摘要
本研究旨在探讨肺结节病中支气管肺泡和血液单个核细胞体外产生炎症介质的能力。17例肺结节病患者(I期8例;II/III期n = 9)和10名正常对照组。支气管肺泡和外周血单个核细胞在无血清培养液中培养24 h,无刺激,分析上清液中白细胞介素(IL)-1 β (IL-1 β)、IL-2、IL-6、肿瘤坏死因子- α (tnf - α)、粒细胞-巨噬细胞集落刺激因子(GM-CSF)、干扰素(IFN-gamma)和新蝶呤。与正常对照组相比,结节病患者的支气管肺泡灌洗细胞(BALC)释放的tnf - α、IL-6、ifn - γ和新甲乙素含量显著升高。当吸烟者被排除在外时,IL-1 β和GM-CSF的释放也增加。在结节组中,IL-1 β、IL-6、tnf - α和GM-CSF的水平之间存在高度相关性,而与IL-2、IFN-gamma和neopterin无相关性。BALC释放更多tnf - α或GM-CSF的结节样患者肺泡巨噬细胞百分率较高,但灌洗淋巴细胞较少。在肉瘤患者中,外周血单个核细胞(pbnc)也比正常对照组释放更多的IL-1 β、tnf - α、IL-6和GM-CSF,但新甲乙素较少。 Patients whose PBMNC produced more IL-1 beta, IL-6 and GM-CSF had higher absolute and relative lavage neutrophil counts. No relationships were observed between cytokine release and radiographic or physiological markers of disease severity. We conclude from this study that sarcoid inflammation is associated with an increased and concerted release of monocyte/macrophage-derived cytokines not only in the lung but also in the peripheral blood. We speculate that the lymphokines, IFN-gamma and IL-2, are not the primary triggers.