Background and Objectives. Sarcoidosis is an inflammatory disease with increased levels of inflammatory cytokines. Previous studies have shown a relation between the degree of granuloma infiltration and serum cytokine levels, except for interleukin- (IL-) 10. The aim of the study was to further investigate the serum levels of IL-10 in patients with sarcoidosis and relate them to fungal exposure in terms of the amount of fungi in the air of their homes and β-glucan in bronchoalveolar lavage (BAL) fluid. Methods. Patients with sarcoidosis ( ) and healthy controls ( ) were enrolled. IL-10 was determined in serum. BAL was performed and the amount of β-glucan was measured. Domestic exposure to fungi was determined by measuring airborne β-N-acetylhexosaminidase (NAHA) in the bedrooms. Results. At high levels of fungal exposure (domestic fungal exposure and β-glucan in BAL), serum IL-10 values were lower than at low and intermediate exposure levels. Conclusion. The low serum IL-10 values at high fungal exposure suggest that fungal cell wall agents play a role in granuloma formation in sarcoidosis by inhibiting the secretion of the anti-inflammatory cytokine IL-10. 1. Introduction Sarcoidosis is an inflammatory disease, often leading to granuloma formation [1, 2]. Several studies demonstrate that the amounts of inflammatory cytokines, particularly interleukin- (IL-) 10 and IL-12, are elevated in serum and in bronchoalveolar lavage fluid [3–6]. Previous studies have demonstrated that exposure to fungi is a risk factor for sarcoidosis [7–9]. One fungal cell wall agent (FCWA)—β-glucan—can induce different changes in the immune system and granulomas, depending on dose and means of administration (review in [10]). The formation of granuloma can be suppressed by IL-10 [11]. Chitin is another FCWA that can induce immune changes, depending on the size of the particles [12]. In in vitro studies on the reactivity of peripheral blood mononuclear cells (PBMC), particulate β-glucan was found to induce the secretion of TNFα, IL-6, IL-10, and IL-12 from PBMC [13] with a higher secretion from PBMC taken from patients with sarcoidosis [14]. A clinical study evaluated the relation between the extent of granuloma infiltration using an x-ray score and the amount of serum TNFα, IL-6, IL-10, IL-12, angiotensin converting enzyme (ACE), and chitotriosidase (CTO) [15]. There was a linear relationship for all inflammatory mediators and markers except for IL-10. For this cytokine, there was an initial increase with an increased X-ray score but the values were lower at the highest X-ray
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