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Merzel Šabović EK, Starbek Zorko M, Hosta V, Žgavec B, Bajuk V. Microblading reaction as a manifestation of systemic sarcoidosis: two case reports and a review of the literature. J Med Case Rep 2024; 18:221. [PMID: 38654341 DOI: 10.1186/s13256-024-04439-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2023] [Accepted: 02/07/2024] [Indexed: 04/25/2024] Open
Abstract
BACKGROUND Sarcoidosis is a multisystemic disease characterized by granulomatous inflammation. Sarcoidosis often poses a diagnostic challenge owing to its nonspecific or mild clinical features. In 20-35% of cases, sarcoidosis initially presents on skin. However, skin lesions commonly mimic dermatological conditions. Therefore, it is important to not underestimate the skin manifestations and perform histopathological examinations to make a timely diagnosis. CASE PRESENTATION We present two cases of 33-year-old Caucasian female patients with orange-red macules and plaques that developed in the eyebrow area 1 and 6 years after microblading, respectively. Histopathological examination confirmed a diagnosis of sarcoidosis. The lymph nodes and lungs were also affected in both patients. CONCLUSION Our two reports suggest that an esthetic procedure involving dermal or subcutaneous injection of foreign materials can trigger the development of cutaneous and systemic sarcoidosis. However, this relationship has not been described yet. Physicians should, therefore, be aware of this complication to properly evaluate and treat such patients in a timely manner.
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Affiliation(s)
- Eva Klara Merzel Šabović
- Dermatology and Venereology Clinic, University Medical Centre Ljubljana, Gradiskova 10, 1000, Ljubljana, Slovenia.
- Medical Faculty Ljubljana, University of Ljubljana, Ljubljana, Slovenia.
| | - Mateja Starbek Zorko
- Dermatology and Venereology Clinic, University Medical Centre Ljubljana, Gradiskova 10, 1000, Ljubljana, Slovenia
- Medical Faculty Ljubljana, University of Ljubljana, Ljubljana, Slovenia
| | - Violeta Hosta
- Dermatology and Venereology Clinic, University Medical Centre Ljubljana, Gradiskova 10, 1000, Ljubljana, Slovenia
| | - Borut Žgavec
- Dermatology and Venereology Clinic, University Medical Centre Ljubljana, Gradiskova 10, 1000, Ljubljana, Slovenia
| | - Vid Bajuk
- Dermatology and Venereology Clinic, University Medical Centre Ljubljana, Gradiskova 10, 1000, Ljubljana, Slovenia
- Medical Faculty Ljubljana, University of Ljubljana, Ljubljana, Slovenia
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Akata K, Yamasaki K, Nemoto K, Ikegami H, Kawaguchi T, Noguchi S, Kawanami T, Fukuda K, Mukae H, Yatera K. Sarcoidosis Associated with Enlarged Mediastinal Lymph Nodes with the Detection of Streptococcus gordonii and Cutibacterium acnes Using a Clone Library Method. Intern Med 2024; 63:299-304. [PMID: 37258161 PMCID: PMC10864086 DOI: 10.2169/internalmedicine.1887-23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Accepted: 04/25/2023] [Indexed: 06/02/2023] Open
Abstract
A 77-year-old Japanese woman with mediastinal lymphadenopathy and uveitis was diagnosed with sarcoidosis. The bacterial flora in biopsied samples from mediastinal lymph nodes was analyzed using a clone library method with Sanger sequencing of the 16S rRNA gene, and Streptococcus gordonii (52 of 71 clones) and Cutibacterium acnes (19 of 71 clones) were detected. No previous study has conducted a bacterial floral analysis using the Sanger method for the mediastinal lymph node in sarcoidosis, making this case report the first to document the presence of S. gordonii and C. acnes in the mediastinal lymph node of a patient with sarcoidosis.
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Affiliation(s)
- Kentaro Akata
- Division of Infection Control and Prevention, University of Occupational and Environmental Health, Japan
- Department of Respiratory Medicine, University of Occupational and Environmental Health, Japan
| | - Kei Yamasaki
- Department of Respiratory Medicine, University of Occupational and Environmental Health, Japan
| | - Kazuki Nemoto
- Department of Respiratory Medicine, University of Occupational and Environmental Health, Japan
| | - Hiroaki Ikegami
- Department of Respiratory Medicine, University of Occupational and Environmental Health, Japan
| | - Takako Kawaguchi
- Department of Respiratory Medicine, University of Occupational and Environmental Health, Japan
| | - Shingo Noguchi
- Department of Respiratory Medicine, University of Occupational and Environmental Health, Japan
| | - Toshinori Kawanami
- Department of Respiratory Medicine, University of Occupational and Environmental Health, Japan
| | - Kazumasa Fukuda
- Department of Microbiology, University of Occupational and Environmental Health, Japan
| | - Hiroshi Mukae
- Department of Respiratory Medicine, Nagasaki University Graduate School of Biomedical Sciences, Japan
| | - Kazuhiro Yatera
- Department of Respiratory Medicine, University of Occupational and Environmental Health, Japan
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Afzal A, Khawar MB, Habiba U, Afzal H, Hamid SE, Rafiq M, Abbasi MH, Sheikh N, Abaidullah R, Asif Z, Saeed T. Diagnostic and therapeutic value of EVs in lungs diseases and inflammation. Mol Biol Rep 2023; 51:26. [PMID: 38127201 DOI: 10.1007/s11033-023-09045-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Accepted: 11/02/2023] [Indexed: 12/23/2023]
Abstract
Extracellular vesicles (EVs) are membrane-derived messengers which have been playing an important role in the inflammation and pathogenesis of lung diseases. EVs contain varieties of DNA, RNA, and membrane receptors through which they work as a delivery system for bioactive molecules as well as intracellular communicators. EV signaling mediates tumor progression and metastasis. EVs are linked with many diseases and perform a diagnostic role in lung injury and inflammation so are used to diagnose the severity of diseases. EVs containing a variety of biomolecules communicate with the recipient cells during pathophysiological mechanisms thereby acquiring the attention of clinicians toward the diagnostic and therapeutic potential of EVs in different lung diseases. In this review, we summarize the role of EVs in inflammation with an emphasis on their potential as a novel candidate in the diagnostics and therapeutics of chronic obstructive pulmonary disease, asthma, and sarcoidosis.
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Affiliation(s)
- Ali Afzal
- Molecular Medicine and Cancer Therapeutics Lab, Department of Zoology, Faculty of Sciences, University of Central Punjab, Lahore, Pakistan
- Institute of Translational Medicine, Medical College, Yangzhou University, Yangzhou, China
| | - Muhammad Babar Khawar
- Institute of Translational Medicine, Medical College, Yangzhou University, Yangzhou, China.
- Applied Molecular Biology and Biomedicine Lab, Department of Zoology, University of Narowal, Narowal, Pakistan.
| | - Ume Habiba
- Department of Zoology, University of Education, Lahore, Pakistan
| | - Hanan Afzal
- Molecular Medicine and Cancer Therapeutics Lab, Department of Zoology, Faculty of Sciences, University of Central Punjab, Lahore, Pakistan
| | - Syeda Eisha Hamid
- Molecular Medicine and Cancer Therapeutics Lab, Department of Zoology, Faculty of Sciences, University of Central Punjab, Lahore, Pakistan
| | - Mussarat Rafiq
- Cell & Molecular Biology Lab, Institute of Zoology, University of the Punjab, Lahore, Pakistan
| | | | - Nadeem Sheikh
- Cell & Molecular Biology Lab, Institute of Zoology, University of the Punjab, Lahore, Pakistan
| | - Rimsha Abaidullah
- Applied Molecular Biology and Biomedicine Lab, Department of Zoology, University of Narowal, Narowal, Pakistan
| | - Zoya Asif
- Applied Molecular Biology and Biomedicine Lab, Department of Zoology, University of Narowal, Narowal, Pakistan
| | - Tahaa Saeed
- Department of Biology, Syed Babar Ali School of Science and Engineering, Lahore University of Management Sciences, Lahore, Pakistan
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Kim J, Lee S, Moodley Y, Yagnik L, Birnie D, Dwivedi G. The role of the host-microbiome and metabolomics in sarcoidosis. Am J Physiol Cell Physiol 2023; 325:C1336-C1353. [PMID: 37746695 DOI: 10.1152/ajpcell.00316.2023] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Revised: 09/19/2023] [Accepted: 09/19/2023] [Indexed: 09/26/2023]
Abstract
Sarcoidosis is a complex inflammatory fibrotic disease that affects multiple organ systems. It is characterized by the infiltration of lymphocytes and mononuclear phagocytes, which form non-caseating granulomas in affected organs. The lungs and intrathoracic lymph nodes are the most commonly affected organs. The underlying cause of sarcoidosis is unknown, but it is believed to occur in genetically predisposed individuals who are exposed to pathogenic organisms, environmental contaminants, or self and non-self-antigens. Recent research has suggested that the microbiome may play a role in the development of respiratory conditions, including sarcoidosis. Additionally, metabolomic studies have identified potential biomarkers for monitoring sarcoidosis progression. This review will focus on recent microbiome and metabolomic findings in sarcoidosis, with the goal of shedding light on the pathogenesis and possible diagnostic and therapeutic approaches.
