Sarcoidosis and Tuberculosis Cytokine Profiles: Indistinguishable in Bronchoalveolar Lavage but Different in Blood

Scriba, Thomas Jens, Thillai, Muhunthan, Eberhardt, Christian, Lewin, Alex M., Potiphar, Lee, Hingley-Wilson, Suzie, Sridhar, Saranya, Macintyre, Jonathan, Kon, Onn Min, Wickremasinghe, Melissa, Wells, Athol, Weeks, Mark E., Mitchell, Donald and Lalvani, Ajit (2012) Sarcoidosis and Tuberculosis Cytokine Profiles: Indistinguishable in Bronchoalveolar Lavage but Different in Blood. PLoS ONE, 7 (7). e38083. doi:10.1371/journal.pone.0038083

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Abstract

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.

Item Type: Article
Article Type: Article
Uncontrolled Keywords: Sarcoidosis; Tuberculosis; Diagnosis, differential; Cytokines; Biomarkers
Subjects: R Medicine > RC Internal medicine
Divisions: Schools and Research Institutes > School of Health and Social Care > Nursing
Research Priority Areas: Sport, Exercise, Health & Wellbeing
Depositing User: Marta Kemp
Date Deposited: 11 Feb 2020 14:06
Last Modified: 01 Jun 2020 15:48
URI: http://eprints.glos.ac.uk/id/eprint/8151

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