Desrues B, Delaval P, Genetet N, Kernec J, Pencolé C, Merdrignac G, Cornillet B, Genetet B
Service de Pneumologie, Hôpital Pontchaillou, Centre Hospitalier Régional de Rennes, France.
Pathol Biol (Paris). 1987 Dec;35(10):1301-8.
Accumulation of inflammatory and immune cells within lung parenchyma would constitute the initial step in producing the alveolar structural abnormalities. It is usually assumed that alveolitis, as assessed by broncho-alveolar lavage (BAL), represents a biological assessment of lung disease activity. The aim of this study, using monoclonal antibodies, is to characterize the T lymphocytes alveolitis in the lung and in peripheral blood in 3 well-defined populations: 1 degree) control subjects (n = 7); 2 degrees) patients with biopsy proven mediastino-pulmonary sarcoidosis (sarc) (n = 73), classified according to their clinical activity as active, inactive, chronic, and treated; 3 degrees) patients with extrinsic alveolar alveolitis (EAA) (n = 19). For the same BAL volume, the % of CD4+ cells and the CD4/CD8 ratio are increased in chronic and active sarc, contrasting with an increase in the % of CD8+ cells and a decrease in the CD4/CD8 ratio in the EAA. In absolute values, there are 2 times as many CD4+ cells and 5 times as many CD8+ cells in EAA than in sarcoidosis. In sarcoidosis, corticotherapy tends to normalize the CD4/CD8 ratio although the intensity of the lymphocytic alveolitis is not affected. In the peripheral blood, lymphopenia is observed only in the active form of sarc. in the CD4+ population, without any significant change in the CD4/CD8 ratio compared to the other groups. The number and distributions of BAL. T lymphocytes subsets may constitute a biological indicator for diagnostic orientation, but they do not distinguish sufficiently between the different groups of sarcoidosis to be of any prognostic value.
肺实质内炎症和免疫细胞的积聚是导致肺泡结构异常的起始步骤。通常认为，通过支气管肺泡灌洗（BAL）评估的肺泡炎代表了肺部疾病活动的生物学评估。本研究旨在使用单克隆抗体对3组明确人群的肺和外周血中的T淋巴细胞肺泡炎进行特征分析：1组）对照受试者（n = 7）；2组）经活检证实的纵隔-肺结节病（结节病）患者（n = 73），根据临床活动情况分为活动期、非活动期、慢性期和已治疗组；3组）外源性肺泡炎（EAA）患者（n = 19）。对于相同的BAL体积，慢性和活动期结节病患者的CD4 +细胞百分比和CD4/CD8比值升高，而EAA患者的CD8 +细胞百分比升高且CD4/CD8比值降低。绝对值方面，EAA中的CD4 +细胞数量是结节病的2倍，CD8 +细胞数量是结节病中的5倍。在结节病中，皮质激素治疗倾向于使CD4/CD8比值正常化，尽管淋巴细胞性肺泡炎的强度未受影响。在外周血中，仅在活动期结节病患者中观察到淋巴细胞减少，CD4 +细胞群体中与其他组相比CD4/CD8比值无显著变化。BAL中T淋巴细胞亚群的数量和分布可能构成诊断方向的生物学指标，但它们在不同组的结节病之间区分不够充分，没有任何预后价值可言。
