Immunophenotyping and extracellular matrix remodeling in pulmonary and extrapulmonary sarcoidosis.
OBJECTIVE
To investigate the significance of cellular immune markers, as well as that of collagen and elastic components of the extracellular matrix, within granulomatous structures in biopsies of patients with pulmonary or extrapulmonary sarcoidosis.


METHODS
We carried out qualitative and quantitative evaluations of inflammatory cells, collagen fibers, and elastic fibers in granulomatous structures in surgical biopsies of 40 patients with pulmonary and extrapulmonary sarcoidosis using histomorphometry, immunohistochemistry, picrosirius red staining, and Weigert's resorcin-fuchsin staining.


RESULTS
The extrapulmonary tissue biopsies presented significantly higher densities of lymphocytes, macrophages, and neutrophils than did the lung tissue biopsies. Pulmonary granulomas showed a significantly higher number of collagen fibers and a lower density of elastic fibers than did extrapulmonary granulomas. The amount of macrophages in the lung samples correlated with FVC (p < 0.05), whereas the amount of CD3+, CD4+, and CD8+ lymphocytes correlated with the FEV1/FVC ratio and VC. There were inverse correlations between TLC and the CD1a+ cell count (p < 0.05), as well as between DLCO and collagen/elastic fiber density (r = -0.90; p = 0.04).


CONCLUSIONS
Immunophenotyping and remodeling both showed differences between pulmonary and extrapulmonary sarcoidosis in terms of the characteristics of the biopsy samples. These differences correlated with the clinical and spirometric data obtained for the patients, suggesting that two different pathways are involved in the mechanism of antigen clearance, which was more effective in the lungs and lymph nodes.
Universidade de São Paulo, São Paulo, SP, Brazil.
Pedro Henrique Ramos Quintino da
PH
Silva
Edwin Roger
ER
Parra
William Sanches
WS
Zocolaro
Ivy
I
Narde
Fabíola
F
Rodrigues
Ronaldo Adib
RA
Kairalla
Carlos Roberto Ribeiro de
CR
Carvalho
Vera Luiza
VL
Capelozzi
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D001706:Biopsy; D003094:Collagen / Q000276:immunology; D004547:Elastic Tissue / Q000276:immunology / Q000473:pathology; D005109:Extracellular Matrix / Q000276:immunology* / Q000473:pathology; D005260:Female; D015769:Granuloma, Respiratory Tract / Q000276:immunology / Q000473:pathology; D006801:Humans; D007111:Immunity, Cellular; D016130:Immunophenotyping / Q000379:methods*; D008168:Lung / Q000276:immunology / Q000473:pathology; D008198:Lymph Nodes / Q000276:immunology / Q000473:pathology; D008214:Lymphocytes / Q000276:immunology; D016676:Macrophages, Alveolar / Q000276:immunology; D008297:Male; D008875:Middle Aged; D012507:Sarcoidosis / Q000276:immunology* / Q000473:pathology; D017565:Sarcoidosis, Pulmonary / Q000276:immunology / Q000473:pathology
D003094:Collagen