Open AccessTumor necrosis factor-alpha and CD4/CD8 ratio in patients with hypersensitivity pneumonitis
Author(s) -
Alaa Rashad,
Asmaa Nafady,
Mona Atia,
Ahmed Khair
Publication year - 2016
Publication title -
egyptian journal of chest diseases and tuberculosis/egyptian journal of chest diseases and tuberculosis
Language(s) - English
Resource type - Journals
eISSN - 2090-9950
pISSN - 0422-7638
DOI - 10.1016/j.ejcdt.2016.03.005
Subject(s) - medicine , hypersensitivity pneumonitis , cd8 , gastroenterology , alpha (finance) , tumor necrosis factor alpha , lung , immunology , pathology , endocrinology , antigen , surgery , construct validity , patient satisfaction
Hypersensitivity pneumonitis (HP) is an immunologically induced lung disease caused by inhalation of a variety of environmental agents. HP is not a uniform disease but rather a complex syndrome characterized by varying intensities of responsiveness to different antigens leading to an immunopathology with variable clinical presentation and natural history. We studied the association between serum TNF-alpha and CD4/CD8 ratio with chest computed tomography findings and steroid responsiveness.MethodsThe study included 46 patients with chronic hypersensitivity pneumonitis, 22 (47.8%) male and 24 (52.8%) female. mean age 49±8years. All patients underwent high resolution chest computed tomography, TNF-alpha ELIZA assay, and cd3, cd4, cd8, CD4/CD8 by flow cytometry.ResultsThe TNF-alpha level was (mean±SD) 299±427pg/ml, CD4/CD8 ratio (84±36). With regard to steroid responsiveness (26) 57% patients were steroid responders while 20 (43%) were non-responders.TNF-alpha level was significantly lower in patients with predominant ground glass in their chest computed tomography (p=0.014), however CD3, CD4, CD8, CD4/CD8 levels showed insignificant differences between patients with ground glass and those with fibrosis in their chest computed tomography.Finally, TNF-alpha level was significantly lower in patients with good steroid response (p=0.014), on the other hand CD4/CD8 ratio was significantly higher in those with good steroid response (P=0.011).ConclusionLow TNF-alpha and high CD4/CD8 ratio could be used as a predictor of steroid responsiveness in CHP patients