Diagnostic value of CD103 expression in bronchoalveolar lymphocytes in sarcoidosis
Summary Background Pulmonary sarcoidosis is frequently characterized by a CD4+ /CD8+ ratio ≥3.5 in bronchoalveolar lavage fluid (BALF), although up to 40% of the cases present a normal or even decreased ratio, pointing out its variability and limitation as a diagnostic marker for sarcoidosis. Lung l...
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| Veröffentlicht in: | Respiratory medicine 2012-07, Vol.106 (7), p.1014-1020 |
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| creator | Mota, Patrícia Caetano Morais, António Palmares, Carmo Beltrão, Marília Melo, Natália Santos, Ana Cristina Delgado, Luís |
| description | Summary Background Pulmonary sarcoidosis is frequently characterized by a CD4+ /CD8+ ratio ≥3.5 in bronchoalveolar lavage fluid (BALF), although up to 40% of the cases present a normal or even decreased ratio, pointing out its variability and limitation as a diagnostic marker for sarcoidosis. Lung lymphocytes within the bronchial epithelium, the alveolar walls, and BALF express the integrin CD103. Our aim was to compare the expression of CD103 in BALF T-lymphocytes between sarcoidosis and other interstitial lung diseases (ILD) and to evaluate its relevance as a BALF diagnostic marker for sarcoidosis. Methods A total of 86 patients with ILD (mean age ± standard deviation, 42.6 ± 16.6 years; 60.5% female), who underwent BALF as part of their initial diagnostic work-up, were enrolled into 2 groups: sarcoidosis ( n = 41) and other ILD ( n = 45). Area under the receiver operating characteristic (ROC) curve (AUC) was used to describe the performance of CD103 for sarcoidosis diagnosis. Results Sarcoidosis patients presented a significantly reduced CD103 expression in BALF T-lymphocytes, more pronounced in the CD4+ subset. The BALF CD103+ CD4+ /CD4+ ratio for a cutoff point of 0.45 was associated with a better diagnostic performance for sarcoidosis (AUC: 0.86 [95% confidence interval (95% CI): 0.78–0.94]; sensitivity: 81%; specificity: 78%), even for those with a CD4+ /CD8+ ratio |
| doi_str_mv | 10.1016/j.rmed.2012.03.020 |
| format | Article |
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Lung lymphocytes within the bronchial epithelium, the alveolar walls, and BALF express the integrin CD103. Our aim was to compare the expression of CD103 in BALF T-lymphocytes between sarcoidosis and other interstitial lung diseases (ILD) and to evaluate its relevance as a BALF diagnostic marker for sarcoidosis. Methods A total of 86 patients with ILD (mean age ± standard deviation, 42.6 ± 16.6 years; 60.5% female), who underwent BALF as part of their initial diagnostic work-up, were enrolled into 2 groups: sarcoidosis ( n = 41) and other ILD ( n = 45). Area under the receiver operating characteristic (ROC) curve (AUC) was used to describe the performance of CD103 for sarcoidosis diagnosis. Results Sarcoidosis patients presented a significantly reduced CD103 expression in BALF T-lymphocytes, more pronounced in the CD4+ subset. The BALF CD103+ CD4+ /CD4+ ratio for a cutoff point of 0.45 was associated with a better diagnostic performance for sarcoidosis (AUC: 0.86 [95% confidence interval (95% CI): 0.78–0.94]; sensitivity: 81%; specificity: 78%), even for those with a CD4+ /CD8+ ratio <3.5 (AUC: 0.79 [95% CI: 0.64–0.93]; sensitivity: 75%; specificity: 78%). Conclusions Assessment of CD103 expression in BALF CD4+ T-lymphocytes may be a reliable tool for sarcoidosis diagnosis, independently of CD4+ /CD8+ ratio, pointing out the relevance of evaluating the CD103+ CD4+ /CD4+ ratio in the ILD diagnostic work-up.