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The plasma membrane of the capillary endothelial cells showed that the both a little unclear and unclear or disappeared is 89% (34/38 cases) and control cases 32% (8/25) in the broncho-alveolar tract in the patients with sarcoidosis at the electron microscopic level. The clear plasma membrane in sarcoidosis is 11% (4/38) and control 68% (17/25). Early sarcoidosis cases showed a wide area of defective plasma membrane of the capillary endothelial cells. Realization of the biphasic, crescent figured lipid droplets involving unsaturated fatty acid and lysosomal granules are 38% in frequencies and specific findings for sarcoidosis patients and having no lipid droplets in controls. Dark monophasic (unsaturated) lipid droplets with lysosome showed 25% in sarcoidosis patients, and 0% in controls. We demonstrated that lipid substances originated of swollen mitochondria, we suggested that the above described endothelial plasma membrane defect was mostly responsible for genesis of the lipid droplets with lysosome granules. About findings of the autonomic nerve fibers surrounding capillaries in the main bronchus in sarcoidosis are observed swelling, elongation of myelinated fibers, and demyelinaton. Interestingly, we could to see the same biphasic, crescent figured lipid droplets in the peripheral nerve fibers. This fact suggested that the sources of the lipid droplets are originated from not only the capillary endothelial cell membrane of the respiratory tract, but also broadly capillary endothelial cell in the peripheral nerve in myelin. Our immunohistochemical study in von Willebrand factor 11 exactly suggested that sarcoidosis is disease of the capillaries in meaning of vast extent. PLA2 as a target enzyme act on the membrane phospholipids and degrade the capillary wall, but the changed lysophpspholipids protect oneself against infection, and behave immunosuppression. Stomatin and stomatin-like proteins (SLP-2) locating at the plasma membrane interact with lipid droplets suggesting a role in intracellular lipid transport and suggest important membrane organizing function. Furthermore, SLP-2 associated with the plasma membrane and T cells and an important player in T cell activation, in which sarcoidosis granuloma formation depends on T cell modulation. In conclusively, we detected defect in the plasma membrane of the broncho-alveolar capillary at the ultrastructural level, and following lipid metabolic anomaly introduce a critical change by PLA2 and SLP-2, in which situated in the plasma membrane in sarcoidosis.

journal of infectious pulmonary diseases

Pathogenetic Study from Fine Structure of the Capillary Endothelial Cells in the Sarcoidosis Patients-Defects are Observed in the Plasma Membrane, Lipid Droplets and Peripheral Nerve Fibers involving Hilological Consideration for Phospholipase A2 (PLA2) and Stomatin-like Protein 2 (SLP-2)