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Affiliation(s)
- Junwoo Kim
- Department of Advanced Clinical and Translational Cardiovascular Imaging, Harry Perkins Institute of Medical Research, Murdoch, Western Australia, Australia
- School of Medicine, The University of Western Australia, Crawley, Western Australia, Australia
| | - Silvia Lee
- Department of Advanced Clinical and Translational Cardiovascular Imaging, Harry Perkins Institute of Medical Research, Murdoch, Western Australia, Australia
- School of Medicine, The University of Western Australia, Crawley, Western Australia, Australia
| | - Yuben Moodley
- Department of Advanced Clinical and Translational Cardiovascular Imaging, Harry Perkins Institute of Medical Research, Murdoch, Western Australia, Australia
- School of Medicine, The University of Western Australia, Crawley, Western Australia, Australia
- Department of Respiratory Internal Medicine, Fiona Stanley Hospital, Murdoch, Western Australia, Australia
| | - Lokesh Yagnik
- Department of Advanced Clinical and Translational Cardiovascular Imaging, Harry Perkins Institute of Medical Research, Murdoch, Western Australia, Australia
- School of Medicine, The University of Western Australia, Crawley, Western Australia, Australia
- Department of Respiratory Internal Medicine, Fiona Stanley Hospital, Murdoch, Western Australia, Australia
| | - David Birnie
- Department of Advanced Clinical and Translational Cardiovascular Imaging, Harry Perkins Institute of Medical Research, Murdoch, Western Australia, Australia
- School of Medicine, The University of Western Australia, Crawley, Western Australia, Australia
- Division of Cardiology, Department of Medicine, University of Ottawa, University of Ottawa Heart Institute, Ottawa, Ontario, Canada
| | - Girish Dwivedi
- Department of Advanced Clinical and Translational Cardiovascular Imaging, Harry Perkins Institute of Medical Research, Murdoch, Western Australia, Australia
- School of Medicine, The University of Western Australia, Crawley, Western Australia, Australia
- Division of Cardiology, Department of Medicine, University of Ottawa, University of Ottawa Heart Institute, Ottawa, Ontario, Canada
- Department of Cardiology, Fiona Stanley Hospital, Murdoch, Western Australia, Australia
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Shen Y, Liu C, Zheng L, Zhao Y. Sarcoidosis or Tuberculosis: Should Corticosteroids Be Used? Cureus 2023; 15:e47191. [PMID: 38022146 PMCID: PMC10652288 DOI: 10.7759/cureus.47191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/16/2023] [Indexed: 12/01/2023] Open
Abstract
Sarcoidosis shows high similarity with tuberculosis in clinical manifestations and imaging features. It is rarely reported whether sarcoidosis patients with suspected latent tuberculosis can be treated safely with immunosuppressive therapy. We reported on a 54-year-old man who presented with enlarged lymph nodes persisting for decades, accompanied by renal impairment and refractory hypercalcemia. The patient was diagnosed with sarcoidosis and suspected latent tuberculosis (as suggested by a positive tuberculin test and tuberculosis interferon-gamma release assays) and received prednisone under follow-up. The patient showed significant amelioration in hypercalcemia and shrinkage of lymph nodes, without evidence of developing active tuberculosis. For sarcoidosis patients with suspected latent tuberculosis, immunosuppressive agents can be utilized safely based on close monitoring. Further efforts are required to reveal whether sarcoidosis and tuberculosis can trigger similar immune responses and what the clinical implications are.
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Affiliation(s)
- Yuting Shen
- Department of Nephrology, Chengdu Seventh People's Hospital (Affiliated Cancer Hospital of Chengdu Medical College), Chengdu, CHN
- Department of Nephrology, Kidney Research Institute, West China Hospital of Sichuan University, Chengdu, CHN
| | - Caihong Liu
- Department of Nephrology, Kidney Research Institute, West China Hospital of Sichuan University, Chengdu, CHN
| | - Lan Zheng
- Department of Nephrology, Zhongjiang County People's Hospital, Deyang, CHN
| | - Yuliang Zhao
- Department of Nephrology, Kidney Research Institute, West China Hospital of Sichuan University, Chengdu, CHN
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Plichta J, Kuna P, Panek M. Biologic drugs in the treatment of chronic inflammatory pulmonary diseases: recent developments and future perspectives. Front Immunol 2023; 14:1207641. [PMID: 37334374 PMCID: PMC10272527 DOI: 10.3389/fimmu.2023.1207641] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Accepted: 05/22/2023] [Indexed: 06/20/2023] Open
Abstract
Chronic inflammatory diseases of the lung are some of the leading causes of mortality and significant morbidity worldwide. Despite the tremendous burden these conditions put on global healthcare, treatment options for most of these diseases remain scarce. Inhaled corticosteroids and beta-adrenergic agonists, while effective for symptom control and widely available, are linked to severe and progressive side effects, affecting long-term patient compliance. Biologic drugs, in particular peptide inhibitors and monoclonal antibodies show promise as therapeutics for chronic pulmonary diseases. Peptide inhibitor-based treatments have already been proposed for a range of diseases, including infectious disease, cancers and even Alzheimer disease, while monoclonal antibodies have already been implemented as therapeutics for a range of conditions. Several biologic agents are currently being developed for the treatment of asthma, chronic obstructive pulmonary disease, idiopathic pulmonary fibrosis and pulmonary sarcoidosis. This article is a review of the biologics already employed in the treatment of chronic inflammatory pulmonary diseases and recent progress in the development of the most promising of those treatments, with particular focus on randomised clinical trial outcomes.
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7
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Adhikari B, Ji B, Waqar SHB, Khatri S. A Hypercalcemic Enigma: A Rare Case of Bone Marrow Sarcoidosis. Cureus 2023; 15:e40534. [PMID: 37461767 PMCID: PMC10350330 DOI: 10.7759/cureus.40534] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/16/2023] [Indexed: 07/20/2023] Open
Abstract
Sarcoidosis is a multisystem inflammatory disease involving granuloma formation. The exact etiology of the disease remains unknown. While the lungs are the most commonly involved organs in sarcoidosis, bone marrow-only involvement is quite rare. As bone marrow-only involvement can have a presentation that closely resembles multiple myeloma, a significant diagnostic dilemma can occur as the treatment for sarcoidosis is different compared to multiple myeloma. We present a case of a 62-year-old female who presented with worsening lower extremity weakness and fatigue. She was found to have new-onset hypercalcemia, normocytic anemia, and lytic bony lesions. Extensive laboratory workup for multiple myeloma was negative with bone marrow biopsy showing non-caseating granulomas, thus diagnosing the patient with sarcoidosis involving the bone marrow.
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Affiliation(s)
- Biplov Adhikari
- Internal Medicine, MedStar Union Memorial Hospital, Baltimore, USA
| | - Beisi Ji
- Internal Medicine, State University of New York Downstate Health Sciences University, New York City, USA
| | - Syed Hamza Bin Waqar
- Internal Medicine, State University of New York Downstate Health Sciences University, New York City, USA
| | - Sagun Khatri
- Internal Medicine, B.P. Koirala Institute of Health Sciences, Dharan, NPL
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8
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Mocanu A, Bogos RA, Trandafir LM, Cojocaru E, Ioniuc I, Alecsa M, Lupu VV, Miron L, Lazaruc TI, Lupu A, Miron IC, Starcea IM. The Overlap of Kidney Failure in Extrapulmonary Sarcoidosis in Children-Case Report and Review of Literature. Int J Mol Sci 2023; 24:ijms24087327. [PMID: 37108489 PMCID: PMC10138650 DOI: 10.3390/ijms24087327] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Revised: 04/11/2023] [Accepted: 04/13/2023] [Indexed: 04/29/2023] Open
Abstract
Sarcoidosis is a non-necrotizing granulomatous inflammatory multisystemic disorder of unknown etiology. In children, as in adults, it can involve a few or all organ systems to a varying extent and degree, entailing multisystemic manifestations. Kidney involvement in pediatric-onset adult-type sarcoidosis is rare, with a wide range of renal manifestations, most of them related to calcium metabolism. Children with renal sarcoidosis tend to be more symptomatic than adults, although male patients have a higher prevalence. We present the case of a 10-year-old boy who presented with advanced renal failure with nephrocalcinosis and important hepatosplenomegaly. The diagnosis was established by histopathological examination, with consequent cortisone therapy and hemodialysis. This review emphasizes that sarcoidosis should be considered in the differential diagnosis of pediatric patients with acute kidney insufficiency or chronic kidney disease of an unknown etiology. As far as we know, this is the first study regarding extrapulmonary sarcoidosis in children from Romania.
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Affiliation(s)
- Adriana Mocanu
- Faculty of General Medicine, "Grigore T. Popa" University of Medicine and Pharmacy, 16 Universitatii Street, 700115 Iasi, Romania
- Nephrology Division, St. Mary's Emergency Children Hospital, 700309 Iasi, Romania
| | - Roxana Alexandra Bogos
- Faculty of General Medicine, "Grigore T. Popa" University of Medicine and Pharmacy, 16 Universitatii Street, 700115 Iasi, Romania
- Nephrology Division, St. Mary's Emergency Children Hospital, 700309 Iasi, Romania
| | - Laura Mihaela Trandafir
- Faculty of General Medicine, "Grigore T. Popa" University of Medicine and Pharmacy, 16 Universitatii Street, 700115 Iasi, Romania
| | - Elena Cojocaru
- Faculty of General Medicine, "Grigore T. Popa" University of Medicine and Pharmacy, 16 Universitatii Street, 700115 Iasi, Romania
| | - Ileana Ioniuc
- Faculty of General Medicine, "Grigore T. Popa" University of Medicine and Pharmacy, 16 Universitatii Street, 700115 Iasi, Romania
| | - Mirabela Alecsa
- Faculty of General Medicine, "Grigore T. Popa" University of Medicine and Pharmacy, 16 Universitatii Street, 700115 Iasi, Romania
| | - Vasile Valeriu Lupu
- Faculty of General Medicine, "Grigore T. Popa" University of Medicine and Pharmacy, 16 Universitatii Street, 700115 Iasi, Romania
| | - Lucian Miron
- Faculty of General Medicine, "Grigore T. Popa" University of Medicine and Pharmacy, 16 Universitatii Street, 700115 Iasi, Romania
| | - Tudor Ilie Lazaruc
- Faculty of General Medicine, "Grigore T. Popa" University of Medicine and Pharmacy, 16 Universitatii Street, 700115 Iasi, Romania
| | - Ancuta Lupu
- Faculty of General Medicine, "Grigore T. Popa" University of Medicine and Pharmacy, 16 Universitatii Street, 700115 Iasi, Romania
| | - Ingrith Crenguta Miron
- Faculty of General Medicine, "Grigore T. Popa" University of Medicine and Pharmacy, 16 Universitatii Street, 700115 Iasi, Romania
| | - Iuliana Magdalena Starcea
- Faculty of General Medicine, "Grigore T. Popa" University of Medicine and Pharmacy, 16 Universitatii Street, 700115 Iasi, Romania
- Nephrology Division, St. Mary's Emergency Children Hospital, 700309 Iasi, Romania
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Mistry HY, Betancourt D, Schuller D, Lavezo J. Hypoxemic Respiratory Failure Due to Alveolar Pulmonary Sarcoidosis Following COVID-19 Infection. Cureus 2023; 15:e35790. [PMID: 37025737 PMCID: PMC10072786 DOI: 10.7759/cureus.35790] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/05/2023] [Indexed: 03/07/2023] Open
Abstract
Pulmonary sarcoidosis is typically recognized as an interstitial lung disease with an infrequent occurrence of alveolar filling or acinar pattern. This rare form of alveolar sarcoidosis is known to have a rapid progression. Several case reports showed the development/worsening of sarcoidosis after COVID-19 infection. We present a case of a 60-year-old male with chronic hypoxic respiratory failure since having COVID-19 disease followed by gradual progression in symptoms, who had atypical sarcoid-like alveolar opacities on radiography, two prior negative bronchoscopies, transbronchial biopsy and BAL, and third bronchoscopic transbronchial biopsy suggestive of findings of poorly formed granulomas with high suspicion of alveolar sarcoidosis after ruling out other comparative possibilities, and later having a drastic improvement with sarcoidosis management. Our patient's worsening symptoms after COVID-19 infection suggest impaired immunoregulation role of the infection in developing the disease process.
