The CD4/CD8 Ratio in Vitreous Fluid Is of High Diagnostic Value in Sarcoidosis
The CD4/CD8 Ratio in Vitreous Fluid Is of High Diagnostic Value in Sarcoidosis
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DOI：
10.1016/j.ophtha.2012.05.033
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发表时间：
2012-11-01
期刊：
影响因子：
13.7
通讯作者：
Kinoshita, Shigeru
中科院分区：
文献类型：
--
作者：
Kojima, Kentaro;Maruyama, Kazuichi;Kinoshita, Shigeru
目的：结节病是一种累及多器官的特发性炎症性疾病，眼部表现（以肉芽肿性葡萄膜炎为代表）是其常见特征之一。结节病的一个众所周知的免疫学特征是支气管肺泡灌洗液（BAL）中CD 4+辅助T细胞1型淋巴细胞亚群增加。目前的研究调查了眼结节病的玻璃体淋巴细胞亚群，以阐明这种疾病在eye.Design的免疫学特征：病例对照研究。参与者和控制：51眼眼的38例眼结节病，国际诊断标准确认，参加了这项研究。26名患有其他原因的葡萄膜炎患者的27只眼睛被纳入作为非结节病对照。方法：评估眼部结节病细胞谱的诊断测试。通过细胞学、聚合酶链反应和流式细胞术分析玻璃体样本中的淋巴细胞。外周血也从每个病人和分析比较与玻璃体samples.Main结果Measures：玻璃体和外周血T淋巴细胞的CD 4/CD 8比值。结果：CD 4/CD 8比值的玻璃体T淋巴细胞显着高于眼结节病比非结节病玻璃体样品。眼结节病患者玻璃体T淋巴细胞的CD 4/CD 8比值明显高于外周血T淋巴细胞的CD 4/CD 8比值。非结节病患者玻璃体和外周血T淋巴细胞的CD 4/CD 8比值无显著性差异。眼结节病患者外周血T淋巴细胞CD_4/CD_8比值明显高于非结节病患者。结论：玻璃体浸润淋巴细胞的CD 4/CD 8比值对眼结节病的诊断具有较高的价值，与BAL液淋巴细胞增多症的CD 4/CD 8比值对肺结节病的诊断价值相当。外周血T淋巴细胞CD 4/CD 8比值升高应作为眼结节病的实验室检查指标之一。诊断性玻璃体切除术使用流式细胞仪分析可能是一个有用的辅助诊断眼结节病，特别是在复杂的cases.Financial披露（S）：作者（S）没有专有或商业利益的任何材料在这篇文章中讨论。Ophthalmology 2012;119：2386-2392（C）2012，美国眼科学会。
Purpose: Sarcoidosis is an idiopathic inflammatory disorder involving multiple organs, and ocular manifestation (represented by granulomatous uveitis) is one of the common features. A well-known immunologic feature in sarcoidosis is an increased CD4+ helper T-cell type 1 lymphocyte subset in bronchoalveolar lavage (BAL) fluid. The current study investigated the vitreous lymphocyte subsets of ocular sarcoidosis to elucidate the immunologic features of this disorder in the eye.Design: Case-control study.Participants and Controls: Fifty-one eyes of 38 patients with ocular sarcoidosis, confirmed by international diagnostic criteria, were enrolled in this study. Twenty-seven eyes of 26 patients with other causes of uveitis were enrolled as nonsarcoid controls.Methods: Evaluation of diagnostic tests for cell profiles of ocular sarcoidosis. Lymphocytes in the vitreous samples were analyzed by cytology, polymerase chain reaction, and flow cytometry. Peripheral blood was also obtained from each patient and analyzed in comparison with the vitreous samples.Main Outcome Measures: CD4/CD8 ratios of vitreal and peripheral T lymphocytes.Results: CD4/CD8 ratios of the vitreous T lymphocytes were significantly higher in ocular sarcoidosis than in nonsarcoidosis vitreous samples. In the patients with ocular sarcoidosis, the CD4/CD8 ratios of vitreal T lymphocytes were significantly higher than the CD4/CD8 ratios of peripheral T lymphocytes. No significant differences were found between the CD4/CD8 ratios of vitreal and peripheral T lymphocytes in the patients without sarcoidosis. Moreover, the CD4/CD8 ratios of peripheral T lymphocytes in the patients with ocular sarcoidosis were significantly higher than in patients without sarcoidosis. The sensitivity and specificity of the vitreal CD4/CD8 ratio were 100% and 96.3%, respectively, for the diagnosis of ocular sarcoidosis.Conclusions: Our findings suggest that the CD4/CD8 ratio of vitreous-infiltrating lymphocytes has high diagnostic value in ocular sarcoidosis, comparable to that of the CD4/CD8 ratio in BAL fluid lymphocytosis for pulmonary sarcoidosis. Furthermore, a high CD4/CD8 ratio of peripheral blood T lymphocytes should be one of the laboratory findings for ocular sarcoidosis. Diagnostic vitrectomy using flow cytometric analysis may be a useful adjunct for the diagnosis of ocular sarcoidosis, particularly in complex cases.Financial Disclosure(s): The author(s) have no proprietary or commercial interest in any materials discussed in this article. Ophthalmology 2012;119: 2386-2392 (C) 2012 by the American Academy of Ophthalmology.