Iida K, Kadota J, Kawakami K, Matsubara Y, Shirai R, Kohno S
Second Department of Internal Medicine, Nagasaki University School of Medicine, Japan.
Thorax. 1997 May;52(5):431-7. doi: 10.1136/thx.52.5.431.
Sarcoidosis is a systemic granulomatous disorder of unknown origin characterised by accumulation of T lymphocytes and macrophages in multiple organs. Several cytokines and adhesion molecules may contribute to the accumulation of T lymphocytes in pulmonary sarcoidosis. The distribution of T lymphocyte subsets, T cell bearing CD11a and beta chemokines such as regulated on activation normal T expressed and secreted (RANTES), macrophage inflammatory peptide 1 alpha (MIP-1 alpha), and macrophage chemoattractant protein 1 (MCP-1) in bronchoalveolar lavage (BAL) fluid and peripheral blood were compared in untreated patients with sarcoidosis and normal subjects.
Flow cytometric analysis with monoclonal antibodies to cell surface antigens was used to identify T lymphocyte subsets in the BAL fluid of untreated patients with sarcoidosis (n = 40)--either without (group A, n = 12) or with (group B, n = 28) radiological evidence of pulmonary involvement--and in 22 normal subjects. The level of different beta chemokines was estimated by enzyme linked immunosorbent assay (ELISA).
A high percentage of CD3+ cells, CD4+ cells expressing HLA-DR antigen, and a high CD4/CD8 ratio were detected in the BAL fluid of patients compared with normal subjects. In particular, CD4+ CD29+ memory T cells were significantly increased in patients with sarcoidosis. Furthermore, these cells were higher in those in group B than group A. The level of RANTES in the BAL fluid of patients was significantly higher than in normal subjects and correlated well with the percentage, number, and expression of CD29 on CD4 cells. The expression of CD11a (alpha chain of lymphocyte function associated antigen-1, LFA-1) on CD3+ cells in the BAL fluid of patients with sarcoidosis was not different from that of normal subjects. However, the expression of CD11a on CD3+ cells in the BAL fluid of patients in group A was significantly lower than that of patients in group B and normal subjects.
These results suggest a possible interaction between activated memory T cells bearing CD11a and RANTES which may contribute to the pulmonary involvement in patients with sarcoidosis.
结节病是一种病因不明的系统性肉芽肿性疾病，其特征为多个器官中T淋巴细胞和巨噬细胞的积聚。多种细胞因子和黏附分子可能导致肺结节病中T淋巴细胞的积聚。对未经治疗的结节病患者和正常受试者支气管肺泡灌洗（BAL）液及外周血中T淋巴细胞亚群、表达CD11a的T细胞以及β趋化因子（如调节激活正常T细胞表达和分泌因子（RANTES）、巨噬细胞炎性蛋白1α（MIP-1α）和巨噬细胞趋化蛋白1（MCP-1））的分布进行了比较。
使用针对细胞表面抗原的单克隆抗体进行流式细胞术分析，以鉴定未经治疗的结节病患者（n = 40）——无（A组，n = 12）或有（B组，n = 28）肺部受累放射学证据——以及22名正常受试者BAL液中的T淋巴细胞亚群。通过酶联免疫吸附测定（ELISA）估计不同β趋化因子的水平。
与正常受试者相比，在患者的BAL液中检测到高百分比的CD3 +细胞、表达HLA-DR抗原的CD4 +细胞以及高CD4/CD8比值。特别是，结节病患者中CD4 + CD29 +记忆T细胞显著增加。此外，这些细胞在B组患者中高于A组。患者BAL液中RANTES水平显著高于正常受试者，且与CD4细胞上CD29的百分比、数量和表达密切相关。结节病患者BAL液中CD3 +细胞上CD11a（淋巴细胞功能相关抗原-1（LFA-1）的α链）的表达与正常受试者无差异。然而，A组患者BAL液中CD3 +细胞上CD11a的表达显著低于B组患者和正常受试者。
这些结果表明表达CD11a的活化记忆T细胞与RANTES之间可能存在相互作用，这可能导致结节病患者的肺部受累。