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Spagnolo P, Bernardinello N. Sarcoidosis. Immunol Allergy Clin North Am 2023; 43:259-272. [PMID: 37055088 DOI: 10.1016/j.iac.2023.01.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/06/2023]
Abstract
Sarcoidosis is a disease of unknown cause characterized by granulomatous inflammation. Although the lung is almost universally involved, any organ can be affected. Complex pathogenesis and protean clinical manifestations are additional features of the disease. The diagnosis is one of exclusion, although the presence of noncaseating granulomas at disease sites is a prerequisite in most cases. The management of sarcoidosis requires a multidisciplinary approach, particularly when the heart, the brain, or the eyes are involved. The paucity of effective therapies and the lack of reliable predictors of disease behavior greatly contribute to making sarcoidosis a challenging disease to manage.
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Affiliation(s)
- Paolo Spagnolo
- Respiratory Disease Unit, Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, via Giustiniani 2, Padova 35128, Italy.
| | - Nicol Bernardinello
- Respiratory Disease Unit, Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, via Giustiniani 2, Padova 35128, Italy
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Lackey E, Shen J, Veal K, Paredes D, Masha N, Shah S, Eckstein C. Steroid-induced weight gain in the treatment of neurosarcoidosis. Mult Scler Relat Disord 2023; 71:104587. [PMID: 36827876 DOI: 10.1016/j.msard.2023.104587] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Revised: 02/04/2023] [Accepted: 02/19/2023] [Indexed: 02/23/2023]
Affiliation(s)
- Elijah Lackey
- Department of Neurology, Duke University, 2301 Erwin Road, Durham, NC 27705, United States.
| | - Jeffrey Shen
- Department of Rheumatology, Duke University, United States
| | - Kristen Veal
- Department of Neurology, Duke University, 2301 Erwin Road, Durham, NC 27705, United States
| | - Danelvis Paredes
- Department of Neurology, Duke University, 2301 Erwin Road, Durham, NC 27705, United States
| | - Nidhila Masha
- Department of Neurology, Duke University, 2301 Erwin Road, Durham, NC 27705, United States
| | - Suma Shah
- Department of Neurology, Duke University, 2301 Erwin Road, Durham, NC 27705, United States
| | - Christopher Eckstein
- Department of Neurology, Duke University, 2301 Erwin Road, Durham, NC 27705, United States
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12
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Mohaghegh F, Hatami P, Refaghat A, Matini AH, Mohseni Afshar Z, Aryanian Z. Unmasking sarcoidosis following SARS-CoV-2 vaccination: A case report. Clin Case Rep 2022; 10:e6660. [PMID: 36483855 PMCID: PMC9723247 DOI: 10.1002/ccr3.6660] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Revised: 11/07/2022] [Accepted: 11/13/2022] [Indexed: 12/12/2022] Open
Abstract
Sarcoidosis is an inflammatory and granulomatous disorder, developed due to dysregulation between immune response and certain environmental antigens. We hereby report an interesting case of sarcoidosis following COVID-19 vaccination (COVIran Barekat), which presented with inflammation of previous tattoo sites as well as the development of erythema nodosum and systemic lymphadenopathy, suggested a possible link between the COVID vaccination and dysregulation of the inflammatory process and served as a reminder for clinicians to have enough vigilance before proposing a vaccine booster to these patients.
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Affiliation(s)
- Fatemeh Mohaghegh
- Department of Dermatology, Skin Diseases and Leishmaniasis Research CenterIsfahan University of Medical SciencesIsfahanIran
| | - Parvaneh Hatami
- Autoimmune Bullous Diseases Research CenterTehran University of Medical SciencesTehranIran
| | - Arezoo Refaghat
- Department of DermatologyIsfahan University of Medical SciencesIsfahanIran
| | - Amir Hassan Matini
- Department of Clinical PathologyKashan University of Medical SciencesIsfahanIran
| | - Zeinab Mohseni Afshar
- Clinical Research Development CenterImam Reza Hospital, Kermanshah University of Medical SciencesKermanshahIran
| | - Zeinab Aryanian
- Autoimmune Bullous Diseases Research CenterTehran University of Medical SciencesTehranIran,Department of DermatologyBabol University of Medical SciencesBabolIran
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Bashinskaya A, Fernandez AD, Morgan MB. Permanent Makeup Procedure Heralds the Development of Systemic Sarcoidosis. Cureus 2022; 14:e30918. [DOI: 10.7759/cureus.30918] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/31/2022] [Indexed: 11/07/2022] Open
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Knudsen KS, Lehmann S, Nielsen R, Tangedal S, Paytuvi-Gallart A, Sanseverino W, Martinsen EMH, Hiemstra PS, Eagan TM. The lower airways microbiota and antimicrobial peptides indicate dysbiosis in sarcoidosis. MICROBIOME 2022; 10:175. [PMID: 36258251 PMCID: PMC9580159 DOI: 10.1186/s40168-022-01362-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Accepted: 08/30/2022] [Indexed: 05/14/2023]
Abstract
BACKGROUND The role of the pulmonary microbiome in sarcoidosis is unknown. The objectives of this study were the following: (1) examine whether the pulmonary fungal and bacterial microbiota differed in patients with sarcoidosis compared with controls; (2) examine whether there was an association between the microbiota and levels of the antimicrobial peptides (AMPs) in protected bronchoalveolar lavage (PBAL). METHODS Thirty-five sarcoidosis patients and 35 healthy controls underwent bronchoscopy and were sampled with oral wash (OW), protected BAL (PBAL), and left protected sterile brushes (LPSB). The fungal ITS1 region and the V3V4 region of the bacterial 16S rRNA gene were sequenced. Bioinformatic analyses were performed with QIIME 2. The AMPs secretory leucocyte protease inhibitor (SLPI) and human beta defensins 1 and 2 (hBD-1 and hBD-2), were measured in PBAL by enzyme-linked immunosorbent assay (ELISA). RESULTS Aspergillus dominated the PBAL samples in sarcoidosis. Differences in bacterial taxonomy were minor. There was no significant difference in fungal alpha diversity between sarcoidosis and controls, but the bacterial alpha diversity in sarcoidosis was significantly lower in OW (p = 0.047) and PBAL (p = 0.03) compared with controls. The beta diversity for sarcoidosis compared with controls differed for both fungi and bacteria. AMP levels were significantly lower in sarcoidosis compared to controls (SLPI and hBD-1: p < 0.01). No significant correlations were found between alpha diversity and AMPs. CONCLUSIONS The pulmonary fungal and bacterial microbiota in sarcoidosis differed from in controls. Lower antimicrobial peptides levels were seen in sarcoidosis, indicating an interaction between the microbiota and the innate immune system. Whether this dysbiosis represents a pathogenic mechanism in sarcoidosis needs to be confirmed in experimental studies. Video Abstract.
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Affiliation(s)
| | - Sverre Lehmann
- Department of Clinical Science, University of Bergen, Bergen, Norway
- Department of Thoracic Medicine, Haukeland University Hospital, Bergen, Norway
| | - Rune Nielsen
- Department of Clinical Science, University of Bergen, Bergen, Norway
- Department of Thoracic Medicine, Haukeland University Hospital, Bergen, Norway
| | - Solveig Tangedal
- Department of Clinical Science, University of Bergen, Bergen, Norway
| | | | | | | | - Pieter S. Hiemstra
- Department of Pulmonology, Leiden University Medical Center, Leiden, Netherlands
| | - Tomas M. Eagan
- Department of Clinical Science, University of Bergen, Bergen, Norway
- Department of Thoracic Medicine, Haukeland University Hospital, Bergen, Norway
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15
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Numakura T, Murakami K, Tamada T, Yamaguchi C, Inoue C, Ohkouchi S, Tode N, Sano H, Aizawa H, Sato K, Mitsune A, Kurosawa H, Nakazawa T, Sugiura H. A Novel Development of Sarcoidosis Following COVID-19 Vaccination and a Literature Review. Intern Med 2022; 61:3101-3106. [PMID: 35945009 PMCID: PMC9646347 DOI: 10.2169/internalmedicine.0104-22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
BNT162b2 (Pfizer/BioNTech) is a coronavirus disease 2019 (COVID-19) vaccine containing nucleoside-modified messenger RNA encoding the severe acute respiratory syndrome coronavirus 2 spike glycoprotein. Recently, ocular complications of mRNA vaccines have been reported increasingly frequently. However, immunological adverse events due to mRNA vaccines in real-world settings are not fully known. We herein report the novel development of sarcoidosis manifested as uveitis, bilateral hilar lymphadenopathy, angiotensin-converting enzyme elevation, and epithelioid and giant cell granuloma formation in the lung soon after the first BNT162b2 injection and review the current literature, including three reported cases of sarcoid-like reaction following COVID-19 vaccination.
