1
|
Celada SI, Lim CX, Carisey AF, Ochsner SA, Arce Deza CF, Rexie P, Poli De Frias F, Cardenas-Castillo R, Polverino F, Hengstschläger M, Tsoyi K, McKenna NJ, Kheradmand F, Weichhart T, Rosas IO, Van Kaer L, Celada LJ. SHP2 promotes sarcoidosis severity by inhibiting SKP2-targeted ubiquitination of TBET in CD8 + T cells. Sci Transl Med 2023; 15:eade2581. [PMID: 37703351 PMCID: PMC11126869 DOI: 10.1126/scitranslmed.ade2581] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Accepted: 08/24/2023] [Indexed: 09/15/2023]
Abstract
Sarcoidosis is an interstitial lung disease (ILD) characterized by interferon-γ (IFN-γ) and T-box expressed in T cells (TBET) dysregulation. Although one-third of patients progress from granulomatous inflammation to severe lung damage, the molecular mechanisms underlying this process remain unclear. Here, we found that pharmacological inhibition of phosphorylated SH2-containing protein tyrosine phosphatase-2 (pSHP2), a facilitator of aberrant IFN-γ abundance, decreased large granuloma formation and macrophage infiltration in the lungs of mice with sarcoidosis-like disease. Positive treatment outcomes were dependent on the effective enhancement of TBET ubiquitination within CD8+ T cells. Mechanistically, we identified a posttranslational modification pathway in which the E3 F-box protein S-phase kinase-associated protein 2 (SKP2) targets TBET for ubiquitination in T cells under normal conditions. However, this pathway was disrupted by aberrant pSHP2 signaling in CD8+ T cells from patients with progressive pulmonary sarcoidosis and end-stage disease. Ex vivo inhibition of pSHP2 in CD8+ T cells from patients with end-stage sarcoidosis enhanced TBET ubiquitination and suppressed IFN-γ and collagen synthesis. Therefore, these studies provided new mechanistic insights into the SHP2-dependent posttranslational regulation of TBET and identified SHP2 inhibition as a potential therapeutic intervention against severe sarcoidosis. Furthermore, these studies also suggest that the small-molecule SHP2 inhibitor SHP099 might be used as a therapeutic measure against human diseases linked to TBET or ubiquitination.
Collapse
Affiliation(s)
- Sherly I. Celada
- Department of Biological Sciences, Tennessee State University, Nashville, TN 37209, USA
| | - Clarice X. Lim
- Center of Pathobiochemistry and Genetics, Institute of Medical Genetics, Medical University of Vienna, Vienna, Austria
| | - Alexandre F. Carisey
- William T. Shearer Center for Human Immunobiology, Texas Children’s Hospital, Houston, TX 77030, USA
- Department of Pediatrics, Baylor College of Medicine, Houston, TX 77030, USA
- Department of Cell and Molecular Biology, St. Jude Children’s Hospital, Memphis, TN 38105, USA
| | - Scott A. Ochsner
- Department of Molecular and Cellular Biology, Houston, TX 77030, USA
| | - Carlos F. Arce Deza
- Department of Medicine, Section of Pulmonary, Critical Care and Sleep Medicine, Baylor College of Medicine, Houston, TX 77030, USA
| | - Praveen Rexie
- Center of Pathobiochemistry and Genetics, Institute of Medical Genetics, Medical University of Vienna, Vienna, Austria
| | - Fernando Poli De Frias
- Department of Medicine, Section of Pulmonary, Critical Care and Sleep Medicine, Baylor College of Medicine, Houston, TX 77030, USA
- Mout Sinai Medical Center, Miami Beach, FL 33140, USA
| | - Rafael Cardenas-Castillo
- Department of Medicine, Section of Pulmonary, Critical Care and Sleep Medicine, Baylor College of Medicine, Houston, TX 77030, USA
