Prognostic Assessment of the Inflammatory Process Activity in Sarcoidosis of Respiratory Organs: Potential Use of C-reactive Protein and TNF-α

  • Mykola Ostrovskyy Ivano-Frankivsk National Medical University
  • Kostiantyn Shvets Ivano-Frankivsk National Medical University
Keywords: sarcoidosis, activity criteria, prognosis


This research work is devoted to the development of new additional criteria for the activity of inflammatory process in sarcoidosis of respiratory organs. The objective is to assess the effectiveness of performed treatment of sarcoidosis of respiratory organs by using low-cost highly-sensitive inflammatory markers.

Materials and methods. The study involved 68 patients with lung sarcoidosis before and after the three-month treatment. In addition to general-clinical methods of examination, patients with sarcoidosis were also determined the levels of TNF-α and СRP.

Results and their discussion. Patients with active lung sarcoidosis had 17.6 times (p<0.05) increased level of CRP in bronchoalveolar lavage fluid and 9.0 times (p<0.05) increased levels in peripheral blood serum; the levels of TNF-α increased by 4.98 times (p<0.05) in bronchoalveolar lavage fluid and by 3.2 times (p<0.05) in peripheral blood serum as compared to the findings in the control group of patients. The study showed that in the group of patients, where the efficacy of the prescribed therapy was noted, the level of CRP decreased by 2.76 times (p<0.05) in bronchoalveolar lavage fluid and by 2.58 times (p<0.05) in peripheral blood serum, and the concentration of TNF-α decreased by 3.87 times (p<0.05) in bronchoalveolar lavage fluid and by 2.06 times in peripheral blood serum as compared to the initial indices.

Conclusions. The decrease of TNF-α level in bronchoalveolar lavage fluid on the background of three-months treatment correlated (r=0.89; p<0.05) to the changes in peripheral blood serum; at the same time the decrease of TNF-α level in peripheral blood serum correlated (r=0.82; p<0.05) to the decrease of CRP in peripheral blood serum of patients with sarcoidosis of respiratory organs. 


Ahmadzai H, Loke WSJ, Huang S et al. Biomarkers in sarcoidosis: a review. Dove Medical Press. 2014; 4: 93-106. DOI:

ATS/ERS/WASOG Committee. Statement on Sarcoidosis. Sarcoidosis Vasc Diffuse Lung Dis 1999; 16: 149-173. [PMid:10560120]

Baughman RP, Nunes H, Sweiss NJ et al. Established and experimental medical therapy of pulmonary sarcoidosis. European Respiratory Journal. 2013; 41: 1424-1438. DOI: [PMid:23397302]

Baughman RP, Culver DA, Judson MA. A concise review of pulmonary sarcoidosis. Am J Respir Crit Care Med. 2011; 183(5): 573-581. DOI: [PMid:21037016 PMCid:PMC3081278]

Costabel U. Sarcoidosis: clinical update. European Respiratory Journal. 2001; 18: 56-68.

Feshchenko YI, Protsyk LM, Cherednyk YO. Sarcoidosis of respirotary organs: present state of the problem: Ukr. Pulmonol. J. 2006; 3: 5-10.

Gavrysyuk VK. Pulmonary Sarcoidosis. Health of Ukr. 2010; 2: 29-31.

Gavrysyuk VK. Pulmonary sarcoidosis: epidemiology, clinical forms and stages, results of treatment: Health of Ukr. 2014; 1(25): 32-33.

Mannino DM, Ford ES, Redd SC: Obstructive and restrictive lung disease and markers of inflammation: Data from the Third National Health and Nutrition Examination. Am J Med 2003; 114: 758-762. DOI:

Meyer KC, Raghu G. Bronchoalveolar lavage for the evaluation of interstitial lung disease: is it clinically useful? European Respiratory Journal. 2011; 38: 761-769. DOI: [PMid:21540304]

Pepys MB, Hirschfield GM. C-reactive protein: a critical update. J Clin Invest. 2003;111: 1805-1812. DOI:

Sweiss NJ, Curran J, Baughman RP. Sarcoidosis, role of tumor necrosis factor inhibitors and other biologic agents, past, present, and future concepts. Clin Dermatol. 2007; 25: 341-346. DOI: [PMid:17560312]

Sahoo DH, Bandyopadhyay D, Xu M, Pearson K et al. Effectiveness and safety of leflunomide for pulmonary and extrapulmonary sarcoidosis. European Respiratory Journal. 2011; 38: 1145-1150. DOI: [PMid:21565914]

Takahashi T, Azuma F, Abe S et al. Significance of lymphocytosis in bronchoalveolar lavage in suspected ocular sarcoidosis. European Respiratory Journal. 2001; 18: 515-521. DOI: [PMid:11589349]

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