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The following is a summary of “Predictive role of natural killer cells in bronchoalveolar lavage fluid of patients with sarcoidosis,” published in the January 2024 issue of Pulmonology by Bergantini et al.
Sarcoidosis, a granulomatous disease of uncertain origin, falls within the spectrum of interstitial lung diseases. Despite debates about its limitations, bronchoalveolar lavage (BAL) fluid remains a valuable matrix for investigating sarcoidosis pathogenesis. Natural killer (NK) cells, identified in BAL fluid of sarcoidosis patients, have been associated with adverse outcomes. This study aimed to assess NK cells in BAL samples from sarcoidosis patients at diagnosis and correlate them with clinical features to determine their prognostic significance. Among 276 patients clinically suspected of sarcoidosis, 248 received a definitive diagnosis.
Clinical parameters, Scadding stage, and extrapulmonary involvement were recorded. Fibrotic sarcoidosis patients exhibited elevated lymphocyte percentages in BAL samples, particularly NK cells, compared to other groups. Receiver operating characteristic (ROC) analysis identified NK cell percentages as the most effective predictive markers for distinguishing stage 4 sarcoidosis from other radiographic stages (AUC=0.85, p<0.0001). Moreover, patients with more extrapulmonary involvement demonstrated higher NK cell percentages in BAL fluid.
In conclusion, NK cell percentages in BAL fluid serve as a valuable prognostic marker for fibrotic sarcoidosis phenotypes and extrapulmonary organ involvement, albeit with limited diagnostic utility.
Source: sciencedirect.com/science/article/pii/S2531043723002374