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Affiliation(s)
- Tadahisa Numakura
- Department of Respiratory Medicine, Tohoku University Graduate School of Medicine, Japan
| | - Koji Murakami
- Department of Respiratory Medicine, Tohoku University Graduate School of Medicine, Japan
| | - Tsutomu Tamada
- Department of Respiratory Medicine, Tohoku University Graduate School of Medicine, Japan
| | - Chiaki Yamaguchi
- Department of Ophthalmology, Tohoku University Graduate School of Medicine, Japan
| | - Chihiro Inoue
- Department of Anatomic Pathology, Tohoku University Graduate School of Medicine, Japan
| | - Shinya Ohkouchi
- Department of Occupational Health, Tohoku University Graduate School of Medicine, Japan
| | - Naoki Tode
- Department of Respiratory Medicine, Tohoku University Graduate School of Medicine, Japan
| | - Hirohito Sano
- Department of Respiratory Medicine, Tohoku University Graduate School of Medicine, Japan
| | - Hiroyuki Aizawa
- Department of Respiratory Medicine, Tohoku University Graduate School of Medicine, Japan
| | - Kei Sato
- Department of Respiratory Medicine, Tohoku University Graduate School of Medicine, Japan
| | - Ayumi Mitsune
- Department of Respiratory Medicine, Tohoku University Graduate School of Medicine, Japan
| | - Hajime Kurosawa
- Department of Occupational Health, Tohoku University Graduate School of Medicine, Japan
| | - Toru Nakazawa
- Department of Ophthalmology, Tohoku University Graduate School of Medicine, Japan
| | - Hisatoshi Sugiura
- Department of Respiratory Medicine, Tohoku University Graduate School of Medicine, Japan
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16
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Perlamutrov YN, Drobyshev AU, Olkhovskaya KB, Miterev AA, Plehanova EN. Rossolimo–Melkersson–Rosenthal syndrome as a manifestation of lip sarcoidosis. VESTNIK DERMATOLOGII I VENEROLOGII 2022. [DOI: 10.25208/vdv1278] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
Abstract
A 38-year-old female patient complained of lip augmentation. With a preliminary diagnosis of RossolimoMelkerssonRosenthal syndrome (monosymptomatic form), chronic fissure of the lower lip, the patient was sent for examination in order to exclude tumor pathology and vascular malformation. According to the results of a comprehensive clinical and laboratory examination, it was found that lip enlargement is due to the formation of granulomas. Additional follow-up by a pulmonologist confirmed the presence of sarcoidosis of the lungs with involvement of the mediastinal lymph nodes. A comprehensive examination made it possible to verify the diagnosis of multisystem sarcoidosis in a patient with macrocheilitis. As a result of complex therapy using surgical methods and systemic glucocorticosteroids, a rapid dynamics of clinical symptoms was observed and remission was achieved. This clinical case demonstrates a combination of sarcoid lesions of the tissues of the mediastinal lymph nodes, lung parenchyma and lips. It was the presence of macrocheilitis that was the main reason for visiting a dermatovenereologist and was the reason for choosing the subsequent tactics of examination and treatment. As a result of complex therapy using surgical methods of treatment and systemic glucocorticosteroids, carried out entirely within the framework of the program of state guarantees of free medical care for citizens, a stable remission of the disease was achieved.
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17
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Mogal MR, Sompa SA, Junayed A, Mahmod MR, Abedin MZ, Sikder MA. Common genetic aspects between COVID-19 and sarcoidosis: A network-based approach using gene expression data. Biochem Biophys Rep 2022; 29:101219. [PMID: 35128085 PMCID: PMC8803645 DOI: 10.1016/j.bbrep.2022.101219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2021] [Revised: 01/18/2022] [Accepted: 01/21/2022] [Indexed: 11/21/2022] Open
Abstract
The pandemic situation of novel coronavirus disease 2019 (COVID-19) is a global threat on our current planet, with its rapid spread and high mortality rate. Sarcoidosis patients are at high risk to COVID-19 severity for having lung injuries as well as treating with immunosuppressive agents. So, physicians are in dilemma whether they should use immunosuppressive agents or not for the patients with sarcoidosis history and COVID-19 infection. Therefore, common factors should be identified to provide effective treatment. For determining the common genes between COVID-19 and sarcoidosis, GSE164805 and GSE18781 were retrieved from the Gene Expression Omnibus (GEO) database. Common upregulated genes were identified by using R language to investigate their involved pathways and gene ontologies (GO). With the aid of the STRING Cytoscape plugin tool, protein-protein interactions (PPIs) network was constructed. From the PPIs network, Hub genes and essential modules were detected by using Cytohubba, and MCODE respectively. For hub genes, TFs, TFs-miRNA, and drug, interaction networks were built through the NetworkAnalyst web platform. A total of 34 common upregulated genes were identified and among them, five hub genes, including TET2, MUC5AC, VDR, NFE2L2, and BCL6 were determined. In addition, a cluster having VDR and NFE2L2 was detected from the PPIs network. Moreover, 32 transcription factors and 9 miRNA were recognized for hub genes. Furthermore, vitamin D and some of its analogous compounds were obtained from the drug interaction network. In conclusion, hub genes identified in this study might have potential roles in modulating COVID-19 infection and sarcoidosis. However, further studies are required to corroborate this study. Sarcoidosis patients are at high risk to COVID-19 severity. This study aimed to find out common genetic factors for COVID-19 and Sarcoidosis. 34 common upregulated genes were identified from GSE164805 and GSE18781 datasets. From common upregulated genes, five hub genes, VDR, NFE2L2, BCL6, TET2, and MUC5AC, were recognized. Hub genes associated with miRNA, TFs, and drug molecules were also identified.
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18
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Capaccione KM, McGroder C, Garcia CK, Fedyna S, Saqi A, Salvatore MM. COVID-19-induced pulmonary sarcoid: A case report and review of the literature. Clin Imaging 2022; 83:152-158. [PMID: 35051738 PMCID: PMC8755635 DOI: 10.1016/j.clinimag.2021.12.021] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Revised: 12/23/2021] [Accepted: 12/27/2021] [Indexed: 02/07/2023]
Abstract
Background The COVID-19 pandemic has resulted in dramatic loss of life worldwide, but as the large number of acutely ill patients subsides, the emerging group of “COVID-19 long-haulers” present a clinical challenge. Studies have shown that many of these patients suffer long-term pulmonary disease related to residual fibrosis. Prior studies have shown that while many patients have non-specific findings of fibrotic-like changes, others develop specific patterns of interstitial lung disease. Case report Here, we present the first case of a patient developing pulmonary sarcoidosis one year after critical illness from COVID-19. He developed numerous non-necrotizing and well-formed granulomas in mediastinal lymph nodes and pulmonary nodules, compatible radiographically and pathologically with sarcoid. Conclusions While the pathophysiology of sarcoid is incompletely understood, inflammation is mediated through the dysregulation of a number of different cytokines (IFNγ, IL-2, IL-12, IL-17, IL-22). This case provides valuable clues for better understanding of the shared pathophysiology of cytokine dysregulation seen in COVID-19 and other interstitial lung diseases such as sarcoidosis.
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Affiliation(s)
- Kathleen M Capaccione
- Division of Cardiothoracic Imaging, Department of Radiology, Columbia University Irving Medical Center, New York, NY, United States of America.
| | - Claire McGroder
- Division of Pulmonology, Allergy, and Critical Care, Department of Medicine, Columbia University Irving Medical Center, New York, NY, United States of America
| | - Christine Kim Garcia
- Division of Pulmonology, Allergy, and Critical Care, Department of Medicine, Columbia University Irving Medical Center, New York, NY, United States of America
| | - Sean Fedyna
- Division of Pulmonology, Allergy, and Critical Care, Department of Medicine, Columbia University Irving Medical Center, New York, NY, United States of America
| | - Anjali Saqi
- Department of Pathology & Cell Biology, Columbia University Irving Medical Center, NY, New York, United States of America
| | - Mary M Salvatore
- Division of Cardiothoracic Imaging, Department of Radiology, Columbia University Irving Medical Center, New York, NY, United States of America
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19
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Haraldsdóttir SÓ, Jonasson JG, Jorundsdottir KB, Hannesson HJ, Gislason T, Gudbjornsson B. Sarcoidosis in Iceland: a nationwide study of epidemiology, clinical picture and environmental exposure. ERJ Open Res 2021; 7:00550-2021. [PMID: 34912885 PMCID: PMC8666626 DOI: 10.1183/23120541.00550-2021] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Accepted: 09/22/2021] [Indexed: 11/24/2022] Open
Abstract
Background This nationwide study aimed to elucidate the incidence and clinical characteristics of tissue-verified sarcoidosis in Iceland. A secondary aim was to analyse sex differences and identify possible environmental factors contributing to the pathological process. Materials and methods This is a descriptive study covering 36 years (January 1, 1981 through December 31, 2016). Histopathological reports and electronic hospital discharge registries were reviewed in context for granulomas and/or sarcoidosis. National data were used for comparison regarding smoking habits and occupation, adjusted for age, sex and year of diagnosis. The data were stored in FileMaker and calculations were made by extracting data from this database to the statistical software package R. Results A total of 418 patients (54% females) were diagnosed with tissue-verified sarcoidosis. The incidence rate was 4.15/100 000/year, similar among females and males. The mean age at diagnosis was higher among females (53.0±14.2 years) than males (48.2±13.8 years). Fatigue was the most frequent single symptom (49.7%), but when all respiratory symptoms were grouped, they were the most frequent symptoms (60%). No significant difference was found between smoking status and sarcoidosis. Possible hazardous exposure in the workplace was reported by 19.4% of the cases. Conclusion The incidence of sarcoidosis in Iceland was higher than in an Asian population where the same inclusion criteria were applied. The clinical picture diverges partly from that in the Asian population but resembles that among other Caucasians. Fatigue and respiratory symptoms were predominant. The biphasic pattern of age at disease debut seen elsewhere among females was not evident in Iceland. This paper describes a nationwide study on the incidence of tissue-verified sarcoidosis in Iceland, focusing on clinical symptoms, smoking and occupation. The incidence is low, and main symptoms are fatigue and symptoms of the respiratory tract.https://bit.ly/3ur6jk8
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Affiliation(s)
| | - Jon Gunnlaugur Jonasson
- Dept of Pathology, Landspitali University Hospital, Reykjavik, Iceland.,Faculty of Medicine, University of Iceland, Reykjavik, Iceland
| | | | | | - Thorarinn Gislason
- Faculty of Medicine, University of Iceland, Reykjavik, Iceland.,Dept of Sleep, Landspitali University Hospital, Reykjavik, Iceland
| | - Bjorn Gudbjornsson
- Faculty of Medicine, University of Iceland, Reykjavik, Iceland.,Centre for Rheumatology Research, Landspitali University Hospital, Reykjavik, Iceland
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20
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Murakami K, Hata S, Ishibashi N, Kubota M, Eishi Y, Uchida K, Tabata T, Nakamura Y, Murakami K. A Solitary Necrotizing Sarcoid Granulomatosis-like Pulmonary Lesion Possibly Associated with Propionibacterium acnes and Mycobacterium avium. Intern Med 2021; 60:3773-3778. [PMID: 34121004 PMCID: PMC8710391 DOI: 10.2169/internalmedicine.7162-21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
We report a case of a pulmonary necrotizing sarcoid granulomatosis (NSG)-like lesion possibly associated with coinfection of Mycobacterium avium and Propionibacterium acnes. A solitary nodule in the right middle lobe of the lung was notable for coagulative necrosis with aggregates of sarcoid-like epithelioid granulomas. Small arteries were damaged by granulomas. Both M. avium and P. acnes were detected in the lesion. Furthermore, more P. acnes genomes were detected in the granulomas than in the non-lesion lung. These findings blur the pathophysiologic boundaries among NSG, sarcoidosis, and mycobacteriosis, and suggest that NSG needs to be recognized as continuous spectra of sarcoidosis/mycobcteriosis.
