Abstract
Immunological competence in sarcoidosis was measured by in vivo and in vitro immunological testing of eighteen subjects who had never been treated with prednisone, and eleven subjects treated with prednisone. Three of the latter group had been studied before steroid therapy. Cutaneous delayed hypersensitivity was assessed by intradermal skin testing with five antigens. Thymus-derived `T' lymphocytes and bone marrow-derived `B' lymphocytes were enumerated and the ability of lymphocytes to respond to stimulation with phytohaemagglutinin (PHA), Candida albicans and allogeneic irradiated lymphocytes (mixed lymphocyte reaction) was measured and compared to results obtained with lymphocytes from healthy subjects.
The non-steroid-treated and the steroid-treated groups did not respond as well as a control group to intradermal challenge. The responses of lymphocytes from patients with untreated sarcoidosis to PHA and Candida albicans was normal but the response to allogeneic lymphocytes was reduced. In comparison stimulation indices for lymphocytes from the group who were receiving steroids were significantly reduced, with eight of eleven individuals having abnormal responses. Significant reduction in T lymphocytes was observed in only three of eleven of the non-steroid-treated subjects and five of ten of the steroid-treated subjects that were studied.
Studies on patients before and after steroid therapy suggest that steroid therapy and not sarcoidosis was responsible for the poorer responses of the steroid-treated group. The most striking finding of this study was the marked disparity between the cutaneous reactivity to Candida albicans, which was abnormal, and the in vitro lymphocyte response to this antigen which was normal. This suggests that the anergy of sarcoidosis cannot be attributed to an inherent lymphocyte dysfunction or to a depletion of these cells.
Full text
PDF












Selected References
These references are in PubMed. This may not be the complete list of references from this article.
- AISENBERG A. C. Studies on delayed hypersensitivity in Hodgkin's disease. J Clin Invest. 1962 Nov;41:1964–1970. doi: 10.1172/JCI104654. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Bankhurst A. D., Warner N. L. Surface immunoglobulins on mouse lymphoid cells. J Immunol. 1971 Aug;107(2):368–373. [PubMed] [Google Scholar]
- Buckley C. E., 3rd, Nagaya H., Sieker H. O. Altered immunologic activity in sarcoidosis. Ann Intern Med. 1966 Mar;64(3):508–520. doi: 10.7326/0003-4819-64-3-508. [DOI] [PubMed] [Google Scholar]
- Buckley C. E., 3rd, Zitt M. J., Cate T. R. Two categories of lymphocyte unresponsiveness to phytohemagglutinin. Cell Immunol. 1973 Jan;6(1):140–148. doi: 10.1016/0008-8749(73)90014-2. [DOI] [PubMed] [Google Scholar]
- CITRON K. M. Skin tests in sarcoidosis. Tubercle. 1957 Feb;38(1):33–41. doi: 10.1016/s0041-3879(57)80069-5. [DOI] [PubMed] [Google Scholar]
- Dwyer J. M., Bullock W. E., Fields J. P. Disturbance of the blood T:B lymphocyte ratio in lepromatous leprosy. Clinical and immunologic correlations. N Engl J Med. 1973 May 17;288(20):1036–1039. doi: 10.1056/NEJM197305172882002. [DOI] [PubMed] [Google Scholar]
- Dwyer J. M., Mackay I. R. Antigen-binding lymphocytes in human blood. Lancet. 1970 Jan 24;1(7639):164–167. doi: 10.1016/s0140-6736(70)90406-x. [DOI] [PubMed] [Google Scholar]