| | - Francesca Polverino
- Department of Medicine, Section of Pulmonary, Critical Care and Sleep Medicine, Baylor College of Medicine, Houston, TX 77030, USA
| | - Markus Hengstschläger
- Center of Pathobiochemistry and Genetics, Institute of Medical Genetics, Medical University of Vienna, Vienna, Austria
| | - Konstantin Tsoyi
- Department of Medicine, Section of Pulmonary, Critical Care and Sleep Medicine, Baylor College of Medicine, Houston, TX 77030, USA
| | - Neil J. McKenna
- Department of Molecular and Cellular Biology, Houston, TX 77030, USA
| | - Farrah Kheradmand
- Department of Medicine, Section of Pulmonary, Critical Care and Sleep Medicine, Baylor College of Medicine, Houston, TX 77030, USA
- Center for Translational Research on Inflammatory Diseases, Michael E. DeBakey, Houston, TX 77030, USA
| | - Thomas Weichhart
- Center of Pathobiochemistry and Genetics, Institute of Medical Genetics, Medical University of Vienna, Vienna, Austria
| | - Ivan O. Rosas
- Department of Medicine, Section of Pulmonary, Critical Care and Sleep Medicine, Baylor College of Medicine, Houston, TX 77030, USA
| | - Luc Van Kaer
- Department of Pathology, Microbiology and Immunology, Vanderbilt University School of Medicine, Nashville, TN 37232 USA
| | - Lindsay J. Celada
- Department of Medicine, Section of Pulmonary, Critical Care and Sleep Medicine, Baylor College of Medicine, Houston, TX 77030, USA
- Department of Medicine, Vanderbilt University School of Medicine, Nashville, TN 37232 USA
| |
Collapse
|
2
|
Manika K, Domvri K, Kyriazis G, Kontakiotis T, Papakosta D. BALF and BLOOD NK- cells in different stages of pulmonary sarcoidosis. SARCOIDOSIS, VASCULITIS, AND DIFFUSE LUNG DISEASES : OFFICIAL JOURNAL OF WASOG 2022; 38:e2021039. [PMID: 35115746 PMCID: PMC8787376 DOI: 10.36141/svdld.v38i4.10810] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Accepted: 08/31/2021] [Indexed: 12/16/2022]
Abstract
Background and objective: Data on natural killer (NK)- and natural killer T (NKT)- like cells in the immunopathogenesis of sarcoidosis remain limited. The aim was to assess NK- and NKT-like cells across different stages in bronchoalveolar lavage (BALF) versus peripheral blood (PB) in comparison to controls. Methods: Forty four patients (32 women and 12 men, mean age 46.6±14.4 years) with biopsy-proven sarcoidosis and 10 healthy individuals (6 women, 4 men mean age 52.6±19.1 years) were submitted to BALF. Total cells and cell differentials were counted, while CD45+, CD3+, CD4+, CD8+, CD19+, CD3-CD16/56 (NK cells) and CD3+CD16/56+ (NKT-like cells) were determined by dual flow cytometry in BALF and PB. Results: A significantly lower percentage of both NK and NKT-like cells was observed in BALF of controls and sarcoid patients (SP) compared to PB. Both BALF NK and NKT-cell counts were significantly higher in SP than in controls (NK: p=0.046, NKT-like: p=0.012) In addition BALF NK cell percentage differed among sarcoidosis stages (p=0.005). In PB NK-cell count was lower in sarcoidosis patients but the difference did not reach statistical significance. Also, in sarcoid patients’ BALF NK-cell percentage negatively correlated with lymphocyte percentage (r=-0.962, p<0.001). Conclusions: The increased count of BALF NK and NKT-like cells in sarcoidosis compared to controls along with the increase of NK cells with stage progression are in line with a growing number of investigations suggesting the involvement of NK- and NKT-like cells in the pathogenesis of sarcoidosis.
