Alveolar lymphocyte proliferation induced by Propionibacterium acnes in sarcoidosis patients.

The proliferation of lymphocytes induced by Propionibacterium acnes (P. acnes) was measured by the in vitro incorporation of 3H-thymidine. The mean response rate of alveolar lymphocytes obtained by bronchoalveolar lavage was 2.23 +/- 0.89 in nine untreated sarcoidosis patients, 0.85 +/- 0.17 in five sarcoidosis patients given corticosteroids and 0.78 +/- 0.29 in 11 controls. The proliferation was significantly enhanced in the untreated patients compared to both the treated patients (p less than 0.01) and controls (p less than 0.001), but there was no significant difference in response rates between the treated patients and controls. The response rate of alveolar lymphocytes was significantly higher in four active patients (3.05 +/- 0.61) than in four inactive patients (1.77 +/- 0.44) (p less than 0.05) and in the controls (p less than 0.001). In sarcoidosis patients, the response rates showed a good correlation with activities of serum lysozyme (r = 0.695, p less than 0.01), and with percentages of lymphocytes in bronchoalveolar lavage fluid (r = 0.591, p less than 0.05). There was a low correlation between angiotensin-converting enzyme activities and the response rates (r = 0.508, p less than 0.1). Neither peripheral blood lymphocytes in sarcoidosis patients nor in controls showed any response to P. acnes, but alveolar lymphocytes of the untreated active sarcoidosis patients were sensitive to P. acnes. The lymphocytes activated by P. acnes may play a central role in the induction of alveolitis in sarcoidosis patients.</p

Clinical features of 125 patients with sarcoidosis: Okayama University Hospital review of a recent 10-year period.

Clinical features were studied in 125 patients with sarcoidosis (72 females and 53 males) diagnosed at Okayama University Hospital during a recent 10-year period. The age distribution had two peaks in patients in their 20s and the 50s. Over half of the patients were detected at health screening check and were asymptomatic, while the remaining were symptomatic. Twelve patients were in stage 0, 41 were in stage I, 54 were in stage II, 16 were in stage III, and 2 were in stage IV according to the chest x-ray findings. Serum angiotensin converting enzyme levels and serum lysozyme levels were elevated in 60% and 76% of the patients, respectively. The bronchoalveolar lavage fluid showed lymphocytosis, especially of helper T-cells. The clinical features of sarcoidosis appear to depend on the duration of the disease.</p

Interleukin-1 production of alveolar macrophages in sarcoidosis

The production of interleukin-1 (IL-1) in alveolar macrophages (AMs) was studied in 25 patients with sarcoidosis to inversigate the role of immune mechanisms in this disease. The radioimmunoassay (RIA) method was compared with the bioassay method for detecting IL-1 in the supernatants of AM cultures. The level of IL-1β measured by RIA was closely corrrelated with the IL-1 activity measured by bioassay (r=0.88, p<0.01). The amount of IL-1β in the supernatant of AM cultures from sarcoidosis patients was compared with those from control subjects. No significant IL-1β activity was detected in the culture supernatants of unstimulated AMs from either group of subjects. However, the production of IL-1β by AMs stimulated with Propionibacterium acnes (P. acnes) was significantly higher in patients with sarcoidosis than in controls (p<0.05). Lipopolysaccharide (LPS) induced increased IL-1β production by AMs from both sarcoidosis patients and controls compared to unstimulated or P. acnes-stimulated AMS, but the mean IL-1β level for sarcoidosis AMs did not differ from that for control AMs. There was no difference in the IL-1β production of peripheral blood monocytes between sarcoidosis patients and controls. These data suggest that AMs are activated in sarcoidosis and may modulate alveolar lymphocyte functions to play a critical role in the pathogenesis of the disease