- Girard J. P., Poupon M. F., Press P. Culture of peripheral blood lymphocytes from sarcoidosis; response to mitogenic factor. Int Arch Allergy Appl Immunol. 1971;41(4):604–619. doi: 10.1159/000230553. [DOI] [PubMed] [Google Scholar]
- Gross N. J. The paradoxical skin response in sarcoidosis. A hypothesis. Am Rev Respir Dis. 1973 May;107(5):798–801. doi: 10.1164/arrd.1973.107.5.798. [DOI] [PubMed] [Google Scholar]
- HIRSCHHORN K., SCHREIBMAN R. R., BACH F. H., SILTZBACH L. E. IN-VITRO STUDIES OF LYMPHOCYTES FROM PATIENTS WITH SARCOIDOSIS AND LYMPHOPROLIFERATIVE DISEASES. Lancet. 1964 Oct 17;2(7364):842–843. doi: 10.1016/s0140-6736(64)90691-9. [DOI] [PubMed] [Google Scholar]
- Jondal M., Holm G., Wigzell H. Surface markers on human T and B lymphocytes. I. A large population of lymphocytes forming nonimmune rosettes with sheep red blood cells. J Exp Med. 1972 Aug 1;136(2):207–215. doi: 10.1084/jem.136.2.207. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Kurti V., Mankiewicz E. In vitro study of macrophages from patients with sarcoidosis. Can Med Assoc J. 1972 Sep 23;107(6):509–515. [PMC free article] [PubMed] [Google Scholar]
- Mangi R. J., Dwyer J. M., Kantor F. S. The effect of plasma upon lymphocyte response in vitro. Demonstration of a humoral inhibitor in patients with sarcoidosis. Clin Exp Immunol. 1974 Dec;18(4):519–528. [PMC free article] [PubMed] [Google Scholar]
- Mangi R. J., Mardiney M. R., Jr Purification of human lymphocytes by simple centrifugation. Rev Eur Etud Clin Biol. 1970 Oct;15(8):911–912. [PubMed] [Google Scholar]
- Mangi R. J., Mardiney M. R., Jr The in vitro transformation of frozen-stored lymphocytes in the mixed lymphocyte reaction and in culture with phytohemagglutinin and specific antigens. J Exp Med. 1970 Sep 1;132(3):401–416. doi: 10.1084/jem.132.3.401. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Miller J. F., Osoba D. Current concepts of the immunological function of the thymus. Physiol Rev. 1967 Jul;47(3):437–520. doi: 10.1152/physrev.1967.47.3.437. [DOI] [PubMed] [Google Scholar]
- Mitchell G. F., Miller J. F. Immunological activity of thymus and thoracic-duct lymphocytes. Proc Natl Acad Sci U S A. 1968 Jan;59(1):296–303. doi: 10.1073/pnas.59.1.296. [DOI] [PMC free article] [PubMed] [Google Scholar]
- PYKE D. A., SCADDING J. G. Effect of cortisone upon skin sensitivity to tuberculin in sarcoidosis. Br Med J. 1952 Nov 22;2(4794):1126–1128. doi: 10.1136/bmj.2.4794.1126. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Papamichail M., Brown J. C., Holborow E. J. Immunoglobulins on the surface of human lymphocytes. Lancet. 1971 Oct 16;2(7729):850–852. doi: 10.1016/s0140-6736(71)90224-8. [DOI] [PubMed] [Google Scholar]
- Pascual R. S., Gee J. B., Finch S. C. Usefulness of serum lysozyme measurement in diagnosis and evaluation of sarcoidosis. N Engl J Med. 1973 Nov 15;289(20):1074–1076. doi: 10.1056/NEJM197311152892007. [DOI] [PubMed] [Google Scholar]
- Roitt I. M., Greaves M. F., Torrigiani G., Brostoff J., Playfair J. H. The cellular basis of immunological responses. A synthesis of some current views. Lancet. 1969 Aug 16;2(7616):367–371. doi: 10.1016/s0140-6736(69)92712-3. [DOI] [PubMed] [Google Scholar]
- SONES M., ISRAEL H. L. Altered immunologic reactions in sarcoidosis. Ann Intern Med. 1954 Feb;40(2):260–268. doi: 10.7326/0003-4819-40-2-260. [DOI] [PubMed] [Google Scholar]
- URBACH F., SONES M., ISRAEL H. L. Passive transfer of tuberculin sensitivity to patients with sarcoidosis. N Engl J Med. 1952 Nov 30;247(21):794–797. doi: 10.1056/NEJM195211202472103. [DOI] [PubMed] [Google Scholar]