Collapse
Affiliation(s)
- Katerina Manika
- Pulmonary Department, Aristotle University of Thessaloniki, "G. Papanikolaou" Hospital, Exochi, Thessaloniki, Greece
| | - Kalliopi Domvri
- Pulmonary Department, Aristotle University of Thessaloniki, "G. Papanikolaou" Hospital, Exochi, Thessaloniki, Greece
| | - George Kyriazis
- Pulmonary Department, Aristotle University of Thessaloniki, "G. Papanikolaou" Hospital, Exochi, Thessaloniki, Greece
| | - Theodoros Kontakiotis
- Pulmonary Department, Aristotle University of Thessaloniki, "G. Papanikolaou" Hospital, Exochi, Thessaloniki, Greece
| | - Despina Papakosta
- Pulmonary Department, Aristotle University of Thessaloniki, "G. Papanikolaou" Hospital, Exochi, Thessaloniki, Greece
| |
Collapse
|
3
|
Kullberg S, Rivera NV, Grunewald J, Eklund A. Effects of infliximab on lung and circulating natural killer cells, CD56+ T cells and B cells in sarcoidosis. BMJ Open Respir Res 2021; 8:8/1/e000933. [PMID: 34233893 PMCID: PMC8264913 DOI: 10.1136/bmjresp-2021-000933] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Accepted: 05/15/2021] [Indexed: 11/18/2022] Open
Abstract
Background Tumour necrosis factor α (TNF-α) is pivotal in sarcoid granuloma formation, and inhibitors of TNF-α offer an attractive third-line treatment option in sarcoidosis. The sarcoid inflammation is characterised by an exaggerated T helper 1 response, and evidence indicates a contribution of dysregulated and/or deficient NK (natural killer) cells, CD56+ T cells and B cells. Objectives Insight into how TNF-α inhibitors influence these cells may provide more information on inflammatory mechanisms in sarcoidosis and improve understanding of such treatment. We therefore evaluated treatment effects of the TNF-α inhibitor infliximab on lung and peripheral blood (PB) NK, CD56+ T cells and B cells. Methods Fifteen patients were assessed with PB samples, spirometry and CT scan, and 11 of them also underwent bronchoalveolar lavage (BAL) close to start of infliximab treatment. These investigations were repeated after 6 months of treatment. Results Twelve out of 15 patients disclosed a clinical improvement at follow-up. Median percentage of BAL fluid (BALF) CD56+ T cells increased while a decrease was seen in PB (p<0.05 and 0.005, respectively). No significant changes were observed for NK cells. There was a trend towards increased median percentage of PB B cells (p=0.07), and a negative correlation was observed between PB and BALF B cells after treatment (p<0.05). Conclusion In conclusion, 6 months of infliximab treatment in patients with sarcoidosis, of whom the majority benefited from the treatment, influenced immune cells in the lung and circulation differently, highlighting the importance of investigating several compartments concomitantly when evaluating treatment effects on the inflammatory activity.
Collapse
Affiliation(s)
- Susanna Kullberg
- Department of Respiratory Medicine, Theme Inflammation and Ageing, Karolinska University Hospital, Stockholm, Sweden .,Respiratory Medicine Division, Department of Medicine, Karolinska Institute, Stockholm, Sweden
| | - Natalia V Rivera
- Respiratory Medicine Division, Department of Medicine, Karolinska Institute, Stockholm, Sweden
| | - Johan Grunewald
- Department of Respiratory Medicine, Theme Inflammation and Ageing, Karolinska University Hospital, Stockholm, Sweden.,Respiratory Medicine Division, Department of Medicine, Karolinska Institute, Stockholm, Sweden
| | - Anders Eklund
- Department of Respiratory Medicine, Theme Inflammation and Ageing, Karolinska University Hospital, Stockholm, Sweden.,Respiratory Medicine Division, Department of Medicine, Karolinska Institute, Stockholm, Sweden
| |
Collapse
|
4
|
Key Players and Biomarkers of the Adaptive Immune System in the Pathogenesis of Sarcoidosis. Int J Mol Sci 2020; 21:ijms21197398. [PMID: 33036432 PMCID: PMC7582702 DOI: 10.3390/ijms21197398] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2020] [Revised: 10/03/2020] [Accepted: 10/05/2020] [Indexed: 12/16/2022] Open
Abstract
Sarcoidosis is a systemic inflammatory disease characterized by development of granulomas in the affected organs. Sarcoidosis is often a diagnosis of exclusion, and traditionally used tests for sarcoidosis demonstrate low sensitivity and specificity. We propose that accuracy of diagnosis can be improved if biomarkers of altered lymphocyte populations and levels of signaling molecules involved in disease pathogenesis are measured for patterns suggestive of sarcoidosis. These distinctive biomarkers can also be used to determine disease progression, predict prognosis, and make treatment decisions. Many subsets of T lymphocytes, including CD8+ T-cells and regulatory T-cells, have been shown to be dysfunctional in sarcoidosis, and the predominant CD4+ T helper cell subset in granulomas appears to be a strong indicator of disease phenotype and outcome. Studies of altered B cell populations, B cell signaling molecules, and immune complexes in sarcoidosis patients reveal promising biomarkers as well as possible explanations of disease etiology. Furthermore, examined biomarkers raise questions about new treatment methods and sarcoidosis antigens.
