Comparison of bronchoalveolar lavage helper/suppressor T-cell ratios in sarcoidosis versus other interstitial lung diseases.

In order to compare the frequency of elevated lymphocyte proportions and elevated Leu3/Leu2 (helper/inducer to suppressor/cytotoxic) ratios in sarcoidosis with those in clinically similar interstitial lung diseases (ILDs), bronchoalveolar lavage (BAL) lymphocyte proportions and Leu3/Leu2 ratios were determined for 20 patients with sarcoidosis and 30 patients with other (non-sarcoidosis) ILDs [cryptogenic fibrosing alveolitis (seven), lung connective tissue disease (seven), extrinsic allergic alveolitis (four), lymphoproliferative disease (two), and asbestosis (ten)], as well as in eight control subjects. BAL lymphocyte proportions were elevated above control values in 19 (95%) patients with pulmonary sarcoidosis (mean value 36 +/- 3%) but also in 12 (39%) patients with non-sarcoidosis ILDs (mean value 17 +/- 4%). Leu3/Leu2 ratios were over 2.5 in 15 (75%) of the sarcoidosis patients (mean ratio 4.4 +/- 1). In all control subjects, however, and in all but one of the non-sarcoidosis groups, Leu3/Leu2 ratios were below 2.5 (p less than 0.001 for each compared to sarcoidosis patients). Helper/suppressor ratios over 2.5 are found in the majority of our sarcoidosis patients and, unlike raised lymphocyte proportions alone, are not commonly seen in other ILDs, suggesting that evaluation of BAL helper/suppressor cell ratios may be of value in the investigation of patients with ILD.