title: Patient characteristics and clinical features of Japanese sarcoidosis patients with low bronchoalveolar lavage CD4/CD8 ratios.
abstract: BACKGROUND
  Previous studies have shown that there is an association between low BALF (bronchoalveolar lavage fluid) CD4/CD8 ratio and lower remission rates in sarcoidosis patients.
  
  
  OBJECTIVE
  To investigate the patient characteristics and clinical features of Japanese sarcoidosis patients with low BALF CD4/CD8 ratios.
  
  
  METHODS
  322 Japanese sarcoidosis patients were retrospectively analyzed, and 3 groups were selected according to BALF CD4/CD8 ratios as follows: patients with the BALF CD4/CD8 ratio in the lowest 5 percentile (Group 1: 0.43-1.41), median 5 percentile (Group II: 4.68-5.47), and top 5 percentile (Group III: 12.6-60.1). Each group consisted of 16 patients (5% of 322 patients). The patient characteristics, clinical features, and the short-term prognosis for at least 2 years (average 116 months) were compared among the groups. Multivariate analysis was performed for 322 patients to investigate the determinants of BALF CD4/CD8 ratios.
  
  
  RESULTS
  The number of BALF CD8+ cells were greater in Group I than in the other two groups. In Group I, there were higher incidences of younger age, male gender, and lower number of extrathoracic lesions compared with Group III. Multivariate analysis showed that younger age and male gender were independently associated with low BALF CD4/CD8 ratios. The frequency of treatment with corticosteroid and progression to pulmonary fibrosis tended to be higher in Group I.
  
  
  CONCLUSIONS
  Low BALF CD4/CD8 ratios were due to increased number of BALF CD8+ cells. Younger age and male gender were independently associated with low BALF CD4/CD8 ratios in sarcoidosis patients.
authors.affiliation: Department of Respiratory Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
authors.forename: Tomohiro
authors.initials: T
authors.lastname: Handa
authors.forename: Sonoko
authors.initials: S
authors.lastname: Nagai
authors.forename: Michio
authors.initials: M
authors.lastname: Shigematsu
authors.forename: Rollin P
authors.initials: RP
authors.lastname: Tabuena
authors.forename: Minoru
authors.initials: M
authors.lastname: Takeuchi
authors.forename: Takeshi
authors.initials: T
authors.lastname: Mikuniya
authors.forename: Kunio
authors.initials: K
authors.lastname: Hamada
authors.forename: Takateru
authors.initials: T
authors.lastname: Izumi
authors.forename: Michiaki
authors.initials: M
authors.lastname: Mishima
mesh_terms: D000328:Adult; D044466:Asian People; D015415:Biomarkers; D001992:Bronchoalveolar Lavage Fluid / Q000166:cytology / Q000276:immunology*; D016516:CD4-CD8 Ratio; D002452:Cell Count; D018450:Disease Progression; D005260:Female; D005434:Flow Cytometry; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D007564:Japan / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D017565:Sarcoidosis, Pulmonary / Q000208:ethnology* / Q000276:immunology*; D012720:Severity of Illness Index
chemical_list: D015415:Biomarkers