Collapse
|
5
|
Sokhatska O, Padrão E, Sousa-Pinto B, Beltrão M, Mota PC, Melo N, Delgado L, Morais A. NK and NKT cells in the diagnosis of diffuse lung diseases presenting with a lymphocytic alveolitis. BMC Pulm Med 2019; 19:39. [PMID: 30760244 PMCID: PMC6373142 DOI: 10.1186/s12890-019-0802-1] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2018] [Accepted: 02/04/2019] [Indexed: 02/03/2023] Open
Abstract
Background Diffuse lung diseases (DLD) are characterized by different immunophenotypes in the bronchoalveolar lavage fluid (BALF). We aimed to evaluate the diagnostic value of BALF NK and NKT cell counts of patients with DLD and lymphocytic alveolitis. Methods We assessed 202 patients with DLD, who underwent BALF immunophenotyping. Samples were routinely processed by flow cytometry and lymphocyte subsets were compared between patients with sarcoidosis (n = 106), hypersensitivity pneumonitis (HP; n = 53), and other DLDs (n = 43). We compared absolute counts and percentages of NK and NKT cells between patients with HP versus the remaining DLD patients. To assess the accuracy of BALF lymphocyte subsets in the diagnosis of HP, we calculated the respective areas under the receiver operating characteristic curves (AUC-ROC). Results Patients with HP had significantly higher numbers of BALF NK cells, and its percentage was significantly associated with a higher odds of HP, even after adjustment for the NKT and CD8+ cells. For the absolute number of BALF NK cells, we found an AUC-ROC of 0.76 (95%CI = 0.68–0.84) when comparing patients with HP versus the remaining DLD. The cut-offs of 2000 NK cells/mL and of 2.4% NK cells in the BALF had a specificity and a negative predictive value over 80% for the diagnosis of HP. BALF NK cells absolute counts were significantly higher in HP patients with a restrictive pattern. No such differences were observed for NKT cells. Conclusions BALF NK immunophenotyping may be a helpful adjunct to the diagnostic work-up of DLD, particularly in the differential diagnosis of HP. Electronic supplementary material The online version of this article (10.1186/s12890-019-0802-1) contains supplementary material, which is available to authorized users.
Collapse
Affiliation(s)
- Oksana Sokhatska
- Basic & Clinical Immunology Unit, Department of Pathology, Faculty of Medicine, Alameda Professor Hernâni Monteiro, University of Porto, 4200-319, Porto, Portugal.
| | - Eva Padrão
- Department of Pulmonology, Hospital de São João and Faculty of Medicine, University of Porto, Porto, Portugal
| | - Bernardo Sousa-Pinto
- Basic & Clinical Immunology Unit, Department of Pathology, Faculty of Medicine, Alameda Professor Hernâni Monteiro, University of Porto, 4200-319, Porto, Portugal.,CINTESIS - Center for Health Technology and Services Research, Faculty of Medicine, University of Porto, Porto, Portugal.,MEDCIDS - Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine, University of Porto, Porto, Portugal
| | - Marília Beltrão
- Basic & Clinical Immunology Unit, Department of Pathology, Faculty of Medicine, Alameda Professor Hernâni Monteiro, University of Porto, 4200-319, Porto, Portugal
| | - Patrícia Caetano Mota
- Department of Pulmonology, Hospital de São João and Faculty of Medicine, University of Porto, Porto, Portugal
| | - Natália Melo
- Department of Pulmonology, Hospital de São João and Faculty of Medicine, University of Porto, Porto, Portugal
| | - Luís Delgado
