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However, the mechanisms behind PB lymphopenia and its correlation with TNF-\u03b1 levels remain unclear. Understanding the connections among PB lymphocyte subsets, TNF-\u03b1 and clinical phenotype including treatment status could offer insights into how to individualize therapy.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods<\/jats:title>\n            <jats:p>PB samples from 65 consecutive sarcoidosis patients were collected at the Department of Respiratory Medicine, Karolinska University Hospital. Total lymphocyte, T-, B- and natural killer cell and TNF-\u03b1 serum concentrations were measured and correlated to clinical parameters. Penias were defined as values below the lower limit of normal. The medical charts were retrospectively searched for the first PB total lymphocyte count, mostly recorded at time around diagnosis.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>PB total lymphopenia was observed in 35% of patients, was present since time around diagnosis, and associated with a need for treatment later (<jats:italic>p<\/jats:italic>\u2009=\u20090.005). Lymphocyte counts did not change by therapy, except for an increase in patients receiving TNF-\u03b1 inhibitors (TNFi) (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.05).<\/jats:p>\n            <jats:p>B-cell penia, observed in 37% of patients, was the most common abnormality, also in patients with normal total lymphocyte counts, while T-cell penia mainly occurred in patients with total lymphopenia (91 vs 5%, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001).<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p>B-cell penia is common in sarcoidosis patients while T-cell penia is mainly a feature of the sarcoidosis PB lymphopenia phenotype. Increased lymphocyte counts during TNFi treatment suggests that TNF-\u03b1 signaling is of importance for sarcoidosis associated lymphopenia.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1186\/s12931-025-03212-x","type":"journal-article","created":{"date-parts":[[2025,4,9]],"date-time":"2025-04-09T21:22:41Z","timestamp":1744233761000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Associations of peripheral blood lymphopenia to disease course, treatment and TNF-\u03b1 in sarcoidosis"],"prefix":"10.1186","volume":"26","author":[{"given":"Avinash","family":"Padhi","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anders","family":"Eklund","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Clas","family":"Malmestr\u00f6m","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elina","family":"Erikson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gustav","family":"Hall\u00e9n","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"Smed-S\u00f6rensen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susanna","family":"Kullberg","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,4,9]]},"reference":[{"issue":"1","key":"3212_CR1","doi-asserted-by":"publisher","first-page":"45","DOI":"10.1038\/s41572-019-0096-x","volume":"5","author":"J Grunewald","year":"2019","unstructured":"Grunewald J, Grutters JC, Arkema EV, Saketkoo LA, Moller DR, Muller-Quernheim J. 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