Bronchoalveolar cell populations in acute sarcoidosis. Observations in smoking and nonsmoking patients

Bronchoalveolar cells were obtained by segmental lung lavage from 14 patients with sarcoidosis and studied to determine changes in composition associated with acute disease and smoking history. In nonsmoking patients, both the proportion and number of lymphocytes recovered were significantly increased compared to nonsmoking controls (p less than 0.001 in both cases). Furthermore, the number of T cells was increased (4.19 +/- 0.72 vs. 0.896 +/- 0.107 x 10(6) cells/100 ml, p less than 0.001), and activated T cells were also increased (1.04 +/- 0.478 vs. 0.148 +/- 0.032 x 10(6) cells/100 ml, p less than 0.01). Less striking differences in these values were found when smoking sarcoid patients were compared to smoking controls, but there were no significant differences in these values for smoking and nonsmoking patients (p greater than 0.05). Thus acute sarcoidosis in both smoking and nonsmoking patients appears to be associated with a lymphocytosis of the bronchoalveolar space which results from increased numbers of T cells and activated T cells. The potential importance of this finding with regard to diagnosis and pathogenesis is discussed.