Tumor necrosis factor-alpha and CD4/CD8 ratio in patients with hypersensitivity pneumonitis

• Main Authors: Alaa Rashad, Asmaa Nafady, Madlin Atia, Ahmed Khair
• Format: Article
• Language: English
• Published: Wolters Kluwer Medknow Publications 2016-07-01
• Series: Egyptian Journal of Chest Disease and Tuberculosis
• Subjects: Interstitial lung disease; Follow-up; Prognosis
• Online Access: http://www.sciencedirect.com/science/article/pii/S0422763816300279

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. Methods: The study included 46 patients with chronic hypersensitivity pneumonitis, 22 (47.8%) male and 24 (52.8%) female. mean age 49 ± 8 years. All patients underwent high resolution chest computed tomography, TNF-alpha ELIZA assay, and cd3, cd4, cd8, CD4/CD8 by flow cytometry. Results: The TNF-alpha level was (mean ± SD) 299 ± 427 pg/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). Conclusion: Low TNF-alpha and high CD4/CD8 ratio could be used as a predictor of steroid responsiveness in CHP patients.