By means of 2-color analysis, we investigated the lymphocyte subpopulation of bronchoalveolar lavage fluid (BALF) and peripheral blood (PB) of 13 patients with pulmonary sarcoidosis. The BALF-CD4+ T cells of normal subjects and patients with sarcoidosis consisted almost completely of CD4+4B4+ cells (helper inducer T cells) and BALF-CD8+ T cells were almost completely composed of CD8+CD11- cells (cytotoxic T cells). The BALF findings of sarcoidosis were characterized by increased percentages of CD4+4B4+ cells (54.9 +/- 15.7%), decreased percentage of CD8+CD11- cells (12.0 +/- 8.4%) and increased percentage of CD4+HLA-DR+ cells (27.8 +/- 13.1%). These findings suggest that activated CD4+4B4+ cells (helper inducer T cells) may primarily contribute to the pathogenesis of pulmonary sarcoidosis. The in vivo or in vitro functions of CD4+4B4+ cells in sarcoidosis need further investigation.

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