由1型辅助性T细胞（Th1细胞）细胞因子介导的疾病。诱导痰（IS）已被提议作为一种有用的非侵入性方法，主要用于评估气道疾病。本研究的目的是探索结节病患者诱导痰中的CD4 + Th1 T淋巴细胞亚群，并将其与支气管肺泡灌洗液（BALF）中的进行比较。
我们前瞻性地研究了21例结节病患者（12例女性，9例男性），年龄中位数为46岁（范围25 - 65岁），以及10名正常受试者（5例女性，5例男性），年龄中位数为39岁（范围26 - 60岁）。使用超声雾化器用高渗盐溶液进行诱导痰操作。在诱导痰后10天内进行支气管肺泡灌洗。在用佛波酯 - 肉豆蔻酸酯 - 乙酸盐刺激痰液淋巴细胞后，我们使用双重免疫细胞化学方法鉴定CD4 + IFN - γ阳性细胞和IL - 4阳性细胞（分别为Th1和Th2）。
与正常受试者相比，结节病患者诱导痰（p = 0.003）和支气管肺泡灌洗液（p = 0.01）中产生CD4 + -IFN - γ的细胞数量增加。结节病患者与健康对照之间，支气管肺泡灌洗液（p = 0.053，无统计学意义）和诱导痰（p = 0.46，无统计学意义）中CD4 + -IL - 4细胞之间未检测到显著差异。与正常受试者相比，结节病患者支气管肺泡灌洗液和诱导痰中Th1与Th2细胞的比例在统计学上有差异（支气管肺泡灌洗液和诱导痰中p = 0.007）。在结节病患者中，诱导痰中CD4 + IFN - γ阳性细胞与支气管肺泡灌洗液中的阳性细胞之间存在显著相关性（r = 0.685，p = 0.0006）。
这些数据表明，在肺部结节病患者的诱导痰中，CD4 + T淋巴细胞中可观察到类似Th1的细胞因子模式。需要进一步研究以探索诱导痰与支气管肺泡灌洗液在这些患者随访中的价值。
