Zishan Allibhai

An earlier study demonstrated a significantly decreased level of CD103+CD4+/CD4+ in radiographic stage I sarcoidosis compared with healthy controls and significantly elevated levels in radiographic stage II/III sarcoidosis [5].We found no significant differences in CD103+CD4+/CD4+ levels between the two radiographically staged groups in our study.s-ACE is an important marker of sarcoidosis with high sensitivity but low specificity.A polymorphism in the ACE gene affects normal s-ACE concentration [8].A homozygotic deletion in the promoter resulted in high levels of s-ACE (59.8 versus 32.2 U?L -1 for the homozygous insertion allele; p,0.0001) in a north German population [8].Screening for this polymorphism is not common practice; however, the use of genotype-corrected normal ranges may increase the value of this parameter in the diagnosis and follow-up of sarcoidosis.The combinations of CD103+CD4+/CD4+, CD4+/CD8+ and lymphocyte percentages that were tested in this study showed limited diagnostic value in this unselected group of sarcoidosis patients.Previously proposed criteria based on combinations of CD103+CD4+/CD4+ and CD4+/CD8+ had a lower sensitivity in this study than previously reported.s-ACE is an established marker of sarcoidosis and is the most useful of the markers that were investigated in this study.Sarcoidosis is a disease with several phenotypes, which complicates the search for useful diagnostic markers.There remains an unmet need for new improved methods to support diagnosis when there is suspicion of sarcoidosis.