Diagnostic value of CD103 expression in bronchoalveolar lymphocytes in sarcoidosis

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• 作者：Patrí ; cia Caetano Mota^a ; Antó ; nio Morais^a ; ^b ; ^{amorais3@hotmail.com} ; Carmo Palmares^c ; Marí ; lia Beltrã ; o^c ; Natá ; lia Melo^a ; Ana Cristina Santos^d ; ^e ; Luí ; s Delgado^c
• 关键词：Sarcoidosis ; Bronchoalveolar lavage fluid ; CD103+
• 刊名：Respiratory Medicine
• 出版年：2012
• 期刊代码：273_09546111
• 类别：med
• 出版时间：July, 2012
• 卷：106
• 期：7
• 页码：1014-1020
• 文件大小：378 K

摘要

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Summary

Background

Pulmonary sarcoidosis is frequently characterized by a CD4⁺/CD8⁺ ratio 鈮?.5 in bronchoalveolar lavage fluid (BALF), although up to 40%of the cases present a normal or even decreased ratio, pointing out its variability and limitation as a diagnostic marker for sarcoidosis. Lung lymphocytes within the bronchial epithelium, the alveolar walls, and BALF express the integrin CD103. Our aim was to compare the expression of CD103 in BALF T-lymphocytes between sarcoidosis and other interstitial lung diseases (ILD) and to evaluate its relevance as a BALF diagnostic marker for sarcoidosis.

Methods

A total of 86 patients with ILD (mean age聽卤聽standard deviation, 42.6聽卤聽16.6 years; 60.5%female), who underwent BALF as part of their initial diagnostic work-up, were enrolled into 2 groups: sarcoidosis (n聽=聽41) and other ILD (n聽=聽45). Area under the receiver operating characteristic (ROC) curve (AUC) was used to describe the performance of CD103 for sarcoidosis diagnosis.

Results

Sarcoidosis patients presented a significantly reduced CD103 expression in BALF T-lymphocytes, more pronounced in the CD4⁺ subset. The BALF CD103⁺CD4⁺/CD4⁺ ratio for a cutoff point of 0.45 was associated with a better diagnostic performance for sarcoidosis (AUC: 0.86 [95%confidence interval (95%CI): 0.78-0.94]; sensitivity: 81%; specificity: 78%), even for those with a CD4⁺/CD8⁺ ratio <3.5 (AUC: 0.79 [95%CI: 0.64-0.93]; sensitivity: 75%; specificity: 78%).

Conclusions

Assessment of CD103 expression in BALF CD4⁺ T-lymphocytes may be a reliable tool for sarcoidosis diagnosis, independently of CD4⁺/CD8⁺ ratio, pointing out the relevance of evaluating the CD103⁺CD4⁺/CD4⁺ ratio in the ILD diagnostic work-up.