Predictive value of response to treatment of T-lymphocyte subpopulations in idiopathic pulmonary fibrosis

E. Fireman, N. Vardinon, M. Burke, S. Spizer, S. Levin, A. Endler, D. Stav, M. Topilsky, A. Mann, Y. Schwarz, S. Kivity, J. Greif

Research output: Contribution to journalArticlepeer-review

Abstract

T-cell types are important in maintaining immune homeostasis in the lung and their imbalance may be associated with several diseases. We examined the relationship between bronchoalveolar lavage (BAL) T-cell subset profiles and the clinical course of 46 patients with idiopathic pulmonary fibrosis (IPF). A flow cytometry cell sorter (FACS) was used to analyse the T-cell subsets. Pulmonary function tests (PFT) were performed at baseline and 6-12 months later. Patients were divided into two groups according to their CD4/CD8 ratio: CD4/CD8 >1 (group 1, n=21); and CD4/CD8 <1 (group 2, n=25). A lower percentage of lymphocytes, a higher percentage of CD8/S6F1 cells (cytotoxic T-lymphocytes) and a higher percentage of neutrophils were found in the BAL in group 2 compared to group 1 (11±7.5% versus 19±13.2%; p=0.024 and 29.8±17.6% versus 13.3±6.9%; p=0.068, respectively for lymphocytes and cytotoxic T-lymphocytes; and 8±11% versus 29±27%; p=0.003 for neutrophils). Inversely, in the peripheral blood, the distribution of CD8/S6F1 cells was lower in group 1 than in group 2 (8.3±6.9% versus 33.4±16.5%; p=0.0048). The patients were followed over a period of 1 yr in order to test whether those findings could determine efficacy of therapy. The baseline transfer factor of the lung for carbon monoxide (TL,CO) capacity in group 1 and group 2 was 59±22% and 51±21%, respectively (p=0.29), but only in group 1 was the TL,CO capacity improved significantly in response to steroids treatment after 6-12 months. IPF patients with a higher percentage of lymphocytes, a lower percentage of neutrophils, CD4/CD8 >1 and a low percentage of CD8/S6F1 may have a more benign course of disease. These parameters may identify an early stage of reversible disease responsive to therapy. We conclude that these measurements may be a useful tool in monitoring response to treatment in patients with idiopathic pulmonary fibrosis.

Original languageEnglish
Pages (from-to)706-711
Number of pages6
JournalEuropean Respiratory Journal
Volume11
Issue number3
StatePublished - Mar 1998

Keywords

  • Bronchoalveolar lavage
  • Idiopathic pulmonary fibrosis
  • Monoclonal antibodies
  • T-cell subsets

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