Imaging Changes and Immune-Checkpoint Expression on T Cells in Bronchoalveolar Lavage Fluid from Patients with Pulmonary Sarcoidosis

Abstract

Sarcoidosis is a systemic, granulomatous disease caused by unknown immunological abnormalities. The organs most vulnerable to sarcoidosis are the lungs. Patients often resolve spontaneously, but the lungs can also be severely affected. Although details regarding prognostic factors in sarcoidosis patients with lung involvement remain unclear, several reports have suggested that immune checkpoint molecules are involved in the pathogenesis of sarcoidosis. In this study, we divided sarcoidosis patients into two groups based on chest computed tomography (CT) findings and compared immune checkpoint molecules expressed on T cells in bronchoalveolar lavage fluid (BALF) in the two groups, using flow cytometry. We found elevated programmed cell death 1 (PD-1) or T cell immunoglobulin- and mucin-domain-containing molecule-3 (TIM-3) expression on T cells in BALF in patients with spontaneous improvement in CT findings, compared with those in patients without improvement in CT findings. In conclusion, our study implies that PD-1 or TIM-3 expression on T cells in BALF may be a prognostic factor for pulmonary lesions in sarcoidosis.

Immune-Checkpoint Expression on CD4, CD8 and NK Cells in Blood, Bronchoalveolar Lavage and Lymph Nodes of Sarcoidosis

“…IC molecules have also come to the forefront in cancer [ 7 ] and chronic viral infections [ 8 ], where these receptors are highly expressed and are being targeted clinically to improve T-cell responses. Kotetsu and colleagues speculated that T-cell BAL expressing programmed cell death 1 (PD-1) and T-cell immunoglobulin- and mucin-domain-containing molecule-3 (TIM-3) are involved in the pathogenesis of sarcoidosis and are associated with computed tomography (CT) evidence of spontaneous improvement [ 9 ]. IC molecules are also overexpressed on natural killer (NK) cells, inducing cell exhaustion.…”