</description><identifier>ISSN: 0954-6111</identifier><identifier>EISSN: 1532-3064</identifier><identifier>DOI: 10.1016/j.rmed.2012.03.020</identifier><identifier>PMID: 22537923</identifier><language>eng</language><publisher>Kidlington: Elsevier Ltd</publisher><subject>Adult ; Alveoli ; Antigens, CD - metabolism ; Biological and medical sciences ; Biomarkers - metabolism ; Bronchoalveolar lavage fluid ; Bronchoalveolar Lavage Fluid - chemistry ; Bronchoalveolar Lavage Fluid - cytology ; Case-Control Studies ; CD103 ; CD4-CD8 Ratio ; CD4-Positive T-Lymphocytes - metabolism ; CD8-Positive T-Lymphocytes - metabolism ; Comparative analysis ; Confidence intervals ; Disease ; Female ; Humans ; Integrin alpha Chains - metabolism ; Lung diseases ; Lungs ; Lymphocytes ; Male ; Medical sciences ; Middle Aged ; Pneumology ; Pulmonary/Respiratory ; ROC Curve ; Sarcoidosis ; Sarcoidosis, Pulmonary - diagnosis ; Sarcoidosis. Granulomatous diseases of unproved etiology. Connective tissue diseases. Elastic tissue diseases. Vasculitis ; Sensitivity analysis ; Sensitivity and Specificity</subject><ispartof>Respiratory medicine, 2012-07, Vol.106 (7), p.1014-1020</ispartof><rights>Elsevier Ltd</rights><rights>2012 Elsevier Ltd</rights><rights>2015 INIST-CNRS</rights><rights>Copyright © 2012 Elsevier Ltd. All rights reserved.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c546t-92a5a297d73515f7a7f0fd3da8788b1adf542ab7a19e6d9a12b89beaff8306803</citedby><cites>FETCH-LOGICAL-c546t-92a5a297d73515f7a7f0fd3da8788b1adf542ab7a19e6d9a12b89beaff8306803</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S0954611112001308$$EHTML$$P50$$Gelsevier$$Hfree_for_read</linktohtml><link.rule.ids>314,776,780,3536,27903,27904,65309</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=25887994$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/22537923$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Mota, Patrícia Caetano</creatorcontrib><creatorcontrib>Morais, António</creatorcontrib><creatorcontrib>Palmares, Carmo</creatorcontrib><creatorcontrib>Beltrão, Marília</creatorcontrib><creatorcontrib>Melo, Natália</creatorcontrib><creatorcontrib>Santos, Ana Cristina</creatorcontrib><creatorcontrib>Delgado, Luís</creatorcontrib><title>Diagnostic value of CD103 expression in bronchoalveolar lymphocytes in sarcoidosis</title><title>Respiratory medicine</title><addtitle>Respir Med</addtitle><description>Summary Background Pulmonary sarcoidosis is frequently characterized by a CD4+ /CD8+ ratio ≥3.5 in bronchoalveolar lavage fluid (BALF), although up to 40% of the cases present a normal or even decreased ratio, pointing out its variability and limitation as a diagnostic marker for sarcoidosis. Lung lymphocytes within the bronchial epithelium, the alveolar walls, and BALF express the integrin CD103. Our aim was to compare the expression of CD103 in BALF T-lymphocytes between sarcoidosis and other interstitial lung diseases (ILD) and to evaluate its relevance as a BALF diagnostic marker for sarcoidosis. Methods A total of 86 patients with ILD (mean age ± standard deviation, 42.6 ± 16.6 years; 60.5% female), who underwent BALF as part of their initial diagnostic work-up, were enrolled into 2 groups: sarcoidosis ( n = 41) and other ILD ( n = 45). Area under the receiver operating characteristic (ROC) curve (AUC) was used to describe the performance of CD103 for sarcoidosis diagnosis. Results Sarcoidosis patients presented a significantly reduced CD103 expression in BALF T-lymphocytes, more pronounced in the CD4+ subset. The BALF CD103+ CD4+ /CD4+ ratio for a cutoff point of 0.45 was associated with a better diagnostic performance for sarcoidosis (AUC: 0.86 [95% confidence interval (95% CI): 0.78–0.94]; sensitivity: 81%; specificity: 78%), even for those with a CD4+ /CD8+ ratio <3.5 (AUC: 0.79 [95% CI: 0.64–0.93]; sensitivity: 75%; specificity: 78%). Conclusions Assessment of CD103 expression in BALF CD4+ T-lymphocytes may be a reliable tool for sarcoidosis diagnosis, independently of CD4+ /CD8+ ratio, pointing out the relevance of evaluating the CD103+ CD4+ /CD4+ ratio in the ILD diagnostic work-up.