Bronchoalveolar lavage fluid cell subsets associate with the disease course in Löfgren's and non-Löfgren's sarcoidosis patients.


Journal

Respiratory medicine
ISSN: 1532-3064
Titre abrégé: Respir Med
Pays: England
ID NLM: 8908438

Informations de publication

Date de publication:
09 2021
Historique:
pubmed: 2 7 2021
medline: 8 2 2022
entrez: 1 7 2021
Statut: ppublish

Résumé

Sarcoidosis is a multisystem granulomatous inflammatory disorder, that predominantly involves the lungs. Patients with Löfgren's syndrome (LS) are characterized by acute onset and usually have the HLA-DRB1*03 (DR3 We retrospectively included data from 955 non-LS patients, 477 LS patients, and 295 healthy controls (HC) in this study. Intra-group comparison of patients with resolving versus chronic disease was performed in LS and non-LS, respectively. Non-LS patients were divided into two subgroups according to the binary BALF cell concentrations for intra-group comparison (i.e. higher or lower than the 95th percentile of the BALF cells references in healthy individuals). LS patients with a non-resolving disease course had higher BALF lymphocytes, neutrophils, and eosinophils than LS with a favourable outcome. In non-LS subjects increased BALF of the same cells and in addition also of basophils and mast cells were more likely associated with more severe disease course. Increased BALF cells display prognostic significance in sarcoidosis. Certain BALF profiles should promote the clinician to monitor these patients more closely as they may associate non-resolving disease, in turn, resulting in future irreversible functional impairment.

Sections du résumé

BACKGROUND
Sarcoidosis is a multisystem granulomatous inflammatory disorder, that predominantly involves the lungs. Patients with Löfgren's syndrome (LS) are characterized by acute onset and usually have the HLA-DRB1*03 (DR3
METHODS
We retrospectively included data from 955 non-LS patients, 477 LS patients, and 295 healthy controls (HC) in this study. Intra-group comparison of patients with resolving versus chronic disease was performed in LS and non-LS, respectively. Non-LS patients were divided into two subgroups according to the binary BALF cell concentrations for intra-group comparison (i.e. higher or lower than the 95th percentile of the BALF cells references in healthy individuals).
RESULTS
LS patients with a non-resolving disease course had higher BALF lymphocytes, neutrophils, and eosinophils than LS with a favourable outcome. In non-LS subjects increased BALF of the same cells and in addition also of basophils and mast cells were more likely associated with more severe disease course.
CONCLUSION
Increased BALF cells display prognostic significance in sarcoidosis. Certain BALF profiles should promote the clinician to monitor these patients more closely as they may associate non-resolving disease, in turn, resulting in future irreversible functional impairment.

Identifiants

pubmed: 34198166
pii: S0954-6111(21)00227-4
doi: 10.1016/j.rmed.2021.106521
pii:
doi:

Substances chimiques

Biomarkers 0

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

106521

Informations de copyright

Copyright © 2021. Published by Elsevier Ltd.

Auteurs

Muntasir Abo Al Hayja (M)

Respiratory Medicine Division, Department of Medicine, Solna, Karolinska Institutet, SE-171 76, Stockholm, Sweden. Electronic address: muntasir.abo.al.hayja.69@gmail.com.

Jan Wahlström (J)

Respiratory Medicine Division, Department of Medicine, Solna, Karolinska Institutet, SE-171 76, Stockholm, Sweden.

Susanna Kullberg (S)

Respiratory Medicine Division, Department of Medicine, Solna, Karolinska Institutet, SE-171 76, Stockholm, Sweden.

Pernilla Darlington (P)

Respiratory Medicine Division, Department of Clinical Science and Education, Södersjukhuset and Karolinska Institutet, Stockholm, Sweden.

Anders Eklund (A)

Respiratory Medicine Division, Department of Medicine, Solna, Karolinska Institutet, SE-171 76, Stockholm, Sweden.

Johan Grunewald (J)

Respiratory Medicine Division, Department of Medicine, Solna, Karolinska Institutet, SE-171 76, Stockholm, Sweden; Respiratory Medicine Division, Department of Medicine Solna, And Center for Molecular Medicine (CMM), Karolinska Institutet; and Respiratory Medicine, Theme Inflammation and Infection, Karolinska University Hospital, Stockholm, Sweden.

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Classifications MeSH