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Affiliation(s)
- Keigo Murakami
- Division of Pathology, Faculty of Medicine, Tohoku Medical and Pharmaceutical University, Japan
| | - Shuko Hata
- Division of Pathology, Faculty of Medicine, Tohoku Medical and Pharmaceutical University, Japan
| | - Naoya Ishibashi
- Division of Thoracic Surgery, Faculty of Medicine, Tohoku Medical and Pharmaceutical University, Japan
| | - Motoki Kubota
- Division of Pathology, Faculty of Medicine, Tohoku Medical and Pharmaceutical University, Japan
| | - Yoshinobu Eishi
- Department of Human Pathology, Tokyo Medical and Dental University Graduate School, Japan
| | - Keisuke Uchida
- Department of Human Pathology, Tokyo Medical and Dental University Graduate School, Japan
| | - Toshiharu Tabata
- Division of Thoracic Surgery, Faculty of Medicine, Tohoku Medical and Pharmaceutical University, Japan
| | - Yasuhiro Nakamura
- Division of Pathology, Faculty of Medicine, Tohoku Medical and Pharmaceutical University, Japan
| | - Kazuhiro Murakami
- Division of Pathology, Faculty of Medicine, Tohoku Medical and Pharmaceutical University, Japan
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21
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Bradshaw MJ, Pawate S, Koth LL, Cho TA, Gelfand JM. Neurosarcoidosis: Pathophysiology, Diagnosis, and Treatment. NEUROLOGY-NEUROIMMUNOLOGY & NEUROINFLAMMATION 2021; 8:8/6/e1084. [PMID: 34607912 PMCID: PMC8495503 DOI: 10.1212/nxi.0000000000001084] [Citation(s) in RCA: 61] [Impact Index Per Article: 20.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/20/2021] [Accepted: 07/12/2021] [Indexed: 12/23/2022]
Abstract
Although often regarded as a protean illness with myriad clinical and imaging manifestations, neurosarcoidosis typically presents as recognizable syndromes that can be approached in a rational, systematic fashion. Understanding of neurosarcoidosis has progressed significantly in recent years, including updated diagnostic criteria and advances in treatment. The diagnosis of neurosarcoidosis is established by the clinical syndrome, imaging and histopathological findings, and exclusion of other causes. Mounting evidence supports the use of tumor necrosis factor inhibitors as an important addition to the therapeutic armamentarium, along with glucocorticoids and steroid-sparing cytotoxic immunosuppressants. In this narrative review, we summarize recent advances in the diagnosis and treatment of neurosarcoidosis.
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Affiliation(s)
- Michael J Bradshaw
- From the University of Washington and Billings Clinic, (M.J.B.); Vanderbilt University Medical Center (S.P.), Nashville, TN; Division of Pulmonary and Critical Care (L.L.K.), Department of Medicine, University of California, San Francisco; Division of Pulmonary and Critical Care, Department of Medicine; Univeristy of Iowa (T.A.C.), Iowa City; Department of Neurology (J.M.G.), Division of Neuroimmunology and Glial Biology, University of California, San Francisco.
| | - Siddharama Pawate
- From the University of Washington and Billings Clinic, (M.J.B.); Vanderbilt University Medical Center (S.P.), Nashville, TN; Division of Pulmonary and Critical Care (L.L.K.), Department of Medicine, University of California, San Francisco; Division of Pulmonary and Critical Care, Department of Medicine; Univeristy of Iowa (T.A.C.), Iowa City; Department of Neurology (J.M.G.), Division of Neuroimmunology and Glial Biology, University of California, San Francisco
| | - Laura L Koth
- From the University of Washington and Billings Clinic, (M.J.B.); Vanderbilt University Medical Center (S.P.), Nashville, TN; Division of Pulmonary and Critical Care (L.L.K.), Department of Medicine, University of California, San Francisco; Division of Pulmonary and Critical Care, Department of Medicine; Univeristy of Iowa (T.A.C.), Iowa City; Department of Neurology (J.M.G.), Division of Neuroimmunology and Glial Biology, University of California, San Francisco
| | - Tracey A Cho
- From the University of Washington and Billings Clinic, (M.J.B.); Vanderbilt University Medical Center (S.P.), Nashville, TN; Division of Pulmonary and Critical Care (L.L.K.), Department of Medicine, University of California, San Francisco; Division of Pulmonary and Critical Care, Department of Medicine; Univeristy of Iowa (T.A.C.), Iowa City; Department of Neurology (J.M.G.), Division of Neuroimmunology and Glial Biology, University of California, San Francisco
| | - Jeffrey M Gelfand
- From the University of Washington and Billings Clinic, (M.J.B.); Vanderbilt University Medical Center (S.P.), Nashville, TN; Division of Pulmonary and Critical Care (L.L.K.), Department of Medicine, University of California, San Francisco; Division of Pulmonary and Critical Care, Department of Medicine; Univeristy of Iowa (T.A.C.), Iowa City; Department of Neurology (J.M.G.), Division of Neuroimmunology and Glial Biology, University of California, San Francisco
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22
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Pure extra-thoracic sarcoidosis: about 24 cases. ACTA ACUST UNITED AC 2021; 59:312-317. [PMID: 33752271 DOI: 10.2478/rjim-2021-0012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2021] [Indexed: 11/20/2022]
Abstract
Introduction. Pure extra-thoracic sarcoidosis is rare and poorly characterized in the literature. Herein we present features of pure extra-thoracic sarcoidosis, in comparison with sarcoidosis with intra-thoracic involvement, in a population from the south of Tunisia. Methods. Retrospective, descriptive and comparative study of the patients presenting systemic sarcoidosis and attending the Department of Internal Medicine at the Hedi Chaker University Hospital, Sfax, Tunisia, for 21 years, from January 1996 to December 2016. Results. Twenty-four patients presented pure extra-thoracic sarcoidosis (30% of the cases of systemic sarcoidosis). There was a female predominance (79%). The mean age was 50 years. The main features were polyadenopathies (10 patients: 41.7%), cutaneous involvement (10 patients: 41.6%), inflammatory polyarthralgia (8 cases: 33.3%), general symptoms (6 patients: 25%), uveitis (6 cases: 25%), cholestasis (3 cases) and kidney involvement (2 cases). Lymphopenia, hypercalcemia, and hypercalciuria were observed each one in 12.5% of the cases, and high angiotensin converting enzyme (ACE) level in 38.5% of the cases. The histological proof was required in all the patients. Statistically significant associations identified were mainly hepatic involvement with general symptoms (p=0.035), peripheral lymphadenopathies (p=0.035) and kidney damage (p=0.022), and cutaneous involvement with articular manifestations (p=0.032). Systemic corticosteroids were used in half of the cases, with a good outcome in 21 cases, and recurrence in two cases. One patient was lost to follow up. The comparison to the form with mediastino-pulmonary involvement showed less lymphadenopathies (p=0.001), less lymphopenia (p=0.006), and less frequent use of corticosteroids (p=0.044). Conclusion. Our series was characterized by the frequency of the pure extra-thoracic form and the diversity of the systemic manifestations.
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23
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Hysa E, Cutolo CA, Gotelli E, Pacini G, Schenone C, Kreps EO, Smith V, Cutolo M. Immunopathophysiology and clinical impact of uveitis in inflammatory rheumatic diseases: An update. Eur J Clin Invest 2021; 51:e13572. [PMID: 33851422 PMCID: PMC8365741 DOI: 10.1111/eci.13572] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Accepted: 04/08/2021] [Indexed: 12/13/2022]
Abstract
BACKGROUND Uveitis is one of the most frequent ophthalmologic manifestations in rheumatology. Uveal inflammation can underlie a systemic inflammatory rheumatic disease (SIRD) in approximately 30% of cases with a significant burden on the quality of life since it represents a cause of blindness in up to 20% of cases in Western countries. METHODS In this review, we provide a comprehensive overview of the pathophysiology of uveitis associated with SIRDs. According to our literature survey on the epidemiology of uveitis among SIRDs, spondyloarthritides, Behçet's disease and sarcoidosis get the major impact. RESULTS In Behçet's uveitis, the key players are highly polarized Th1 and Th17 lymphocytes, natural killer T cells and γδ T cells. All contribute to a great destructive inflammatory environment with the most serious visual damage resulting from the involvement of the posterior segment of the eye. In contrast, spondyloarthritides-related uveitis derives from a complex interaction between genetic background and extra-ocular inflammatory mediators originating from enthesitis, arthritis, psoriatic lesions and microbiome pro-inflammatory alterations. In such conditions, the immune infiltration of CD4+ T cells, Th17 and natural killer cells along with pro-inflammatory cytokines, TNF-α among all, leads to intraocular inflammation. Lastly, granuloma formation represents the primary hallmark lesion in sarcoid uveitis. This suggests a profound link between the innate system that mainly recruits activated macrophages and adaptive system involving by Th1, Th17 and Th17.1 cells. CONCLUSIONS Awareness among rheumatologists of a potential severe ocular involvement generates new insights into targeted therapeutic approaches and personalized treatments for each patient.