</description><subject>Adult</subject><subject>Alveoli</subject><subject>Antigens, CD - metabolism</subject><subject>Biological and medical sciences</subject><subject>Biomarkers - metabolism</subject><subject>Bronchoalveolar lavage fluid</subject><subject>Bronchoalveolar Lavage Fluid - chemistry</subject><subject>Bronchoalveolar Lavage Fluid - cytology</subject><subject>Case-Control Studies</subject><subject>CD103</subject><subject>CD4-CD8 Ratio</subject><subject>CD4-Positive T-Lymphocytes - metabolism</subject><subject>CD8-Positive T-Lymphocytes - metabolism</subject><subject>Comparative analysis</subject><subject>Confidence intervals</subject><subject>Disease</subject><subject>Female</subject><subject>Humans</subject><subject>Integrin alpha Chains - metabolism</subject><subject>Lung diseases</subject><subject>Lungs</subject><subject>Lymphocytes</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Pneumology</subject><subject>Pulmonary/Respiratory</subject><subject>ROC Curve</subject><subject>Sarcoidosis</subject><subject>Sarcoidosis, Pulmonary - diagnosis</subject><subject>Sarcoidosis. Granulomatous diseases of unproved etiology. Connective tissue diseases. Elastic tissue diseases. Vasculitis</subject><subject>Sensitivity analysis</subject><subject>Sensitivity and Specificity</subject><issn>0954-6111</issn><issn>1532-3064</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2012</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkluLFDEQhYMo7jj6B3yQBhF86Ta37k5ABJn1BguCl-dQna64GXs6s0n34Px708wsC_ugT3mo71Tq1ClCnjNaMcqaN9sq7rCvOGW8oqKinD4gK1YLXgrayIdkRXUty4YxdkGepLSllGop6WNywXktWs3Finy79PBrDGnytjjAMGMRXLG5ZFQU-GcfMSUfxsKPRRfDaK8DDAcMA8RiOO7218EeJ0xLOUG0wfch-fSUPHIwJHx2ftfk58cPPzafy6uvn75s3l-VtpbNVGoONXDd9q2oWe1aaB11vehBtUp1DHpXSw5dC0xj02tgvFO6Q3BOZXuKijV5feq7j-FmxjSZnU8WhwFGDHMyTDZSas2E-D9KmdBMNRlek5f30G2Y45iNZCpPKlra6EzxE2VjSCmiM_vodxCPGVq6NWZrlnDMEo6hwuRwsujFufXcLbVbyW0aGXh1BiBZGFyE0fp0x9VKtVrLzL09cZjXe_AYTbIeR4u9j2gn0wf_7zne3ZPbwY8-__gbj5ju_JqUNeb7ckbLFTFO856oEn8B2uPAlg</recordid><startdate>20120701</startdate><enddate>20120701</enddate><creator>Mota, Patrícia Caetano</creator><creator>Morais, António</creator><creator>Palmares, Carmo</creator><creator>Beltrão, Marília</creator><creator>Melo, Natália</creator><creator>Santos, Ana Cristina</creator><creator>Delgado, Luís</creator><general>Elsevier Ltd</general><general>Elsevier</general><general>Elsevier Limited</general><scope>6I.</scope><scope>AAFTH</scope><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7U9</scope><scope>ASE</scope><scope>FPQ</scope><scope>H94</scope><scope>K6X</scope><scope>K9.</scope><scope>M7N</scope><scope>NAPCQ</scope><scope>7X8</scope><scope>7T5</scope></search><sort><creationdate>20120701</creationdate><title>Diagnostic value of CD103 expression in bronchoalveolar lymphocytes in sarcoidosis</title><author>Mota, Patrícia Caetano ; Morais, António ; Palmares, Carmo ; Beltrão, Marília ; Melo, Natália ; Santos, Ana Cristina ; Delgado, Luís</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c546t-92a5a297d73515f7a7f0fd3da8788b1adf542ab7a19e6d9a12b89beaff8306803</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2012</creationdate><topic>Adult</topic><topic>Alveoli</topic><topic>Antigens, CD - metabolism</topic><topic>Biological and medical sciences</topic><topic>Biomarkers - metabolism</topic><topic>Bronchoalveolar lavage fluid</topic><topic>Bronchoalveolar Lavage Fluid - chemistry</topic><topic>Bronchoalveolar Lavage Fluid - cytology</topic><topic>Case-Control Studies</topic><topic>CD103</topic><topic>CD4-CD8 Ratio</topic><topic>CD4-Positive T-Lymphocytes - metabolism</topic><topic>CD8-Positive T-Lymphocytes - metabolism</topic><topic>Comparative analysis</topic><topic>Confidence intervals</topic><topic>Disease</topic><topic>Female</topic><topic>Humans</topic><topic>Integrin alpha Chains - metabolism</topic><topic>Lung diseases</topic><topic>Lungs</topic><topic>Lymphocytes</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Pneumology</topic><topic>Pulmonary/Respiratory</topic><topic>ROC Curve</topic><topic>Sarcoidosis</topic><topic>Sarcoidosis, Pulmonary - diagnosis</topic><topic>Sarcoidosis. Granulomatous diseases of unproved etiology. Connective tissue diseases. Elastic tissue diseases. Vasculitis</topic><topic>Sensitivity analysis</topic><topic>Sensitivity and Specificity</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Mota, Patrícia Caetano</creatorcontrib><creatorcontrib>Morais, António</creatorcontrib><creatorcontrib>Palmares, Carmo</creatorcontrib><creatorcontrib>Beltrão, Marília</creatorcontrib><creatorcontrib>Melo, Natália</creatorcontrib><creatorcontrib>Santos, Ana