- Basic & Clinical Immunology Unit, Department of Pathology, Faculty of Medicine, Alameda Professor Hernâni Monteiro, University of Porto, 4200-319, Porto, Portugal.,CINTESIS - Center for Health Technology and Services Research, Faculty of Medicine, University of Porto, Porto, Portugal
| | - António Morais
- Department of Pulmonology, Hospital de São João and Faculty of Medicine, University of Porto, Porto, Portugal
| |
Collapse
|
6
|
Abstract
PURPOSE OF REVIEW The present review intends to provide an overview of the diversity and complexity of pulmonary manifestations of rheumatologic diseases and gaps in knowledge to effectively manage them. RECENT FINDINGS Diffuse lung disease in children with rheumatologic diseases represents a heterogeneous group of autoimmune disorders. Despite their significant morbidity and mortality, we have limited understanding about their pathogenesis. Here, we provide an overview of the pathophysiology and current management approach of these disorders, highlighting tools which assist with diagnosis, risk stratification and therapy. In this context, we address the need to develop a standardized approach to diagnose at-risk patients with rheumatologic disease and to predict their progression and the need to develop robust studies which evaluate the factors and interventions that influence pulmonary disease outcome. SUMMARY Diffuse lung disease in children with rheumatologic diseases represents a heterogeneous group of severe autoimmune disorders. By adopting a collaborative research approach among multicenters to help diagnose, risk stratify, and understand disease progression, effective management decisions can be optimized to improve clinical outcome.
Collapse
|
7
|
Valeyre D, Bernaudin JF, Jeny F, Duchemann B, Freynet O, Planès C, Kambouchner M, Nunes H. Pulmonary Sarcoidosis. Clin Chest Med 2016; 36:631-41. [PMID: 26593138 DOI: 10.1016/j.ccm.2015.08.006] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Sarcoidosis is a systemic disease, with lung involvement in almost all cases. Abnormal chest radiography is usually a key step for considering diagnosis. Lung impact is investigated through imaging; pulmonary function; and, when required, 6-minute walk test, cardiopulmonary exercise testing, or right heart catheterization. There is usually a reduction of lung volumes, and forced vital capacity is the most accurate parameter to reflect the impact of pulmonary sarcoidosis with or without pulmonary infiltration at imaging. Various evolution patterns have been described. Increased risk of death is associated with advanced pulmonary fibrosis or cor pulmonale, particularly in African American patients.
Collapse
Affiliation(s)
- Dominique Valeyre
- EA2363, University Paris 13, COMUE Sorbonne-Paris-Cité, 74 rue Marcel Cachin, Bobigny 93009, France; Assistance Publique Hôpitaux de Paris, Pulmonary Department, Avicenne Universitary Hospital, 125 rue de Stalingrad, Bobigny 93009, France.
| | - Jean-François Bernaudin
- Assistance Publique Hôpitaux de Paris, Pathology Department, Tenon Universitary Hospital, 4 rue de la Chine, Paris 75020, France
| | - Florence Jeny
- EA2363, University Paris 13, COMUE Sorbonne-Paris-Cité, 74 rue Marcel Cachin, Bobigny 93009, France; Assistance Publique Hôpitaux de Paris, Pulmonary Department, Avicenne Universitary Hospital, 125 rue de Stalingrad, Bobigny 93009, France
| | - Boris Duchemann
- Assistance Publique Hôpitaux de Paris, Pulmonary Department, Avicenne Universitary Hospital, 125 rue de Stalingrad, Bobigny 93009, France
| | - Olivia Freynet
- Assistance Publique Hôpitaux de Paris, Pulmonary Department, Avicenne Universitary Hospital, 125 rue de Stalingrad, Bobigny 93009, France
