BAL AND SERUM MARKERS FOR DISEASE ACTIVITY IN SARCOIDOSIS

这项正在进行的研究的目的是确定 患者灌洗液（BALF）和血清，其与 肺结节病的疾病活动，可用于 预测未经治疗的患者的病程，并监测对 在接受治疗的患者中进行治疗。 为此将 有两个方面 首先，选定的变量，测量BALF和 血清，将与接受 在两次评价之间的间隔期间不使用皮质类固醇。 第二，患者，无论是治疗和未治疗，将研究 重复支气管肺泡灌洗（3-5支气管肺泡灌洗，6个月。间隔）， 确定哪些变量恢复正常的患者， 显示临床改善，且保持或变得异常 病情恶化或无法改善的患者。 推定标记 将被评估的疾病活动包括细胞变量 （总数、种类、亚群、活力）和可溶性蛋白 组分（免疫球蛋白、急性期反应物、介质）。 将使用单克隆抗体鉴定细胞类型和亚群。 表面标记的抗体。 蛋白质将通过 针对单特异性抗体的放射状免疫扩散。 将在成纤维细胞增殖的生物测定中定量介体。 我们的目的是确定非常具体的标记， 间质性肺病的肺泡化和纤维化阶段，以及 分离出那些化学和细胞变化， 与修复相关的损伤。 的 人口因素在确定自然资源中的作用 疾病的历史将被评估内和之间的 北卡罗来纳州和佛蒙特州的患者群体。

It is the objective of this ongoing study to identify variables in patient lavage fluid (BALF) and serum which are correlated with disease activity in pulmonary sarcoidosis, which can be used to predict course in the untreated patient and monitor response to therapy in the patient who receives treatment. This will be done in two ways. First, selected variables, measured in BALF and in serum, will be matched with clinical course in patients receiving no corticosteroids during an interval between evaluations. Second, patients, both treated and untreated, will be studied by repeat bronchoalveolar lavage (3-5 BAL, at 6 mo. intervals) to determine which variables return to normal in those patients who show clinical improvement, and which remain or become abnormal in patients who deteriorate or fail to improve. Putative markers of disease activity which will be evaluated include cell variables (total numbers, kinds, subsets, viability) and soluble protein components (immunoglobulins, acute phase reactants, mediators). Cell types and subsets will be identified using monoclonal antibodies for surface markers. Proteins will be measured by radial immunodiffusion against monospecific antibodies. Mediators will quantitated in bioassay for fibroblast proliferation. Our purpose is to identify very specific markers for both the alveolitic and fibrotic phases of interstitial lung disease, and to separate out those chemical and cellular changes which are associated with injury from those associated with repair. The contribution of demographic factors in determining the natural history of the disease will be evaluated within and between the North Carolina and Vermont patient groups.