Cristina</creatorcontrib><creatorcontrib>Delgado, Luís</creatorcontrib><collection>ScienceDirect Open Access Titles</collection><collection>Elsevier:ScienceDirect:Open Access</collection><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Virology and AIDS Abstracts</collection><collection>British Nursing Index</collection><collection>British Nursing Index (BNI) (1985 to Present)</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>British Nursing Index</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Algology Mycology and Protozoology Abstracts (Microbiology C)</collection><collection>Nursing & Allied Health Premium</collection><collection>MEDLINE - Academic</collection><collection>Immunology Abstracts</collection><jtitle>Respiratory medicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Mota, Patrícia Caetano</au><au>Morais, António</au><au>Palmares, Carmo</au><au>Beltrão, Marília</au><au>Melo, Natália</au><au>Santos, Ana Cristina</au><au>Delgado, Luís</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Diagnostic value of CD103 expression in bronchoalveolar lymphocytes in sarcoidosis</atitle><jtitle>Respiratory medicine</jtitle><addtitle>Respir Med</addtitle><date>2012-07-01</date><risdate>2012</risdate><volume>106</volume><issue>7</issue><spage>1014</spage><epage>1020</epage><pages>1014-1020</pages><issn>0954-6111</issn><eissn>1532-3064</eissn><abstract>Summary Background Pulmonary sarcoidosis is frequently characterized by a CD4+ /CD8+ ratio ≥3.5 in bronchoalveolar lavage fluid (BALF), although up to 40% of the cases present a normal or even decreased ratio, pointing out its variability and limitation as a diagnostic marker for sarcoidosis. Lung lymphocytes within the bronchial epithelium, the alveolar walls, and BALF express the integrin CD103. Our aim was to compare the expression of CD103 in BALF T-lymphocytes between sarcoidosis and other interstitial lung diseases (ILD) and to evaluate its relevance as a BALF diagnostic marker for sarcoidosis. Methods A total of 86 patients with ILD (mean age ± standard deviation, 42.6 ± 16.6 years; 60.5% female), who underwent BALF as part of their initial diagnostic work-up, were enrolled into 2 groups: sarcoidosis ( n = 41) and other ILD ( n = 45). Area under the receiver operating characteristic (ROC) curve (AUC) was used to describe the performance of CD103 for sarcoidosis diagnosis. Results Sarcoidosis patients presented a significantly reduced CD103 expression in BALF T-lymphocytes, more pronounced in the CD4+ subset. The BALF CD103+ CD4+ /CD4+ ratio for a cutoff point of 0.45 was associated with a better diagnostic performance for sarcoidosis (AUC: 0.86 [95% confidence interval (95% CI): 0.78–0.94]; sensitivity: 81%; specificity: 78%), even for those with a CD4+ /CD8+ ratio <3.5 (AUC: 0.79 [95% CI: 0.64–0.93]; sensitivity: 75%; specificity: 78%). Conclusions Assessment of CD103 expression in BALF CD4+ T-lymphocytes may be a reliable tool for sarcoidosis diagnosis, independently of CD4+ /CD8+ ratio, pointing out the relevance of evaluating the CD103+ CD4+ /CD4+ ratio in the ILD diagnostic work-up.</abstract><cop>Kidlington</cop><pub>Elsevier Ltd</pub><pmid>22537923</pmid><doi>10.1016/j.rmed.2012.03.020</doi><tpages>7</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Adult Alveoli Antigens, CD - metabolism Biological and medical sciences Biomarkers - metabolism Bronchoalveolar lavage fluid Bronchoalveolar Lavage Fluid - chemistry Bronchoalveolar Lavage Fluid - cytology Case-Control Studies CD103 CD4-CD8 Ratio CD4-Positive T-Lymphocytes - metabolism CD8-Positive T-Lymphocytes - metabolism Comparative analysis Confidence intervals Disease Female Humans Integrin alpha Chains - metabolism Lung diseases Lungs Lymphocytes Male Medical sciences Middle Aged Pneumology Pulmonary/Respiratory ROC Curve Sarcoidosis Sarcoidosis, Pulmonary - diagnosis Sarcoidosis. Granulomatous diseases of unproved etiology. Connective tissue diseases. Elastic tissue diseases. Vasculitis Sensitivity analysis Sensitivity and Specificity |
| title | Diagnostic value of CD103 expression in bronchoalveolar lymphocytes in sarcoidosis |
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