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Mediators of Inflammation
Volume 2014, Article ID 438070, 9 pages
Research Article

Bronchoalveolar Lavage Fluid IFN- Th17 Cells and Regulatory T Cells in Pulmonary Sarcoidosis

1Department of Thoracic Medicine, St. Olavs University Hospital, Postboks 3250 Sluppen, 7006 Trondheim, Norway
2Department of Immunology and Transfusion Medicine, St. Olavs University Hospital, 7006 Trondheim, Norway
3Department of Cancer Research and Molecular Medicine, Norwegian University of Science and Technology, 7489 Trondheim, Norway
4Department of Laboratory Medicine, Children’s and Women’s Health, Norwegian University of Science and Technology, 7489 Trondheim, Norway
5Department of Circulation and Imaging, Norwegian University of Science and Technology, 7489 Trondheim, Norway

Received 26 January 2014; Accepted 9 April 2014; Published 5 May 2014

Academic Editor: Teresa Zelante

Copyright © 2014 Anders Tøndell et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


In sarcoidosis, increased Th17 cell fractions have been reported in bronchoalveolar lavage fluid, and elevated numbers of Th17 cells producing IFN-γ have been observed in peripheral blood. The balance between Th1, Th17, and FoxP3+ CD4+ T cell subsets in sarcoidosis remains unclear. Bronchoalveolar lavage fluid cells, from 30 patients with sarcoidosis, 18 patients with other diffuse parenchymal lung diseases, and 15 healthy controls, were investigated with flow cytometry for intracellular expression of FoxP3. In a subset of the patients, expression of the cytokines IL17A and IFN-γ was investigated. The fractions of FoxP3+ CD4+ T cells and Th17 cells were both lower in sarcoidosis compared to controls ( and , resp.). The proportion of Th17 cells positive for IFN-γ was greater in sarcoidosis than controls (median 72.4% versus 31%, ) and increased with radiologic stage ( , , and ). IFN-γ+ Th17 cells were highly correlated with Th1 cells ( , , and ), and the ratio of IFN-γ+ Th17/FoxP3+ CD4+ T cells was prominently increased in sarcoidosis. IFN-γ+ Th17 cells may represent a pathogenic subset of Th17 cells, yet their expression of IFN-γ could be a consequence of a Th1-polarized cytokine milieu. Our results indicate a possible immune cell imbalance in sarcoidosis.