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Affiliation(s)
- Elvis Hysa
- Laboratory of Experimental Rheumatology and Academic Division of Clinical RheumatologyDepartment of Internal MedicineItaly – IRCCS Rheumatology UnitSan Martino PolyclinicUniversity of GenoaGenoaItaly
| | - Carlo Alberto Cutolo
- Ophthalmology Clinic DiNOGMIIRCCS Ophthalmology Unit San Martino PolyclinicUniversity of GenoaGenoaItaly
| | - Emanuele Gotelli
- Laboratory of Experimental Rheumatology and Academic Division of Clinical RheumatologyDepartment of Internal MedicineItaly – IRCCS Rheumatology UnitSan Martino PolyclinicUniversity of GenoaGenoaItaly
| | - Greta Pacini
- Laboratory of Experimental Rheumatology and Academic Division of Clinical RheumatologyDepartment of Internal MedicineItaly – IRCCS Rheumatology UnitSan Martino PolyclinicUniversity of GenoaGenoaItaly
| | - Carlotta Schenone
- Laboratory of Experimental Rheumatology and Academic Division of Clinical RheumatologyDepartment of Internal MedicineItaly – IRCCS Rheumatology UnitSan Martino PolyclinicUniversity of GenoaGenoaItaly
| | - Elke O Kreps
- Department of OphthalmologyGhent University HospitalGhentBelgium
| | - Vanessa Smith
- Department of Internal MedicineDepartment of RheumatologyGhent. University HospitalGhent UniversityGhentBelgium
- Unit for Molecular Immunology and InflammationVIB Inflammation Research Center (IRC)GhentBelgium
| | - Maurizio Cutolo
- Laboratory of Experimental Rheumatology and Academic Division of Clinical RheumatologyDepartment of Internal MedicineItaly – IRCCS Rheumatology UnitSan Martino PolyclinicUniversity of GenoaGenoaItaly
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24
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Zhang C, Tian R, Dreifus EM, Hashemi Shahraki A, Holt G, Cai R, Griswold A, Bejarano P, Jackson R, V Schally A, Mirsaeidi M. Activity of the growth hormone-releasing hormone antagonist MIA602 and its underlying mechanisms of action in sarcoidosis-like granuloma. Clin Transl Immunology 2021; 10:e1310. [PMID: 34257968 PMCID: PMC8256670 DOI: 10.1002/cti2.1310] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Revised: 04/09/2021] [Accepted: 06/15/2021] [Indexed: 12/19/2022] Open
Abstract
OBJECTIVES Growth hormone-releasing hormone (GHRH) is a potent stimulator of growth hormone (GH) secretion from the pituitary gland. Although GHRH is essential for the growth of immune cells, the regulatory effects of its antagonist in granulomatous disease remain unknown. METHODS Here, we report expression of GHRH receptor (R) in human tissue with sarcoidosis granuloma and demonstrate the anti-inflammatory effects of MIA602 (a GHRH antagonist) in two in vitro human granuloma models and an in vivo granuloma model using different methods including ELISA, immunohistochemistry, RNA-seq analysis and flow cytometry. RESULTS MIA602 decreases the levels of IL-2, IL-2R, IL-7, IL-12, IL-17A and TNF-α in an in vitro granuloma model. Further, we show that the anti-inflammatory effect of MIA602 appears to be mediated by a reduction in CD45+CD68+ cells in granulomatous tissue and upregulation in PD-1 expression in macrophages. Analysis of the expression of proteins involved in the mitochondrial stage of apoptosis showed that MIA602 increases the levels of caspase-3, BCL-xL/BAK dimer and MCl-1/Bak dimer in the granuloma. These findings indicate that MIA602 may not induce apoptosis. CONCLUSIONS Our findings further suggest that GHRH-R is potentially a clinical target for the treatment of granulomatous disease and that MIA602 may be used as a novel therapeutic agent for sarcoidosis.
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Affiliation(s)
- Chongxu Zhang
- Section of PulmonaryMiami VA Healthcare SystemMiamiFLUSA
| | - Runxia Tian
- Section of PulmonaryMiami VA Healthcare SystemMiamiFLUSA
| | | | | | - Gregory Holt
- Section of PulmonaryMiami VA Healthcare SystemMiamiFLUSA
- Division of Pulmonary and Critical CareUniversity of MiamiMiamiFLUSA
| | - Renzhi Cai
- Section of PulmonaryMiami VA Healthcare SystemMiamiFLUSA
| | - Anthony Griswold
- School of MedicineJohn P. Hussman Institute for Human GenomicsUniversity of MiamiMiamiFLUSA
| | | | - Robert Jackson
- Section of PulmonaryMiami VA Healthcare SystemMiamiFLUSA
- School of MedicineUniversity of MiamiMiamiFLUSA
| | - Andrew V Schally
- Polypeptide and Cancer InstituteVeterans Affairs Medical CenterMiamiFLUSA
- Department of PathologyUniversity of Miami Miller School of MedicineMiamiFLUSA
| | - Mehdi Mirsaeidi
- Section of PulmonaryMiami VA Healthcare SystemMiamiFLUSA
- Division of Pulmonary and Critical CareUniversity of MiamiMiamiFLUSA
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25
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Chebbi D, Marzouk S, Snoussi M, Jallouli M, Gouiaa N, Boudawara T, Bahloul Z. Retrospective study of elderly onset sarcoidosis in Tunisian patients. SARCOIDOSIS, VASCULITIS, AND DIFFUSE LUNG DISEASES : OFFICIAL JOURNAL OF WASOG 2021; 38:e2021016. [PMID: 34316256 PMCID: PMC8288204 DOI: 10.36141/svdld.v38i2.10338] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/26/2020] [Accepted: 02/15/2021] [Indexed: 12/19/2022]
Abstract
BACKGROUND Sarcoidosis is a systemic granulomatous disease of unknown etiology. It affects mostly young adults. In the elderly, the presentation of this disease is different, often posing positive diagnosis problems. OBJECTIVES We intend to describe the various clinical features and the management of sarcoidosis in elderly patients (age ≥65 years) compared to the younger ones. METHODS We performed a retrospective, descriptive and comparative study in the Department of Internal Medicine in the University Hospital Hedi Chaker, Sfax, Tunisia, between 1996 and 2016. RESULTS From a series of 80 patients, we found sixteen patients (20%) with sarcoidosis diagnosed after the age of 65 years. A female preponderance (81,25%) was noted. Intrathoracic involvement concerned 13 patients (81,3%). Extrapulmonary signs were also frequent (93,8%). The main extrathoracic manifestations were ganglionar involvement (75%), an alteration of the general health (31,3%), hepatic involvement (31,3%), cutaneous involvement (25%) and ocular involvement (25%). Biological manifestations were hypercalcemia, hypercalciuria, lymphopenia and hypergammaglobulinemia noted in respectively 12,5%, 12,5%, 31,3% and 50% of the cases. Angiotensin-converting enzyme(ACE) level was elevated in 100% of the patients. Lymphadenopathy and cutaneous biopsies were important contributing factors to diagnosis (respectively: 100% and 75% were positive). Oral corticosteroid therapy was required in 50% of cases. Evolution was marked by pulmonary fibrosis in two cases. Satisfactory course of the disease was observed in the other patients. CONCLUSION Young and elderly subjects had common characteristics of sarcoidosis, except for more coexisting chronic morbidities, no erythema nodosum and more frequent high levels of ACE in the elderly group.
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Affiliation(s)
- Donia Chebbi
- Department of Internal Medicine, Hedi Chaker University Hospital, Sfax, Tunisia
| | - Sameh Marzouk
- Department of Internal Medicine, Hedi Chaker University Hospital, Sfax, Tunisia
| | - Mouna Snoussi
- Department of Internal Medicine, Hedi Chaker University Hospital, Sfax, Tunisia
| | - Moez Jallouli
- Department of Internal Medicine, Hedi Chaker University Hospital, Sfax, Tunisia
| | - Nawrez Gouiaa
- Department of Histology, Habib Bourguiba University Hospital, Sfax, Tunisia
| | - Tahia Boudawara
- Department of Histology, Habib Bourguiba University Hospital, Sfax, Tunisia
| | - Zouhir Bahloul
- Department of Internal Medicine, Hedi Chaker University Hospital, Sfax, Tunisia
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Fritz D, Ferwerda B, Brouwer MC, van de Beek D. Whole genome sequencing identifies variants associated with sarcoidosis in a family with a high prevalence of sarcoidosis. Clin Rheumatol 2021; 40:3735-3743. [PMID: 33903979 PMCID: PMC8357727 DOI: 10.1007/s10067-021-05684-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2020] [Revised: 12/23/2020] [Accepted: 01/03/2021] [Indexed: 02/07/2023]
Abstract
Objective We studied genetic risk factors associated with sarcoidosis within a family with a high prevalence of this disease. Methods We studied 41 members of a family with a high rate of sarcoidosis, including an index patient with treatment-resistant neurosarcoidosis. Whole genome sequencing was performed for six affected family members and variations associated with loss of function were filtered out as candidate genes. Findings were validated by using amplicon sequencing within all 41 family members with DNA available and candidate genes were screened on absence and presence within the sarcoidosis affected and non-affected. Results Family members (n = 61) from 5 generations were available for participation including 13 subjects diagnosed with sarcoidosis (20%). Analyses identified 36 candidate variants within 34 candidate genes. Variations within three of these genes (JAK2, BACH2, and NCF1) previously have been associated with autoimmune diseases. Conclusions We identified 34 genes with a possible role in the etiology of sarcoidosis, including JAK2. Our results may suggest evaluation of JAK inhibitors in treatment-resistant sarcoidosis.
Key Points • JAK2 has a potential role in the etiology of sarcoidosis and is a potential therapeutic target. • We identified 33 additional candidate genes of which BACH2 and NCF1 have been previously associated with autoimmune disease. |
Supplementary Information The online version contains supplementary material available at 10.1007/s10067-021-05684-w.
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Affiliation(s)
- Daan Fritz
- Department of Neurology, Amsterdam Neuroscience, University of Amsterdam, Amsterdam UMC, P.O. Box 22660, Meibergdreef 9, 1100 DD, Amsterdam, The Netherlands
| | - Bart Ferwerda
- Department of Neurology, Amsterdam Neuroscience, University of Amsterdam, Amsterdam UMC, P.O. Box 22660, Meibergdreef 9, 1100 DD, Amsterdam, The Netherlands
| | - Matthijs C Brouwer
- Department of Neurology, Amsterdam Neuroscience, University of Amsterdam, Amsterdam UMC, P.O. Box 22660, Meibergdreef 9, 1100 DD, Amsterdam, The Netherlands
| | - Diederik van de Beek
- Department of Neurology, Amsterdam Neuroscience, University of Amsterdam, Amsterdam UMC, P.O. Box 22660, Meibergdreef 9, 1100 DD, Amsterdam, The Netherlands.
