Patient characteristics and clinical features of Japanese sarcoidosis patients with low bronchoalveolar lavage CD4/CD8 ratios.
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.
Handa
Tomohiro
T
Department of Respiratory Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
Nagai
Sonoko
S
Shigematsu
Michio
M
Tabuena
Rollin P
RP
Takeuchi
Minoru
M
Mikuniya
Takeshi
T
Hamada
Kunio
K
Izumi
Takateru
T
Mishima
Michiaki
M
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
D015415:Biomarkers