BMC pulmonary medicine · 2025
CD4/CD8 T-cell ratio in bronchoalveolar lavage fluid as a marker of sarcoidosis severity: a retrospective study.
СтатьяНаблюдательное исследованиеНазвание и аннотация: Перевод в очереди
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Zannese Thibaut, Viallard Jean-François, Sridi-Cheniti Soumaya, Prot-Leurent Camille, Dupuy Henry, Léonard Cédric, Duffau Pierre, Lazaro Estibaliz, Greib Carine, Rivière Etienne
Аннотация
BACKGROUND: Sarcoidosis is a complex multisystemic disease with a wide range of clinical manifestations. Its severity and evolution are highly variable and the prognostic utility of paraclinical markers is debated. We analysed the utility of the CD4/CD8 T-cell ratio (R) in bronchoalveolar lavage (BAL) fluid as a marker of sarcoidosis severity.
METHODS: We conducted an observational, retrospective, monocentric study involving patients with systemic sarcoidosis who underwent BAL for diagnostic purposes between June 2010 and April 2020.
RESULTS: Among 62 patients, half had a CD4/CD8 T-cell ratio (R) value ≥ 3.5. Patients with R < 3.5 had more extrapulmonary manifestations, mainly abdominal (32.3% vs. 6.5%, p = 0.01) and tended to have a higher frequency of cardiac/central nervous system involvement (19.4% vs. 6.5%, p = 0.25). They also had more frequent interstitial lung involvement (80.6% vs. 67.7%, p = 0.2) and tended to have more severe respiratory impairment. The activation (p = 0.01) of CD8 + T cells in peripheral blood was significantly higher in patients with R < 3.5. By contrast, patients with R ≥ 3.5 tended to have more frequent musculoskeletal-cutaneous involvement (48.4% vs. 32.3%, p = 0.2). Treatment was initiated more frequently in patients with R < 3.5 (71% vs. 35.5%, p = 0.01), who also more frequently required immunosuppressive agents (54.5% vs. 36.4%, p = 0.02).
CONCLUSION: An R value < 3.5 in BAL fluid has potential as a marker of sarcoidosis severity. Patients with a low R value had a worse prognosis with more severe respiratory impairment and more frequent multisystemic and extra-pulmonary involvement, and more frequently required immunosuppressive agents.
METHODS: We conducted an observational, retrospective, monocentric study involving patients with systemic sarcoidosis who underwent BAL for diagnostic purposes between June 2010 and April 2020.
RESULTS: Among 62 patients, half had a CD4/CD8 T-cell ratio (R) value ≥ 3.5. Patients with R < 3.5 had more extrapulmonary manifestations, mainly abdominal (32.3% vs. 6.5%, p = 0.01) and tended to have a higher frequency of cardiac/central nervous system involvement (19.4% vs. 6.5%, p = 0.25). They also had more frequent interstitial lung involvement (80.6% vs. 67.7%, p = 0.2) and tended to have more severe respiratory impairment. The activation (p = 0.01) of CD8 + T cells in peripheral blood was significantly higher in patients with R < 3.5. By contrast, patients with R ≥ 3.5 tended to have more frequent musculoskeletal-cutaneous involvement (48.4% vs. 32.3%, p = 0.2). Treatment was initiated more frequently in patients with R < 3.5 (71% vs. 35.5%, p = 0.01), who also more frequently required immunosuppressive agents (54.5% vs. 36.4%, p = 0.02).
CONCLUSION: An R value < 3.5 in BAL fluid has potential as a marker of sarcoidosis severity. Patients with a low R value had a worse prognosis with more severe respiratory impairment and more frequent multisystemic and extra-pulmonary involvement, and more frequently required immunosuppressive agents.