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Nishiyama M, Li HJ, Okafuji I, Fujisawa A, Ehara M, Kambe N, Furukawa F, Kanazawa N. Sustained Surface ICAM-1 Expression and Transient PDGF-B Production by Phorbol Myristate Acetate-Activated THP-1 Cells Harboring Blau Syndrome-Associated NOD2 Mutations. CHILDREN-BASEL 2021; 8:children8050335. [PMID: 33923123 PMCID: PMC8145400 DOI: 10.3390/children8050335] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/31/2020] [Revised: 04/19/2021] [Accepted: 04/21/2021] [Indexed: 11/21/2022]
Abstract
Objectives: Blau syndrome is a distinct class of autoinflammatory syndrome presenting with early-onset systemic granulomatosis. Blau syndrome-causing NOD2 mutations located in the central nucleotide-oligomerization domain induce ligand-independent basal NF-κB activation in an in vitro reporter assay. However, the precise role of this signaling on granuloma formation has not yet been clarified. Methods: Blau syndrome-causing NOD2 mutations were introduced into human monocytic THP-1 cells, and their morphological and molecular changes from parental cells were analyzed. Identified molecules with altered expression were examined in the patient’s lesional skin by immunostaining. Results: Although the production of proinflammatory cytokines was not altered without stimulation, mutant NOD2-expressing THP-1 cells attached persistently to the culture plate after stimulation with phorbol myristate acetate. Sustained surface ICAM-1 expression was observed in association with this phenomenon, but neither persistent ICAM-1 mRNA expression nor impaired ADAM17 mRNA expression was revealed. However, the transient induction of PDGF-B mRNA expression was specifically observed in stimulated THP-1 derivatives. In the granulomatous skin lesion of a Blau syndrome patient, ICAM-1 and PDGF-B were positively immunostained in NOD2-expressing giant cells. Conclusions: Sustained surface ICAM-1 expression and transient PDGF-B production by newly differentiating macrophages harboring mutant NOD2 might play a role in granuloma formation in Blau syndrome.
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Affiliation(s)
- Mizuho Nishiyama
- Department of Dermatology, School of Medicine, Wakayama Medical University, Wakayama 641-0012, Japan; (M.N.); (H.-j.L.); (F.F.)
| | - Hong-jin Li
- Department of Dermatology, School of Medicine, Wakayama Medical University, Wakayama 641-0012, Japan; (M.N.); (H.-j.L.); (F.F.)
| | - Ikuo Okafuji
- Department of Pediatrics, Kobe City Medical Center General Hospital, Kobe 650-0047, Japan;
| | - Akihiko Fujisawa
- Department of Dermatology, Graduate School of Medicine, Kyoto University, Kyoto 606-8507, Japan; (A.F.); (N.K.)
| | - Mizue Ehara
- Department of Dermatology, Graduate School of Medicine, Chiba University, Chiba 260-8670, Japan;
| | - Naotomo Kambe
- Department of Dermatology, Graduate School of Medicine, Kyoto University, Kyoto 606-8507, Japan; (A.F.); (N.K.)
- Department of Dermatology, Graduate School of Medicine, Chiba University, Chiba 260-8670, Japan;
| | - Fukumi Furukawa
- Department of Dermatology, School of Medicine, Wakayama Medical University, Wakayama 641-0012, Japan; (M.N.); (H.-j.L.); (F.F.)
| | - Nobuo Kanazawa
- Department of Dermatology, School of Medicine, Wakayama Medical University, Wakayama 641-0012, Japan; (M.N.); (H.-j.L.); (F.F.)
- Department of Dermatology, School of Medicine, Hyogo College of Medicine, Nishinomiya 663-8501, Japan
- Correspondence:
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Minasyan M, Sharma L, Pivarnik T, Liu W, Adams T, Bermejo S, Peng X, Liu A, Ishikawa G, Perry C, Kaminski N, Gulati M, Herzog EL, Dela Cruz CS, Ryu C. Elevated IL-15 concentrations in the sarcoidosis lung are independent of granuloma burden and disease phenotypes. Am J Physiol Lung Cell Mol Physiol 2021; 320:L1137-L1146. [PMID: 33851886 DOI: 10.1152/ajplung.00575.2020] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
Sarcoidosis is a systemic granulomatous disease predominantly affecting the lungs. The mechanisms promoting disease pathogenesis and progression are unknown, although interleukin-15 (IL-15) has been associated with the immune-mediated inflammation of sarcoidosis. Because the identification of a mechanistically based, clinically relevant biomarker for sarcoidosis remains elusive, we hypothesized this role for IL-15. Pulmonary sarcoidosis granuloma formation was modeled using trehalose 6,6'-dimicolate (TDM), which was administered into wild-type and three lineages of mice: those overexpressing IL-15, deficient in IL-15, and deficient in IL-15 receptor α. The number of granulomas per lung was counted and normalized to the wild type. IL-15 concentrations were measured in the bronchoalveolar lavage (BAL) from healthy controls and subjects with sarcoidosis in our cohort, where associations between IL-15 levels and clinical manifestations were sought. Findings were validated in another independent sarcoidosis cohort. TDM administration resulted in similar granuloma numbers across all lineages of mice. IL-15 concentrations were elevated in the BAL of both human cohorts, irrespective of disease phenotypes. In exploratory analysis, an association with obesity was observed, and various other soluble mediators were identified in the BAL of both cohorts. Although IL-15 is enriched in the sarcoidosis lung, it was independent of disease pathogenesis or clinical manifestations in our mouse model and human cohorts of sarcoidosis. An association with obesity perhaps reflects the ongoing inflammatory processes of these comorbid conditions. Our findings showed that IL-15 is redundant for disease pathogenesis and clinical progression of sarcoidosis.
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Affiliation(s)
- Maksym Minasyan
- Section of Pulmonary, Critical Care, and Sleep Medicine, Yale School of Medicine, Yale University, New Haven, Connecticut
| | - Lokesh Sharma
- Section of Pulmonary, Critical Care, and Sleep Medicine, Yale School of Medicine, Yale University, New Haven, Connecticut
| | - Taylor Pivarnik
- Section of Pulmonary, Critical Care, and Sleep Medicine, Yale School of Medicine, Yale University, New Haven, Connecticut
| | - Wei Liu
- Section of Pulmonary, Critical Care, and Sleep Medicine, Yale School of Medicine, Yale University, New Haven, Connecticut
| | - Taylor Adams
- Section of Pulmonary, Critical Care, and Sleep Medicine, Yale School of Medicine, Yale University, New Haven, Connecticut
| | - Santos Bermejo
- Section of Pulmonary, Critical Care, and Sleep Medicine, Yale School of Medicine, Yale University, New Haven, Connecticut
| | - Xiaohua Peng
- Section of Pulmonary, Critical Care, and Sleep Medicine, Yale School of Medicine, Yale University, New Haven, Connecticut
| | - Angela Liu
- Section of Pulmonary, Critical Care, and Sleep Medicine, Yale School of Medicine, Yale University, New Haven, Connecticut
| | - Genta Ishikawa
- Section of Pulmonary, Critical Care, and Sleep Medicine, Yale School of Medicine, Yale University, New Haven, Connecticut
| | - Carrighan Perry
- Section of Pulmonary, Critical Care, and Sleep Medicine, Yale School of Medicine, Yale University, New Haven, Connecticut
| | - Naftali Kaminski
- Section of Pulmonary, Critical Care, and Sleep Medicine, Yale School of Medicine, Yale University, New Haven, Connecticut
| | - Mridu Gulati
- Section of Pulmonary, Critical Care, and Sleep Medicine, Yale School of Medicine, Yale University, New Haven, Connecticut
| | - Erica L Herzog
- Section of Pulmonary, Critical Care, and Sleep Medicine, Yale School of Medicine, Yale University, New Haven, Connecticut
| | - Charles S Dela Cruz
- Section of Pulmonary, Critical Care, and Sleep Medicine, Yale School of Medicine, Yale University, New Haven, Connecticut
| | - Changwan Ryu
- Section of Pulmonary, Critical Care, and Sleep Medicine, Yale School of Medicine, Yale University, New Haven, Connecticut
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Bunting ME, Hawie JB, Lancaster DD, Johnson TM. Firm swelling of the lips and aphthouslike oral ulcers associated with new-onset allergies. J Am Dent Assoc 2021; 153:274-283. [PMID: 33840454 DOI: 10.1016/j.adaj.2021.01.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Revised: 01/15/2021] [Accepted: 01/31/2021] [Indexed: 10/21/2022]
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Yamaguchi T, Costabel U, McDowell A, Guzman J, Uchida K, Ohashi K, Eishi Y. Immunohistochemical Detection of Potential Microbial Antigens in Granulomas in the Diagnosis of Sarcoidosis. J Clin Med 2021; 10:jcm10050983. [PMID: 33801218 PMCID: PMC7957865 DOI: 10.3390/jcm10050983] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Revised: 02/17/2021] [Accepted: 02/23/2021] [Indexed: 01/06/2023] Open
Abstract
Sarcoidosis may have more than a single causative agent, including infectious and non-infectious agents. Among the potential infectious causes of sarcoidosis, Mycobacterium tuberculosis and Propionibacterium acnes are the most likely microorganisms. Potential latent infection by both microorganisms complicates the findings of molecular and immunologic studies. Immune responses to potential infectious agents of sarcoidosis should be considered together with the microorganisms detected in sarcoid granulomas, because immunologic reactivities to infectious agents reflect current and past infection, including latent infection unrelated to the cause of the granuloma formation. Histopathologic data more readily support P. acnes as a cause of sarcoidosis compared with M. tuberculosis, suggesting that normally symbiotic P. acnes leads to granuloma formation in some predisposed individuals with Th1 hypersensitivity against intracellular proliferation of latent P. acnes, which may be triggered by certain host or drug-induced conditions. Detection of bacterial nucleic acids in granulomas does not necessarily indicate co-localization of the bacterial proteins in the granulomas. In the histopathologic diagnosis of sarcoidosis, M. tuberculosis-associated and P. acnes-associated sarcoidosis will possibly be differentiated in some patients by immunohistochemistry with appropriate antibodies that specifically react with mycobacterial and propionibacterial antigens, respectively, for each etiology-based diagnosis and potential antimicrobial intervention against sarcoidosis.
