Abstract
Sarcoidosis is a systemic granulomatous disease, which is thought to result from an aberrant immune response. CD4+ T lymphocytes play an important role in the development of granulomas. Previously, the immunopathogenesis of sarcoidosis was focused on Th1/Th2 disturbances. The aim of this study was to evaluate the balance between newer CD4+ T lymphocytes, i.e., Treg and Th17 cells. In our studies, a decrease in Treg cells and an increase in Th17 cells were observed in the peripheral blood and BALF of sarcoidosis patients. A significant increase in the Th17/Treg cell ratio was observed in sarcoidosis patients. After treatment with prednisone, the expression of Foxp3 mRNA was elevated in the peripheral blood, and expression of (ROR)γt mRNA showed a downward trend. These findings suggest that sarcoidosis is associated with an imbalance between Th17 and Treg cells in peripheral blood and BALF. Therefore, targeting the cytokines that affect the Th17/Treg ratio could provide a new promising therapy for pulmonary sarcoidosis.
Highlights
Sarcoidosis is a multisystem granulomatous disorder, with thoracic involvement occurring in more than 90% of sarcoidosis patients [1]
Since we observed an increase in Th17 cells and a concomitant decrease in Tregs in sarcoidosis patients, we further explored this trend by investigating the balance of Th17 and Treg cells within the same patients and control subjects
We found that the proportion of Th17 cells was elevated both in the peripheral blood and in the bronchoalveolar lavage fluid (BALF) of sarcoidosis patients
Summary
Sarcoidosis is a multisystem granulomatous disorder, with thoracic involvement occurring in more than 90% of sarcoidosis patients [1]. CD4+ T cells, recent reports have identified CD4+ CD25high Foxp3+ regulatory T cells (Tregs) and Th17 cells as two new distinct subsets [4,5]. Recent studies have shown that the aberrant relationship of Treg and Th17 cells is involved in immune mediated diseases, including autoimmune arthritis [8], psoriasis [9], inflammatory bowel disease [10], systemic lupus erythematosus [11], and several others. It is not clear whether the Th17/Treg balance is affected in CD4+ T-cell mediated sarcoidosis
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