| | - Carole Planès
- EA2363, University Paris 13, COMUE Sorbonne-Paris-Cité, 74 rue Marcel Cachin, Bobigny 93009, France; Assistance Publique Hôpitaux de Paris, Physiology Department, Avicenne Universitary Hospital, 125 rue de Stalingrad, Bobigny 93009, France
| | - Marianne Kambouchner
- Assistance Publique Hôpitaux de Paris, Pathology Department, Avicenne Universitary Hospital, 125 rue de Stalingrad, Bobigny 93009, France
| | - Hilario Nunes
- EA2363, University Paris 13, COMUE Sorbonne-Paris-Cité, 74 rue Marcel Cachin, Bobigny 93009, France; Assistance Publique Hôpitaux de Paris, Pulmonary Department, Avicenne Universitary Hospital, 125 rue de Stalingrad, Bobigny 93009, France
| |
Collapse
|
8
|
Tanriverdi H, Erboy F, Altinsoy B, Uygur F, Arasli M, Ozel Tekin I, Tor MM, Atalay F. Bronchoalveolar Lavage Fluid Characteristics of Patients With Sarcoidosis and Nonsarcoidosis Interstitial Lung Diseases: Ten-Year Experience of a Single Center in Turkey. IRANIAN RED CRESCENT MEDICAL JOURNAL 2015; 17:e31103. [PMID: 26566455 PMCID: PMC4636855 DOI: 10.5812/ircmj.31103] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/28/2015] [Revised: 08/05/2015] [Accepted: 09/19/2015] [Indexed: 12/13/2022]
Abstract
Background: Bronchoalveolar lavage (BAL) is a noninvasive and useful technique for evaluating interstitial lung diseases (ILDs). Flow cytometric analysis of BAL fluid reveals specific diagnostic information in some unusual ILDs, and helps to narrow down the possible causes of interstitial diseases in most patients with more common disorders. A high BAL CD4/CD8 ratio is highly specific for sarcoidosis but can also be seen in other ILDs. Objectives: In this retrospective, descriptive, cross-sectional study, we compared BAL fluid characteristics and clinical variables in patients with sarcoidosis and non-sarcoidosis ILDs in a large cohort. Patients and Methods: The study was conducted in a tertiary university hospital in Zonguldak, the biggest city of the western Black Sea region of Turkey. Between 2004 and 2014, all patients who underwent both fiberoptic bronchoscopy and BAL with a suspicion of ILD were included in the study, retrospectively. Patients were divided into two main groups: sarcoidosis and non-sarcoidosis ILDs. Non-sarcoidosis ILDs were further divided into subgroups: pneumoconiosis, tuberculosis (TB), collagen vascular diseases, idiopathic interstitial pneumonias, malignancies, and unclassified ILDs. The clinical data of patients, including age, gender, smoking status, pulmonary function tests, and BAL flow cytometric analysis results, were compared among groups. Results: In total, 261 patients (119 sarcoidosis and 142 non-sarcoidosis ILDs) were enrolled. The median (interquartile range) BAL CD4/CD8 ratio and lymphocyte fraction were significantly higher in sarcoidosis than in non-sarcoidosis ILDs: 3.88 (3.76) versus 0.88 (1.01), respectively, and 20.6 (28.3) versus 6.0 (13.7), respectively. T cell receptor γ delta, CD16+56+, CD103+, CD8+103+, and CD3+16+56+ cells were significantly lower in sarcoidosis than in non-sarcoidosis ILDs. The median BAL CD4/CD8 ratios were significantly higher in patients with TB (1.87, P = 0.01) and malignancies (1.69, P = 0.03) than in other non-sarcoidosis ILDs. Conclusions: Among BAL fluid flow cytometric parameters, CD4/CD8 and lymphocyte fraction may be helpful for distinguishing sarcoidosis from other ILDs, but they are neither specific nor diagnostic for any lung disease. Thus, a multidisciplinary diagnostic discussion is required to differentiate various ILDs.
