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Background  Activated T helper (Th)-1 pulmonary CD4 +  cells and their mediators are essential for the inflammation and granulomatous process in sarcoidosis. Recently, T-cell immunoglobulin and mucin domain (TIM) molecules were suggested to be important regulators of immune function. In this study, we wanted to investigate whether TIM molecules could play a role in sarcoidosis.    Methods  We used real-time polymerase chain reaction to investigate the differential gene expression of TIM-1 and TIM-3 as well as a few Th1 and Th2 cytokines (IL-2, IFN-γ, IL-4, IL-5 and IL-13) in CD4 +  T cells isolated from bronchoalveolar lavage fluid (BALF) of patients  (n = 28)  and healthy controls  (n = 8) . Using flow cytometry, we were also able to analyse TIM-3 protein expression in 10 patients and 6 healthy controls.    Results  A decreased TIM-3 mRNA  (p < 0.05)  and protein  (p < 0.05)  expression was observed in patients, and the level of TIM-3 mRNA correlated negatively with the CD4/CD8 T cell ratio in BALF cells of patients. Compared to a distinct subgroup of patients i.e. those with Löfgren's syndrome, BALF CD4 +  T cells from non- Löfgren's patients expressed decreased mRNA levels of TIM-1  (p < 0.05) . mRNA expression of IL-2 was increased in patients  (p < 0.01)  and non-Löfgren's patients expressed significantly higher levels of IFN-γ mRNA  (p < 0.05 ) versus patients with Löfgren's syndrome.    Conclusion  These findings are the first data on the expression of TIM-1 and TIM-3 molecules in sarcoidosis. The reduced TIM-3 expression in the lungs of patients may result in a defective T cell ability to control the Th1 immune response and could thus contribute to the pathogenesis of sarcoidosis. The down-regulated TIM-1 expression in non-Löfgren'spatients is in agreement with an exaggerated Th1 response in these patients.

Altered expression of T cell Immunoglobulin-Mucin (TIM) molecules in bronchoalveolar lavage CD4+ T cells in sarcoidosis