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Enlarged, activated alveolar macrophages as quantitative surrogates of disease activity in pulmonary sarcoidosis
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Enlarged, activated alveolar macrophages as quantitative surrogates of disease activity in pulmonary sarcoidosis
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Journal Article
Enlarged, activated alveolar macrophages as quantitative surrogates of disease activity in pulmonary sarcoidosis
2026
Overview
In pulmonary sarcoidosis, alveolar macrophages (AMs) undergo epithelioid transformation, but their quantitative morphologic characteristics and association with systemic disease markers remain incompletely defined.
Do enlargement and activation features of AMs in bronchoalveolar lavage (BAL) samples correlate with systemic markers of sarcoidosis activity (ACE and sIL-2R)?
BAL cells from 16 biopsy-confirmed sarcoidosis cases and 4 healthy controls were cytocentrifuged, Diff-Quik®-stained, and analyzed using a digital planimetric microscope. Cell area (CA) of 50 randomly selected AMs per subject (total = 1,000) was quantified and categorized as small, medium, large, or extra-large based on control mean ± SD cutoffs. Nonparametric tests and principal component analysis (PCA) were applied to examine associations among CA, morphological features, serum ACE, and sIL-2R.
The mean CA was 31% greater in sarcoidosis than in controls (368.2 ± 169.3 μm
vs. 281.4 ± 90.9 μm
;
< 0.001), with higher proportions of large/extra-large AMs (41% vs. 14%;
< 0.001). Vacuolation, rosette formation, and membrane ruffling were hallmarks of AM activation, correlating strongly with serum ACE and sIL-2R but not with the BALF CD4/CD8 ratio.
AM enlargement and activation features are quantitative, reproducible surrogates of disease activity in pulmonary sarcoidosis. Clinical implications: Quantitative assessment of alveolar macrophage morphology may aid in assessment and monitoring of sarcoidosis activity and treatment response.
Publisher
Frontiers Media SA,Frontiers Media S.A
Subject
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