title: Alterations of mononuclear inflammatory cells, CD4/CD8+ T cells, interleukin 1beta, and tumour necrosis factor alpha in the bronchoalveolar lavage fluid, peripheral blood, and skin of patients with systemic sclerosis.
abstract: BACKGROUND
  Systemic sclerosis (SSc) is a multisystem disease with underlying immune mechanisms.
  
  
  OBJECTIVE
  To investigate the clinicopathological characteristics of the lesions; immunological alterations in the bronchoalveolar lavage fluid (BALF), peripheral blood, and skin; and correlations between the clinicopathological characteristics and immunological alterations in SSc.
  
  
  METHODS
  Skin biopsies, BALF, and peripheral blood samples were obtained from 19 patients (18 women, one man) with SSc and six age and sex matched healthy controls (HCs). Mononuclear inflammatory cells (MICs), CD4/CD8 cells, tumour necrosis factor alpha (TNFalpha), and interleukin 1beta (IL1-1beta) concentrations were examined in all samples using histological methods, enzyme linked immunosorbent assay, and immunoperoxidase staining.
  
  
  RESULTS
  The mean (SD) age of the patients with SSc was 34.8 (2.6) years. Proteinuria, positive rheumatoid factor, and C reactive protein were seen in 15.8%, 26.3%, and 26.3% of patients, respectively. Compared with HCs, there were significantly higher: total MICs (macrophages, lymphocytes), neutrophils, and eosinophils in BALF, blood, and skin (all p<0.05); cytokine concentrations in BALF (TNFalpha, p<0.001; IL-1, p<0.01) and peripheral blood (p<0.01 and p<0.05); and CD8/CD4+ T cells in peripheral blood (p<0.05). Compared with HCs, lesional skin had significantly higher histiocyte cell counts (p<0.05), lower lymphocyte counts (p<0.05), and higher CD4/CD8 ratios (p<0.001). There were significant correlations between cytokine concentrations and CD8+ T cells and forced vital capacity (p<0.001 and p<0.01, respectively).
  
  
  CONCLUSIONS
  MICs, CD4/CD8+ cells, and cytokines are altered in SSc. These alterations correlated with the underlying disease process and therefore may have pathogenic, modulatory, and potential prognostic roles in SSc.
authors.affiliation: Department of Pathology, Faculty of Medicine, Assiut University, Assiut, Egypt. mrh17@swissinfo.org
authors.forename: M R
authors.initials: MR
authors.lastname: Hussein
authors.forename: H I
authors.initials: HI
authors.lastname: Hassan
authors.forename: E R M
authors.initials: ER
authors.lastname: Hofny
authors.forename: M
authors.initials: M
authors.lastname: Elkholy
authors.forename: N A
authors.initials: NA
authors.lastname: Fatehy
authors.forename: A E A
authors.initials: AE
authors.lastname: Abd Elmoniem
authors.forename: A M
authors.initials: AM
authors.lastname: Ezz El-Din
authors.forename: O A
authors.initials: OA
authors.lastname: Afifi
authors.forename: H G
authors.initials: HG
authors.lastname: Rashed
mesh_terms: D000328:Adult; D001992:Bronchoalveolar Lavage Fluid / Q000276:immunology*; D016516:CD4-CD8 Ratio; D015496:CD4-Positive T-Lymphocytes / Q000276:immunology; D018414:CD8-Positive T-Lymphocytes / Q000276:immunology; D004804:Eosinophils / Q000276:immunology; D005260:Female; D006801:Humans; D007375:Interleukin-1 / Q000032:analysis* / Q000097:blood; D007958:Leukocyte Count; D007962:Leukocytes / Q000276:immunology*; D008264:Macrophages / Q000276:immunology; D008297:Male; D009504:Neutrophils / Q000276:immunology; D012595:Scleroderma, Systemic / Q000097:blood / Q000276:immunology* / Q000473:pathology; D012867:Skin / Q000276:immunology* / Q000473:pathology; D014409:Tumor Necrosis Factor-alpha / Q000032:analysis*
chemical_list: D007375:Interleukin-1; D014409:Tumor Necrosis Factor-alpha