1. Activated CD8.sup.+ T Cells and NKT Cells in BAL Fluid Improve Diagnostic Accuracy in Sarcoidosis
- Author
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Tondell, A., Ro, A. D., Asberg, A., Borset, M., Moen, T., and Sue-Chu, M.
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Lymph nodes ,Sarcoidosis -- Research -- Risk factors -- Development and progression -- Patient outcomes -- Complications and side effects -- Diagnosis ,Health - Abstract
Purpose The clinical diagnosis of pulmonary sarcoidosis is based on the presence of noncaseating granulomas in an appropriate clinical setting with either bilateral hilar adenopathy and/or parenchymal infiltrates. Lymphocytosis with an increased CD4/CD8 T cell ratio in bronchoalveolar lavage fluid is supportive. We evaluated the diagnostic accuracy of a predictive binary logistic regression model in sarcoidosis based on sex, age, and bronchoalveolar lavage fluid cell profile with and without the inclusion of HLA-DR.sup.+ CD8.sup.+ T cells and natural killer T-cell fractions. Methods A retrospective analysis of differential cell counts and lymphocyte phenotypes by flow cytometry in bronchoalveolar lavage was performed in 183 patients investigated for possible diffuse parenchymal lung disease. A logistic regression model with age, sex, lymphocyte fraction, eosinophils, and CD4/CD8 ratio in bronchoalveolar lavage fluid (basic model) was compared with a final model, which also included fractions of HLA-DR.sup.+ CD8.sup.+ T cells and natural killer T cells. Diagnostic accuracy of the two models was assessed by receiver operating characteristic (ROC) curves. Results The area under the ROC curve for the basic and final model was 0.898 [95 % confidence interval (CI) 0.852-0.945] and 0.937 (95 % CI 0.902-0.972), respectively, p = 0.008. Conclusions Assessment of HLA-DR.sup.+ CD8.sup.+ T cell and natural killer T-cell fractions may improve diagnostic accuracy and further strengthen the importance of bronchoalveolar lavage in the diagnostic workup of sarcoidosis. Electronic supplementary material The online version of this article (doi:10.1007/s00408-013-9527-8) contains supplementary material, which is available to authorized users., Author(s): A. Tøndell[sup.1] [sup.2] [sup.4] , A. D. Rø[sup.2] , A. à sberg[sup.3] , M. Børset[sup.2] [sup.4] , T. Moen[sup.2] [sup.5] , M. Sue-Chu[sup.1] [sup.6] Author Affiliations: (1) Department of Thoracic [...]
- Published
- 2014
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