Lawrence E C, Brousseau K P, Berger M B, Kurman C C, Marcon L, Nelson D L
Rockwell-McKelvey Pulmonary Immunology Laboratory, Houston, Texas.
Am Rev Respir Dis. 1988 Apr;137(4):759-64. doi: 10.1164/ajrccm/137.4.759.
Sarcoidosis is a granulomatous disorder of unknown cause characterized by activation of T-lymphocytes. We here report the use of an enzyme-linked immunosorbent assay for the soluble interleukin-2 receptor (IL-2R) as a measure of T-cell activation in serum samples and bronchoalveolar lavage fluids in 15 patients with active sarcoidosis. The geometric mean (x divided by SEM) value for soluble IL-2R in serum samples from patients with sarcoidosis was 1,110 (x divided by 1.17) versus 224 (x divided by 1.08) U/ml for normal control subjects (p less than 0.001). Detectable levels of soluble IL-2R were present in bronchoalveolar lavage fluids from 10 of 15 patients with sarcoidosis versus only 2 of 36 normal control subjects (p less than 0.001). Levels of soluble IL-2R in serum samples from untreated patients with sarcoidosis correlated with 67gallium lung scanning scores (p less than 0.05) but not with serum angiotensin-converting enzyme concentrations or constituents of bronchoalveolar lavage. In 5 patients, the level of soluble IL-2R in serum samples fell from 1,499 (x divided by 1.20) to 476 (x divided by 1.58) U/ml (p less than 0.05) after 6 wk of successful treatment with corticosteroids, whereas the changes in soluble IL-2R in bronchoalveolar lavage fluids were more variable. These observations suggest that measurements of soluble IL-2R, particularly in serum samples, may reflect disease activity and be clinically useful in the management of patients with sarcoidosis.
结节病是一种病因不明的肉芽肿性疾病，其特征为T淋巴细胞激活。我们在此报告，在15例活动期结节病患者中，使用酶联免疫吸附测定法检测可溶性白细胞介素-2受体（IL-2R），以衡量血清样本和支气管肺泡灌洗液中的T细胞激活情况。结节病患者血清样本中可溶性IL-2R的几何均值（x除以SEM）为1110（x除以1.17）U/ml，而正常对照受试者为224（x除以1.08）U/ml（p<0.001）。15例结节病患者中有10例的支气管肺泡灌洗液中可检测到可溶性IL-2R，而36例正常对照受试者中只有2例可检测到（p<0.001）。未经治疗的结节病患者血清样本中可溶性IL-2R水平与镓-67肺扫描评分相关（p<0.05），但与血清血管紧张素转换酶浓度或支气管肺泡灌洗成分无关。5例患者经皮质类固醇成功治疗6周后，血清样本中可溶性IL-2R水平从1499（x除以1.20）降至476（x除以1.58）U/ml（p<0.05），而支气管肺泡灌洗液中可溶性IL-2R的变化则更具变异性。这些观察结果表明，可溶性IL-2R的检测，尤其是在血清样本中的检测，可能反映疾病活动情况，对结节病患者的管理具有临床实用价值。