Collapse
Affiliation(s)
- Hakan Tanriverdi
- Department of Chest Diseases and Tuberculosis, Faculty of Medicine, Bulent Ecevit University, Zonguldak, Turkey
- Corresponding Author: Hakan Tanriverdi, Department of Chest Diseases and Tuberculosis, Faculty of Medicine, Bulent Ecevit University, Zonguldak, Turkey. Tel: +90-3722612685, Fax: +90-3722612001, E-mail:
| | - Fatma Erboy
- Department of Chest Diseases and Tuberculosis, Faculty of Medicine, Bulent Ecevit University, Zonguldak, Turkey
| | - Bulent Altinsoy
- Department of Chest Diseases and Tuberculosis, Faculty of Medicine, Bulent Ecevit University, Zonguldak, Turkey
| | - Firat Uygur
- Department of Chest Diseases and Tuberculosis, Faculty of Medicine, Bulent Ecevit University, Zonguldak, Turkey
| | - Mehmet Arasli
- Department of Immunology, Faculty of Medicine, Bulent Ecevit University, Zonguldak, Turkey
| | - Ishak Ozel Tekin
- Department of Immunology, Faculty of Medicine, Bulent Ecevit University, Zonguldak, Turkey
| | - Muge Meltem Tor
- Department of Chest Diseases and Tuberculosis, Faculty of Medicine, Bulent Ecevit University, Zonguldak, Turkey
| | - Figen Atalay
- Department of Chest Diseases and Tuberculosis, Faculty of Medicine, Bulent Ecevit University, Zonguldak, Turkey
| |
Collapse
|
9
|
Wu W, Jin M, Wang Y, Liu B, Shen D, Chen P, Hannes S, Li Z, Hirani S, Jawad S, Sen HN, Chan CC, Nussenblatt RB, Wei L. Overexpression of IL-17RC associated with ocular sarcoidosis. J Transl Med 2014; 12:152. [PMID: 24885153 PMCID: PMC4059456 DOI: 10.1186/1479-5876-12-152] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2014] [Accepted: 05/14/2014] [Indexed: 12/04/2022] Open
Abstract
Background Sarcoidosis is a chronic inflammatory disease with a systemic granulomatous disorder affecting multiple organs including the eye. Both CD4+ T cell and macrophage have been linked to the pathogenesis of the disease. Methods The expression of IL-17RC was measured using FACS,immunohistochemistry and real-time PCR. Serum level of IL-17 was detected using ELISA. Results An elevated expression of IL-17RC on CD8+ T cells in peripheral blood was found in patients with ocular sarcoidosis as compared to healthy controls. Interestingly, we found a significant increase in the serum level of IL-17 in patients with ocular sarcoidosis as compared to healthy controls, which may be responsible for the induction of IL-17RC on CD8+ cells. In addition, IL-17RC appeared only in the retinal tissue of the patient with clinically active sarcoidosis. Conclusions Our results suggested a potential involvement of IL-17RC+CD8+ T cells in pathogenesis of ocular sarcoidosis.
Collapse
Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | | | - Robert B Nussenblatt
- Laboratory of Immunology, National Eye Institute, National Institutes of Health, Bethesda, MD 20892, USA.
| | | |
Collapse
|
10
|
Bronchoalveolar lavage fluid IFN-γ+ Th17 cells and regulatory T cells in pulmonary sarcoidosis. Mediators Inflamm 2014; 2014:438070. [PMID: 24882950 PMCID: PMC4027000 DOI: 10.1155/2014/438070] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2014] [Accepted: 04/09/2014] [Indexed: 12/19/2022] Open
Abstract
In sarcoidosis, increased Th17 cell fractions have been reported in bronchoalveolar lavage fluid, and elevated numbers of Th17 cells producing IFN-γ have been observed in peripheral blood. The balance between Th1, Th17, and FoxP3+ CD4+ T cell subsets in sarcoidosis remains unclear. Bronchoalveolar lavage fluid cells, from 30 patients with sarcoidosis, 18 patients with other diffuse parenchymal lung diseases, and 15 healthy controls, were investigated with flow cytometry for intracellular expression of FoxP3. In a subset of the patients, expression of the cytokines IL17A and IFN-γ was investigated. The fractions of FoxP3+ CD4+ T cells and Th17 cells were both lower in sarcoidosis compared to controls (P = 0.017 and P = 0.011, resp.). The proportion of Th17 cells positive for IFN-γ was greater in sarcoidosis than controls (median 72.4% versus 31%, P = 0.0005) and increased with radiologic stage (N = 23, rho = 0.45, and P = 0.03). IFN-γ+ Th17 cells were highly correlated with Th1 cells (N = 23, rho = 0.64, and P = 0.001), and the ratio of IFN-γ+ Th17/FoxP3+ CD4+ T cells was prominently increased in sarcoidosis. IFN-γ+ Th17 cells may represent a pathogenic subset of Th17 cells, yet their expression of IFN-γ could be a consequence of a Th1-polarized cytokine milieu. Our results indicate a possible immune cell imbalance in sarcoidosis.
Collapse
|