Danila Edvardas, Aleksonienė Regina, Besusparis Justinas, Gruslys Vygantas, Jurgauskienė Laimutė, Laurinavičienė Aida, Laurinavičius Arvydas, Mainelis Antanas, Zablockis Rolandas, Zeleckienė Ingrida, Žurauskas Edvardas, Malickaitė Radvilė
Clinic of Chest Diseases, Immunology and Allergology, Faculty of Medicine, Vilnius University, 03101 Vilnius, Lithuania.
Center of Pulmonology and Allergology, Vilnius University Hospital Santaros Klinikos, 08661 Vilnius, Lithuania.
Biomedicines. 2023 May 13;11(5):1437. doi: 10.3390/biomedicines11051437.
The search for biological markers, which allow a relatively accurate assessment of the individual course of pulmonary sarcoidosis at the time of diagnosis, remains one of the research priorities in this field of pulmonary medicine. The aim of our study was to investigate possible prognostic factors for pulmonary sarcoidosis with a special focus on cellular immune inflammation markers. A 2-year follow-up of the study population after the initial prospective and simultaneous analysis of lymphocyte activation markers expression in the blood, as well as bronchoalveolar lavage fluid (BALF) and lung biopsy tissue of patients with newly diagnosed pulmonary sarcoidosis, was performed. We found that some blood and BAL fluid immunological markers and lung computed tomography (CT) patterns have been associated with a different course of sarcoidosis. We revealed five markers that had a significant negative association with the course of sarcoidosis (worsening pulmonary function tests and/or the chest CT changes)-blood CD4+CD31+ and CD4+CD44+ T lymphocytes, BALF CD8+CD31+ and CD8+CD103+ T lymphocytes and a number of lung nodules on chest CT at the time of the diagnosis. Cut-off values, sensitivity, specificity and odds ratio for predictors of sarcoidosis progression were calculated. These markers may be reasonable predictors of sarcoidosis progression.
寻找能够在诊断时对肺结节病个体病程进行相对准确评估的生物标志物，仍然是肺部医学领域的研究重点之一。我们研究的目的是调查肺结节病可能的预后因素，特别关注细胞免疫炎症标志物。在对新诊断的肺结节病患者的血液、支气管肺泡灌洗液（BALF）和肺活检组织中的淋巴细胞活化标志物表达进行初步前瞻性同步分析后，对研究人群进行了为期2年的随访。我们发现一些血液和BALF免疫标志物以及肺部计算机断层扫描（CT）模式与结节病的不同病程相关。我们发现了五个与结节病病程（肺功能测试恶化和/或胸部CT改变）有显著负相关的标志物——血液中的CD4+CD31+和CD4+CD44+ T淋巴细胞、BALF中的CD8+CD31+和CD8+CD103+ T淋巴细胞以及诊断时胸部CT上的肺结节数量。计算了结节病进展预测指标的截断值、敏感性、特异性和比值比。这些标志物可能是结节病进展的合理预测指标。
