Abstract

Sarcoidosis is a systemic interstitial lung disease of unknown aetiology. Less invasive diagnostics are needed to decipher disease pathology and to distinguish sub-phenotypes. Here we test if SpotLight proteomics, which combines de novo MS/MS sequencing of enriched IgG and co-extracted proteins with subsequent label-free quantification of new and known peptides, can differentiate controls and sarcoidosis phenotypes (Löfgrens and non-Löfgrens syndrome, LS and nonLS). Intra-individually matched IgG enriched from serum and bronchial lavage fluid (BALF) from controls (n = 12), LS (n = 11) and nonLS (n = 12) were investigated. High-resolution mass-spectrometry SpotLight proteomics and uni- and multivariate-statistical analyses were used for data processing. Major differences were particularly observed in control-BALF versus sarcoidosis-BALF. However, interestingly, information obtained from BALF profiles was still present (but less prominent) in matched serum profiles. By using information from orthogonal partial least squares discriminant analysis (OPLS-DA) differentiating 1) sarcoidosis-BALF and control-BALF and 2) LS-BALF vs. nonLS-BALF, control-serum and sarcoidosis-serum (p = 0.0007) as well as LS-serum and nonLS-serum (p = 0.006) could be distinguished. Noteworthy, many factors prominent in identifying controls and patients were those associated with Fc-regulation, but also features from the IgG-Fab region and novel peptide variants. Differences between phenotypes were mostly IgG-specificity related. The results support the analytical utility of SpotLight proteomics which prospectively have potential to differentiate closely related phenotypes from a simple blood test.

Highlights

  • Sarcoidosis is a systemic inflammatory disease which is characterized by non-caseating granulomas that predominately involve lung and hilar lymph nodes

  • Sarcoidosis can be categorized as Löfgren syndrome (LS) and non-Löfgren syndrome [1]

  • LS has an acute disease onset, usually a more favorable outcome compared to non-Löfgren syndrome (nonLS), in patients expressing human leukocyte antigen (HLA) type HLA-DRB1*03 [2]

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Summary

Introduction

Sarcoidosis is a systemic inflammatory disease which is characterized by non-caseating granulomas that predominately involve lung and hilar lymph nodes. Sarcoidosis can be categorized as Löfgren syndrome (LS) and non-Löfgren syndrome (nonLS) [1]. LS has an acute disease onset, usually a more favorable outcome compared to nonLS, in patients expressing human leukocyte antigen (HLA) type HLA-DRB1*03 [2]. A substantial amount of research has been undertaken, the immunological aetiology behind sarcoidosis remains elusive. Sarcoidosis has conventionally been considered a T-cell mediated disease. Studies have shown antibody recognition towards mycobacterial antigens in patients [3,4] and HLA derived peptides can stimulate

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