Wurm K, Löhr G
Sarcoidosis. 1986 Mar;3(1):52-9.
Monocytosis, occurring in the majority of sarcoidosis cases in the bloodstream, and an increased number of natural killer cells are a manifestation of an increased cellular defence by bone marrow cells. The antigen-offering function of natural killer cells, macrophages and monocytes, should be specially emphasized. While the majority of sarcoidosis patients show an absolute lymphocyte count of less than 1500 cells/microliter during the usual clinical blood tests, the determination of lymphocyte subpopulations by means of monoclonal antibodies displayed a different behaviour of the lymphocyte subpopulations, especially a substantial reduction of T-cells, while B-lymphocytes were at normal levels. The assumption, that sarcoidosis immunology is characterized by an imbalanced homeostasis in the sense of a decrease in cellular and an increase in humoral immune defence, can no longer be maintained. We are rather dealing with an increased immunological activity of the cellular and humoral immune defence. In addition, the investigation of the lymphocyte subpopulations in the blood allows a judgement on the existing activity of the disease. The statement of a helper-suppressor ratio of less than 2.0 suggests progress of disease and indicates therefore drug therapy. Our immunological findings also explain the difference of the prognosis, which is more favourable for women than for men.
单核细胞增多症在大多数结节病病例的血液中出现，自然杀伤细胞数量增加是骨髓细胞增强细胞防御的一种表现。应特别强调自然杀伤细胞、巨噬细胞和单核细胞的抗原呈递功能。虽然大多数结节病患者在常规临床血液检查中淋巴细胞绝对计数低于1500个/微升，但通过单克隆抗体对淋巴细胞亚群的测定显示淋巴细胞亚群表现不同，尤其是T细胞大量减少，而B淋巴细胞水平正常。认为结节病免疫学特征是细胞免疫防御降低和体液免疫防御增加意义上的内稳态失衡这一假设，已不再成立。我们面对的实际上是细胞免疫和体液免疫防御的免疫活性增强。此外，对血液中淋巴细胞亚群的研究有助于判断疾病的现有活动情况。辅助性T细胞与抑制性T细胞比例小于2.0表明疾病进展，因此提示需要药物治疗。我们的免疫学发现也解释了预后差异，即女性预后比男性更有利。
