Document Detail

The effect of corticosteroid or methotrexate therapy on lung lymphocytes and macrophages in sarcoidosis.
MedLine Citation:
PMID:  2252243     Owner:  NLM     Status:  MEDLINE    
Methotrexate appears to be an effective alternative to corticosteroid therapy for some patients with sarcoidosis. The mechanism of action of methotrexate as an immunosuppressive is unknown. Patients with symptomatic pulmonary sarcoidosis underwent pulmonary function tests and bronchoscopy with bronchoalveolar lavage. Patients were treated with 10 mg methotrexate or prednisone weekly for at least 6 months and repeat studies were performed. A comparison was made between those patients receiving methotrexate (12 patients) and those receiving prednisone (12 patients). For both groups, there was a significant improvement in the vital capacity with therapy (Prednisone: Pre = 2.5 +/- 0.14 L (Mean +/- SEM); Post = 3.1 +/- 0.18 L, p less than 0.01; Methotrexate: Pre = 2.4 +/- 0.14 L; Post = 2.8 +/- 0.18 L, p less than 0.01). In addition, the percentage of lymphocytes in the lavage fell significantly for both the prednisone (Pre: 30 +/- 3.5%; Post: 16 +/- 2.7%, p less than 0.001) and methotrexate (Pre: 37 +/- 3.4%; Post: 13 +/- 2.9%, p less than 0.001) groups. Alveolar macrophages from the symptomatic sarcoid patients were found to be spontaneously releasing hydrogen peroxide and tumor necrosis factor. After treatment with either prednisone or methotrexate, alveolar macrophages retrieved by lavage spontaneously released less of either macrophage product. We found that effective doses of methotrexate for sarcoidosis led to significant changes in lymphocyte and macrophages retrieved by lavage.
R P Baughman; E E Lower
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Publication Detail:
Type:  Clinical Trial; Comparative Study; Controlled Clinical Trial; Journal Article; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  The American review of respiratory disease     Volume:  142     ISSN:  0003-0805     ISO Abbreviation:  Am. Rev. Respir. Dis.     Publication Date:  1990 Dec 
Date Detail:
Created Date:  1991-01-17     Completed Date:  1991-01-17     Revised Date:  2007-11-14    
Medline Journal Info:
Nlm Unique ID:  0370523     Medline TA:  Am Rev Respir Dis     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1268-71     Citation Subset:  AIM; IM    
Department of Medicine, University of Cincinnati Medical Center, Ohio.
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MeSH Terms
Bronchoalveolar Lavage Fluid / cytology
Lung / pathology
Lung Diseases / diagnosis,  drug therapy*
Lymphocytes / drug effects*
Macrophages / drug effects*
Methotrexate / therapeutic use*
Prednisone / therapeutic use*
Sarcoidosis / diagnosis,  drug therapy*
Vital Capacity
Grant Support
Reg. No./Substance:
53-03-2/Prednisone; 59-05-2/Methotrexate

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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