Comparison of induced sputum and bronchoalveolar lavage fluid cell profile during the treatment of pulmonary sarcoidosis.

In this study we compared the cellular profiles of induced sputum (IS) and BAL in newly diagnosed sarcoidosis patients before and after 6 months of prednisone therapy. The study encompassed 17 untreated patients with stage II pulmonary sarcoidosis. Sputum was induced with hypertonic saline solution, and bronchoscopy was performed in all patients. The results showed a significantly higher percentage of macrophages in BAL (P<0.05), whereas the percentage of neutrophils was higher in IS samples (P<0.01). The percentage of lymphocytes in IS was significantly lower than that in BAL (P<0.05). The TCD4/CD8 ratio was in favor of CD4 in both BAL and IS samples before prednisone therapy and it significantly decreased after therapy; the ratio was 4.8 vs. 1.8 (P=0.009) in BAL and 3.5 vs. 2.0 (P=0.019) in IS, respectively. Positive BAL/IS correlation characterized T cell populations in regards to CD4+ (r=0.59), CD8+ (r=0.34), CD4/CD8 ratio (r= 0.66) and CD3+ HLA-DR+ (r=0.89) cell population. These finding suggest that IS may serve as a valuable alternative to BAL technique.