[HTML][HTML] Sarcoidosis and tuberculosis cytokine profiles: indistinguishable in bronchoalveolar lavage but different in blood
PLoS One, 2012•journals.plos.org
Background The clinical, radiological and pathological similarities between sarcoidosis and
tuberculosis can make disease differentiation challenging. A complicating factor is that some
cases of sarcoidosis may be initiated by mycobacteria. We hypothesised that immunological
profiling might provide insight into a possible relationship between the diseases or allow us
to distinguish between them. Methods We analysed bronchoalveolar lavage (BAL) fluid in
sarcoidosis (n= 18), tuberculosis (n= 12) and healthy volunteers (n= 16). We further …
tuberculosis can make disease differentiation challenging. A complicating factor is that some
cases of sarcoidosis may be initiated by mycobacteria. We hypothesised that immunological
profiling might provide insight into a possible relationship between the diseases or allow us
to distinguish between them. Methods We analysed bronchoalveolar lavage (BAL) fluid in
sarcoidosis (n= 18), tuberculosis (n= 12) and healthy volunteers (n= 16). We further …
Background
The clinical, radiological and pathological similarities between sarcoidosis and tuberculosis can make disease differentiation challenging. A complicating factor is that some cases of sarcoidosis may be initiated by mycobacteria. We hypothesised that immunological profiling might provide insight into a possible relationship between the diseases or allow us to distinguish between them.
Methods
We analysed bronchoalveolar lavage (BAL) fluid in sarcoidosis (n = 18), tuberculosis (n = 12) and healthy volunteers (n = 16). We further investigated serum samples in the same groups; sarcoidosis (n = 40), tuberculosis (n = 15) and healthy volunteers (n = 40). A cross-sectional analysis of multiple cytokine profiles was performed and data used to discriminate between samples.
Results
We found that BAL profiles were indistinguishable between both diseases and significantly different from healthy volunteers. In sera, tuberculosis patients had significantly lower levels of the Th2 cytokine interleukin-4 (IL-4) than those with sarcoidosis (p = 0.004). Additional serum differences allowed us to create a linear regression model for disease differentiation (within-sample accuracy 91%, cross-validation accuracy 73%).
Conclusions
These data warrant replication in independent cohorts to further develop and validate a serum cytokine signature that may be able to distinguish sarcoidosis from tuberculosis. Systemic Th2 cytokine differences between sarcoidosis and tuberculosis may also underly different disease outcomes to similar respiratory stimuli.
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