The mean values ± SEM of the immunologic marker analysis of the cells in BAL fluid and peripheral blood (PB) samples of the groups studied are summarized in Table 2. In general, the cellular components of BAL fluid samples obtained from all patient groups differed significantly from those obtained from control subjects. The mean percentages of CD4+ and CD8+ T lymphocytes and the CD4/CD8 ratio in BAL fluid samples showed statistically significant differences in the NSm sarcoidosis patients (Fig 1, Table 2). No significant difference could be demonstrated between the three categories of Sm patients, except the mean percentage of CD3+ T lymphocytes in the BAL fluid samples, which appeared to be the highest in patients with erythema nodosum and/or arthralgia, ie, Lofgrens syndrome (Table 2). No В lymphocytes or plasma cells were demonstrated in the BAL fluid samples from the sarcoidosis patient groups or from the control subjects. Obstructive sleep apnea
In BAL fluid samples of all categories of sarcoidosis patients, the total cell count was significantly increased compared with that of the control subjects (p<0.04). The absolute and relative numbers of lymphocytes were increased, as well as the percentages of CD3+ and CD4+ T lymphocytes; in contrast, the percentage of CD8+ T lymphocytes was decreased most of all in patients with M. Lofgren (category C). The CD4/CD8 ratios in the BAL fluid samples were increased in all sarcoidosis patient categories, most prominent in both NSm and Sm patients with Lofgrens syndrome. The CD4/CD8 ratios in the PB samples showed no statistical differences, except in category A of the NSm patients, who demonstrated a decreased ratio compared with that of the control subjects.
Significant differences were demonstrated between Sm and NSm subjects of the studied categories. In general, total cell count and the number of alveolar macrophages were increased, while the percentages of lymphocytes were decreased in the Sm groups. In the sarcoidosis Sm groups studied, also a significant increase in the number of polymorphonuclear neutrophils and a decrease in the number of mast cells were found in BAL fluid samples (data not shown).
Smoker patients with respiratory or constitutional symptoms (ie, group B) showed a decreased percentage of CD3+ T lymphocytes in the PB samples (data not shown) and decreased CD4/CD8 ratios in BAL fluid and PB samples compared with NSm patients of category B. Smoker patients, presenting with Ldfgrens syndrome (ie, group C) showed an increased percentage of CD3+ lymphocytes and less increased CD4/ CD8 ratio in BAL fluid and lower CD4/CD8 ratio in PB samples in comparison with NSm patients. In general, most significant changes were demonstrated in the BAL fluid samples of patients with Lofgrens syndrome both in NSm and Sm patients compared with the other categories and control subjects (Fig 1, Table 2).
Figure 1. CD4/CD8 T lymphocyte ratio in BAL fluid samples in three different clinical presentations of sarcoidosis patients (A=no symptoms; В = respiratory and general constitutional symptoms; С = erythema nodosum and/or arthralgia and hilar lymphadenopathy [ie, Ldfgrens syndrome]; mean±SEM) and control subjects. The general effect of smoking is a reduction of the CD4/CD8 ratio.
Table 2—1bud Сей Count, Lymphocytes, T Lymphocyte Subpopulations and the CD4JCD8 Ratios in Bronchoalveolar Fluid Samples and Peripheral Blood Samples in Three Different Clinical Presentations of Sarcoidosis Patients and Control Subjects
|Croups||Total Cell Count X 10*||Lymphocytes||CD3,%||CD4,%||CD8,%||CD4/CD8 Ratio|
|Control subjects||11.7 (2.7)||1.0 (2.8)||10.8 (1.7)||75.8 (2.3)||49.5 (3.5)||29.6 (4.8)||2.1 (0.3)||2.3 (0.5)|
|A||19.2 (3.5)||4.7 (1.1)||||31.3 (5.1)t|||83.5 (2.4)||||60.9 (4.7)$||19.9 (3.5)$||4.7 (1.1)$||1.3 (0.2)$|
|В||20.8 (1.8)§||7.7 (0.9)||||38.1 (2.6)||||88.3 (1.0)||||69.5 (2.2)||||17.9 (2.0)||||8.0 (1.2)||||2.4 (0.4)|
|С||23.5 (3.2)$||8.7 (1.4)||||40.2 (4.5)||||88.8 (2.1)||||80.3 (2.7)||1||8.9 (0.8)||1||10.7 (1.5)||1||2.6 (0.4)|
|Control subjects||33.3 (12.7)||8.9 (3.5)||4.2 (2.1)||82.3 (5.4)||45.7 (7.2)||40.7 (7.3)||1.3 (0.5)||1.4 (0.6)|
|A||31.0 (5.5)||6.1 (1.4)$||21.3 (3.6)||||89.1 (2.6)8||69.4 (6.8)||||19.4 (5.6)||||5.6 (1.6)$||2.1 (0.5)|
|В||43.9 (14.9)$||10.8 (4.1)||27.1 (6.4)||||86.1 (3.4)||66.2 (6.4)$||22.0 (6.8)||||5.6 (1.2)||||1.7 (0.3)|
|С||31.2 (7.0)||4.7 (1.8)5||18.7 (5.9)||||95.3 (1.2)||1||81.0 (4.0)||1||12.5 (2.8)||1||8.3 (1.8)||1||1.8 (0.5)|