Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2010 Feb 5;5(2):e9088.
doi: 10.1371/journal.pone.0009088.

Significant CD4, CD8, and CD19 lymphopenia in peripheral blood of sarcoidosis patients correlates with severe disease manifestations

Nadera J Sweiss  1 , Rafah Salloum, Seema Gandhi, Maria-Luisa Alegre, Ray Sawaqed, Maria Badaracco, Kenneth Pursell, David Pitrak, Robert P Baughman, David R Moller, Joe G N Garcia, Timothy B Niewold
Affiliations

Significant CD4, CD8, and CD19 lymphopenia in peripheral blood of sarcoidosis patients correlates with severe disease manifestations

Nadera J Sweiss et al. PLoS One. .

Erratum in

Abstract

Background: Sarcoidosis is a poorly understood chronic inflammatory condition. Infiltration of affected organs by lymphocytes is characteristic of sarcoidosis, however previous reports suggest that circulating lymphocyte counts are low in some patients with the disease. The goal of this study was to evaluate lymphocyte subsets in peripheral blood in a cohort of sarcoidosis patients to determine the prevalence, severity, and clinical features associated with lymphopenia in major lymphocyte subsets.

Methodology/principal findings: Lymphocyte subsets in 28 sarcoid patients were analyzed using flow cytometry to determine the percentage of CD4, CD8, and CD19 positive cells. Greater than 50% of patients had abnormally low CD4, CD8, or CD19 counts (p<4x10(-10)). Lymphopenia was profound in some cases, and five of the patients had absolute CD4 counts below 200. CD4, CD8, and CD19 lymphocyte subset counts were significantly correlated (Spearman's rho 0.57, p = 0.0017), and 10 patients had low counts in all three subsets. Patients with severe organ system involvement including neurologic, cardiac, ocular, and advanced pulmonary disease had lower lymphocyte subset counts as a group than those patients with less severe manifestations (CD4 p = 0.0043, CD8 p = 0.026, CD19 p = 0.033). No significant relationships were observed between various medical therapies and lymphocyte counts, and lymphopenia was present in patients who were not receiving any medical therapy.

Conclusions/significance: Significant lymphopenia involving CD4, CD8, and CD19 positive cells was common in sarcoidosis patients and correlated with disease severity. Our findings suggest that lymphopenia relates more to disease pathology than medical treatment.

PubMed Disclaimer

Conflict of interest statement

Competing Interests: The commercial funders, BMS, Genentech and Abbott, supported clinical trial research in sarcoidosis to use novel therapies. It did not support the work in this manuscript and does not alter adherence to PloS One polices. The authors have no financial conflicts of interest.

Figures

Figure 1
Figure 1. Absolute counts and correlation between CD4, CD8, and CD19 lymphocytes in sarcoidosis.
A) Peripheral blood lymphocyte measurements show that 16 patients (57%) had lower than normal CD4 counts, 15 patients (54%) had lower than normal CD8 counts, and 15 patients (54%) had lower than normal CD19 counts. The box indicates the normal range for cell counts (95% of normal control subjects fell within this normal range) (p<4×10−10). B) Correlation between lymphocyte counts in sarcoidosis patients. CD4∶CD8 correlation shown in purple, and CD4∶CD19 shown in blue, with Spearman's rho and p-value indicated for each correlation.
Figure 2
Figure 2. Lymphocyte counts in patients with severe organ system involvement vs. those without severe organ system involvement.
Severe organ system involvement is defined as outlined in the methods.
See this image and copyright information in PMC

References

    1. Noor A, Knox KS. Immunopathogenesis of sarcoidosis. Clin Dermatol. 2007;25:250–258. - PubMed
    1. Zissel G, Prasse A, Muller-Quernheim J. Sarcoidosis–immunopathogenetic concepts. Semin Respir Crit Care Med. 2007;28:3–14. - PubMed
    1. Gerke AK, Hunninghake G. The immunology of sarcoidosis. Clin Chest Med. 2008;29:379–390, vii. - PubMed
    1. Hedfors E, Holm G, Pettersson D. Lymphocyte subpopulations in sarcoidosis. Clin Exp Immunol. 1974;17:219–226. - PMC - PubMed
    1. Lower EE, Smith JT, Martelo OJ, Baughman RP. The anemia of sarcoidosis. Sarcoidosis. 1988;5:51–55. - PubMed

Publication types