Figure 4

Bronchoalveolar lavage fluid (BALF) protein levels of chemokine (C-C motif) ligand 2 (CCL2) from patients with sarcoidosis were elevated as compared to normal healthy controls. BALF protein levels of CCL2 by enzyme-linked immunosorbent assay (ELISA) from (a) all sarcoidosis patients (n = 72) compared with normal healthy volunteers (n = 8), (b) different stages of sarcoidosis (stage I (n = 27), stage II (n = 36) and stage III (n = 9)), (c) sarcoid patients with (n = 27) and without (n = 45) alveolitis, and (d) sarcoidosis patients with (n = 8) and without (n = 64) empirical treatment at the time of diagnosis. *P = 0.001 for sarcoid versus normal; **P < 0.004 for stage I, II, and III verses normal; ***P < 0.004 for with or without alveolitis versus normal; ****P < 0.01 for with or without treatment verses normal. Representative immunohistochemistry for (e) CCL2 and (f) isotype control antibody on lung biopsy tissue from stage I pulmonary sarcoidosis without alveolitis and on empiric therapy. CCL2 protein expression was found in epithelioid histiocytes and multinucleated giant cells forming non-necrotizing granulomas, as well as from surrounding alveolar macrophages and other infiltrating mononuclear cells. Panels were photographed at 50 × original magnification.