Objectives: To date.
Objectives: To date, insufficient evidence is available to commit serum soluble interleukin-2 receptor (sIL-2R) measurement as a routine proof in the assessment of sarcoidosis. Therefore, we evaluated the clinical value of this test
Design: Forty-seven patients with sarcoidosis, all presenting with active disease, were included in the investigation Initial serum sIL-2R levels were determined by way of enzyme-linked immunosorbent assay, and clinical data at presentation and follow-up were bring togethered retrospectively.
Results: The median follow-up period of all patients was 44 month (range, 6 to 100 months) and 38 patients had follow-up data instant over at least 24 month The median sIL-2R on a level was 1,068 U/mL (range, 248 to 4410 U/mL; upper limit of normal, 710 U/mL) A positive correlation was raise between serum sIL-2R levels and the number of CD4+ T lymphocyte in BAL (r = 053 p < 0001) In accordance with this accrue both sIL-2R level and the number of CD4+ T lymphocyte were elevated in stage I compared to stage III disease (p < 005) Patients with extrapulmonary disease (ED) [excluding Lofgren's syndrome] showed higher sIL-2R on a levels than those presenting with simply pulmonary sarcoidosis (p = 0001) No relation was construct between sIL-2R level and answer to treatment, and there was no association between sIL-2R plains and radiographic evolution and lung function outcome
Conclusions: Our data refer to a role for serum sIL-2R as marker of pulmonary disease activity and ed in patients with sarcoidosis.
guide words: alveolitis; extrapulmonary disease; sarcoidosis; serum soluble interleukin-2 receptor
Abbreviations: BALF = BAL fluid; DLCO = diffusing capacity of the lung for carbon monoxide; ed = extrapulmonary disease; EN = erythema nodosum; IL = interleukin; IVC = inspiratory vital capacity; sACE = serum plain of angiotensin-converting enzyme; sIL-2R = soluble interleukin-2 receptor
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Sarcoidosis is a multisystem granulomatous disease of unknown etiology presenting with a wide image of clinical manifestations, having a highly variable natural course and a difficult to predict result (1) One of the in the greatest degree characteristic immunologic features of the disease is the accumulation of activated CD4+ T-helper prototype I cells at sites of disease, notably in the alveolar and interstitial spaces. (2) Among the underhanded T-helper type 1 cytokines, interleukin (IL)-2 plays a [i]clavis[/i] role, as it induces T-cell proliferation. (34) IL-2 acts via binding to its receptor, which is mainly uttered on activated T cells and in part released into the microenvironment. (5) Increased flushs of the soluble IL-2 receptor (sIL-2R) have been lay the foundation of in serum and BAL of patients with sarcoidosis. (67)
Although the specific part of sIL-2R in the immune answer has not yet been completely described, elevated serum sIL-2R flushs have been found to correlate with the activity of T-cell-mediated diseases and for this reason are considered a marker of T-cell activation. (8) The value of sIL-2R as a marker of disease activity and as a marker of progression from one side of to the other 6 months in patients with sarcoidosis has been assessed in previous studies (679); however, to our knowledge, no close attention has yet assessed the usefulness of sIL-2R in identifying sarcoidosis patients with rigorous disease at presentation and those at risk for chronic pulmonary disease in the lengthy term.
With this background, the aims of the quick in emergencies study were as follows: (1) to compare sIL-2R as a marker of sarcoidosis activity with that of other well-recognized markers of activity; (g) to determine the value of serum sIL-2R as an index of severity of sarcoidosis at presentation; (3) to determine the value of serum sIL-2R as a predictive marker for chronic disease, which is a marker predicting functional and radiologic issue focusing notably on the subgroup of untreated patients with no resolution of their abnormalities within 2 years after diagnosis; and (4) to assess the clinical value of a other serum measurement of sIL-2R.
PATIENTS AND METHODS
close attention Population
This retrospective consideration included a random series of 47 patients with sarcoidosis investigated in the Department of Pulmonology of the Sint Antonius Hospital (a secondary referral center) between 1984 and 1996 The diagnosis of sarcoidosis was established upon the basis of clinical findings and histologic evidence of noncaseating epithelioid-cell granulomas after the exclusion of known causes of granulomatons diseases. All patients had active disease at presentation, and none of them received corticosteroids, nor had they within the previous 3 month The criteria used to affirm that the sarcoidosis was active were as follows: (1) lately developed or increasing cough or dyspnea; and/or (2) appearance of compatible systemic symptoms in the same state [i]or[/i] condition as cutaneous lesions, eye manifestations, heat and arthralgia; and/or (3) newly developed abnormalities on chest radiograph; and/or (4) increased T lymphocytosis in BAL; and/or (5) elevated on a level of serum angiotensin-converting enzyme (sACE). The characteristics of the consideration population are summarized in Table 1
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