RESUMEN
AIM: To assess cytokine spectrum changes in different types of pulmonary sarcoidosis (PS). SUBJECTS AND METHODS: Twenty-seven PS patients without signs of pulmonary fibrosis and 14 patients with sarcoidosis complicated by pulmonary fibrosis were examined. Baseline serum Th1 and Th2 cytokine concentrations were studied. A control group comprised 30 healthy donors. RESULTS: A higher interleukin (IL)-4/IL-2 ratio was found in the peripheral blood of the patients with pulmonary fibrosis-complicated sarcoidosis than in the other patients (326.4 +/- 122.6 and 88.2 +/- 28.6%, respectively; p = 0.002). The sarcoidosis patients with signs of pulmonary fibrosis and no symptoms of disease inflammatory activity had elevated blood IL-1 levels whereas an IL-1 receptor antagonist was decreased. CONCLUSION: In the patients with PS, the development and progression of pulmonary fibrosis occur with a shift in the Th1/Th2 balance towards Th2, which manifests itself as a higher IL-4/IL-2 ratio in the peripheral blood. At the same time, the signs of systemic inflammatory activity remain.
Asunto(s)
Citocinas/sangre , Sarcoidosis Pulmonar/sangre , Adulto , Anciano , Comorbilidad , Femenino , Humanos , Mediadores de Inflamación/sangre , Interleucina-2/sangre , Interleucina-4/sangre , Masculino , Persona de Mediana Edad , Fibrosis Pulmonar/sangre , Fibrosis Pulmonar/epidemiología , Fibrosis Pulmonar/patología , Sarcoidosis Pulmonar/epidemiología , Sarcoidosis Pulmonar/patología , Células TH1/inmunología , Células TH1/patología , Células Th2/inmunología , Células Th2/patologíaRESUMEN
In this article the authors discuss the issues related to assessment of activity and severity of sarcoidosis, course and radiographic manifestations of this disease. Problems in defining of different forms of sarcoidosis resulted in suggestion of new version of classification.
Asunto(s)
Proteína C-Reactiva/metabolismo , Clasificación/métodos , Inflamación , Radiografía/métodos , Sarcoidosis , Biomarcadores , Diagnóstico Diferencial , Humanos , Inflamación/metabolismo , Inflamación/fisiopatología , Pronóstico , Sarcoidosis/sangre , Sarcoidosis/clasificación , Sarcoidosis/diagnóstico , Sarcoidosis/fisiopatología , Índice de Severidad de la EnfermedadRESUMEN
Investigation of initial stages of T-lymphocytes activation was performed by coherent phase microscopy (CPM) based on the measurements of phase thickness and diameter of the cell and its organelles. Lymphocytes where activated in two ways: by addition of 2 10-6 g/ml phytohemagglutinin (PHA) and with He-Ne laser (lambda = 633 nm, 10-3 W) radiation. It was shown that phase thickness is proportional to refractivity (difference between refractive indices of an object and the surrounding medium) and geometrical thickness. Phase thickness decreased during activation independently of the nature of the stimuli. Phase thickness in healthy donors was 220 + 60 nm; decreased to 110 + 30 nm 1 h after addition of PHA. The same values were achieved 30 min after stimulation with the He-Ne laser. Characteristic changes in phase thickness in the nucleus and nucleolus were observed after lymphocytes were stimulated with the laser.