Conclusions
In conclusion, we observed a significant decrease in CD4/CD8 ratio,
percentage of CD4+ T-cells expressing the activation marker CD69 and
number of mast cells in patients responding to six months infliximab
therapy. Also our results indicate that the percentage of
Tregs decrease in most patients irrespective of
response.
Given the knowledge that T-cells and mast cells may interact and
propagate inflammatory processes, we speculate that the T-cell
alveolitis and Treg dysfunction in sarcoidosis may lead
to activation of mast cells further promoting the inflammation.
Infliximab treatment seems to interfere in this process in a positive
way reflected by less pronounced chest radiographic changes and improved
lung function. In future studies, as we continue to collect patient
data, we need to study these cells more in detail to gain knowledge in
what way they contribute to the sarcoid inflammation, which also may
have implications for altered therapy with regard to optimal dose,
treatment interval and duration.