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Affiliation(s)
- Tetsuo Yamaguchi
- Department of Human Pathology, Graduate School and Faculty of Medicine, Tokyo Medical and Dental University, Tokyo 113-8519, Japan; (T.Y.); (K.U.); (K.O.)
- Department of Pulmonology, Shinjuku Tsurukame Clinic, Tokyo 151-0053, Japan
| | - Ulrich Costabel
- Department of Pneumology, Ruhrlandklinik, Medical Faculty, University of Duisburg-Essen, 45239 Essen, Germany;
| | - Andrew McDowell
- Nutrition Innovation Centre for Food and Health (NICHE), School of Biomedical Sciences, Ulster University, Coleraine BT52 1SA, UK;
| | - Josune Guzman
- Department of General and Experimental Pathology, Ruhr University, 44801 Bochum, Germany;
| | - Keisuke Uchida
- Department of Human Pathology, Graduate School and Faculty of Medicine, Tokyo Medical and Dental University, Tokyo 113-8519, Japan; (T.Y.); (K.U.); (K.O.)
| | - Kenichi Ohashi
- Department of Human Pathology, Graduate School and Faculty of Medicine, Tokyo Medical and Dental University, Tokyo 113-8519, Japan; (T.Y.); (K.U.); (K.O.)
| | - Yoshinobu Eishi
- Department of Human Pathology, Graduate School and Faculty of Medicine, Tokyo Medical and Dental University, Tokyo 113-8519, Japan; (T.Y.); (K.U.); (K.O.)
- Correspondence: ; Tel.: +81-90-3332-0948
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Ishimaru N, Ohnishi J, Seto H, Kanzawa Y, Sano N, Kinami S. Therapeutic Dilemma of Sarcoidosis and Treatment-naïve Hepatitis C Manifesting as Tattoo Reactions. Intern Med 2021; 60:645-650. [PMID: 32999233 PMCID: PMC7946501 DOI: 10.2169/internalmedicine.5606-20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
A 23-year-old man had an 8-day history of fatigue and dry cough and papulo-nodular reactions on his extensive tattoos. Chest radiography revealed several small granular shadows, and a transbronchial lung biopsy showed non-caseating epithelioid cell granuloma. A skin biopsy of the tattooed area showed histiocytic infiltrates with phagocytized tattoo pigment. Antibody tests for hepatitis C virus were positive. The patient was successfully treated with corticosteroid therapy, and after inflammation was suppressed, he received delayed anti-viral therapy. Sarcoidosis should be considered as a concurrent condition if papules are presented on the tattoos of patients with hepatitis C.
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Affiliation(s)
- Naoto Ishimaru
- Department of General Internal Medicine, Akashi Medical Center, Japan
| | - Jun Ohnishi
- Department of General Internal Medicine, Akashi Medical Center, Japan
| | - Hiroyuki Seto
- Department of General Internal Medicine, Akashi Medical Center, Japan
| | - Yohei Kanzawa
- Department of General Internal Medicine, Akashi Medical Center, Japan
| | - Nobuya Sano
- Department of Pathology, Akashi Medical Center, Japan
| | - Saori Kinami
- Department of General Internal Medicine, Akashi Medical Center, Japan
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Challenges in Cardiac and Pulmonary Sarcoidosis: JACC State-of-the-Art Review. J Am Coll Cardiol 2021; 76:1878-1901. [PMID: 33059834 DOI: 10.1016/j.jacc.2020.08.042] [Citation(s) in RCA: 95] [Impact Index Per Article: 31.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2020] [Revised: 08/12/2020] [Accepted: 08/13/2020] [Indexed: 12/17/2022]
Abstract
Sarcoidosis is a complex disease with heterogeneous clinical presentations that can affect virtually any organ. Although the lung is typically the most common organ involved, combined pulmonary and cardiac sarcoidosis (CS) account for most of the morbidity and mortality associated with this disease. Pulmonary sarcoidosis can be asymptomatic or result in impairment in quality of life and end-stage, severe, and/or life-threatening disease. The latter outcome is seen almost exclusively in those with fibrotic pulmonary sarcoidosis, which accounts for 10% to 20% of pulmonary sarcoidosis patients. CS is problematic to diagnose and may cause significant morbidity and death from heart failure or ventricular arrhythmias. The diagnosis of CS usually requires surrogate cardiac imaging biomarkers, as endomyocardial biopsy has relatively low yield, even with directed electrophysiological mapping. Treatment of CS is often multifactorial, involving a combination of antigranulomatous therapy and pharmacotherapy for cardiac arrhythmias and/or heart failure in addition to device placement and cardiac transplantation.
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Tamada T, Nara M, Murakami K, Gamo S, Aritake H, Shimizu M, Kazama I, Ichinose M, Sugiura H. The Clinical Features of Patients with Sarcoidosis and Malignant Diseases in Japan. Intern Med 2021; 60:209-216. [PMID: 33456025 PMCID: PMC7872817 DOI: 10.2169/internalmedicine.5441-20] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Objective Recent studies suggest a significant association between sarcoidosis and malignancy, although the results have remained controversial. The aim of this study is to evaluate the clinical features of patients with sarcoidosis associated with malignant diseases in Japan. Patients We conducted a medical record review of all sarcoidosis patients in Tohoku University Hospital between January 1, 1981, and May 31, 2017. Methods The clinical records and pathology reports for each patient were screened, and the clinical characteristics of malignancies as well as sarcoidosis were reviewed. Results A total of 52 (18.8%) patients with malignancy were identified among 277 patients with sarcoidosis. Among those 52 patients, we identified 62 with malignant diseases. These patients were older and more likely to be women than the remaining 225 (81.2%) sarcoidosis patients without malignancy. The most prevalent malignant disease was breast cancer (14 cases, 22.6%), followed by stomach cancer (8 cases, 12.9%) and lung cancer (7 cases, 11.3%). Among the 14 patients with both sarcoidosis and breast cancer, 8 (57.1%) were diagnosed with breast cancer before sarcoidosis. All of these eight cases had undergone surgical resection of the cancer. Conclusion This study showed a higher incidence of patients with both sarcoidosis and malignancy in Japan than in some western countries. Breast cancer is the most prevalent malignant disease. The high frequency of sarcoidosis after surgical resection of breast cancer may suggest a causative association between malignancy and the development of sarcoidosis.
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Affiliation(s)
- Tsutomu Tamada
- Department of Respiratory Medicine, Tohoku University Graduate School of Medicine, Japan
| | - Masayuki Nara
- National Hospital Organization Akita National Hospital, Japan
| | - Koji Murakami
- Department of Respiratory Medicine, Tohoku University Graduate School of Medicine, Japan
| | - Shunichi Gamo
- Department of Respiratory Medicine, Tohoku University Graduate School of Medicine, Japan
| | - Hidemi Aritake
- Department of Respiratory Medicine, Tohoku University Graduate School of Medicine, Japan
| | - Megumi Shimizu
- Department of Gerontological and Home Healthcare Nursing, Course of Nursing, Tohoku University Graduate School of Medicine, Japan
| | | | - Masakazu Ichinose
- Department of Respiratory Medicine, Tohoku University Graduate School of Medicine, Japan
| | - Hisatoshi Sugiura
- Department of Respiratory Medicine, Tohoku University Graduate School of Medicine, Japan
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Zhou AY, Seed M, Carder M, Money A, Van Tongeren M, Agius R. Sentinel approach to detect emerging causes of work-related respiratory diseases. Occup Med (Lond) 2020; 70:52-59. [PMID: 31863117 DOI: 10.1093/occmed/kqz159] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND The world of work is continually changing, and this could result in new and emerging risks being introduced, including those that may cause work-related respiratory diseases (WRRD). AIMS To describe recently emerging and new cases of WRRD and the relevant methodology using data in a national occupational respiratory disease surveillance scheme in the UK. METHODS Incident cases of respiratory diseases reported by physicians to the Surveillance of Work-related and Occupational Respiratory Disease (SWORD) between January 2015 and December 2017 were included. Potentially emerging respiratory hazards manifesting in SWORD data were identified with the following hierarchical approach: (i) new respiratory disease not previously associated with work, (ii) specific exposure/agent not previously associated with WRRD and (iii) industry and/or occupation not previously associated with WRRD. RESULTS A total of 1215 cases of WRRD were reported to SWORD between January 2015 and December 2017. No new WRRD were identified. Thirteen potentially emerging causes of occupational asthma were identified, including exposures to agents such as ninhydrin. Four potential new causes were identified for interstitial pneumonia, which included wood and brass dust. Two potentially emerging causes of WRRD were identified for inhalational accidents (green coffee and nitrocellulose), hypersensitivity pneumonitis (diphenylmethane diisocyanate and salami mould), rhinitis (morphine and Amaranthus quitensis) and sarcoidosis (prions and horses). CONCLUSIONS Continuous monitoring and reporting of any new work-related disease is a critical function of any occupational disease reporting scheme. Potential emerging causes of work-related health risks have been identified by using a simple and systematic way of detecting emerging causes of WRRDs.
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Affiliation(s)
- A Y Zhou
- Centre of Occupational and Environmental Health, University of Manchester, Oxford Rd, Manchester, UK
| | - M Seed
- Centre of Occupational and Environmental Health, University of Manchester, Oxford Rd, Manchester, UK
| | - M Carder
- Centre of Occupational and Environmental Health, University of Manchester, Oxford Rd, Manchester, UK
| | - A Money
- Centre of Occupational and Environmental Health, University of Manchester, Oxford Rd, Manchester, UK
| | - M Van Tongeren
- Centre of Occupational and Environmental Health, University of Manchester, Oxford Rd, Manchester, UK
| | - R Agius
- Centre of Occupational and Environmental Health, University of Manchester, Oxford Rd, Manchester, UK
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Mukai T, Fujiwara D, Miyake T, Fujita S, Morizane S, Morita Y. Tattoo skin reaction as a skin manifestation of systemic sarcoidosis. Mod Rheumatol Case Rep 2020; 5:167-171. [PMID: 32967569 DOI: 10.1080/24725625.2020.1816645] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
A 41-year-old man presented with itching of the skin surrounding his tattoos, blurred vision, fever, general fatigue, and arthralgia. Physical examination revealed skin bulges confined to the tattoo ink lines. Histological analyses of the skin revealed non-caseating granulomas surrounding the tattoo inks. Together with other clinical manifestations including uveitis, lymph nodes swelling, and elevated serum angiotensin-converting enzyme and lysozyme, he was diagnosed with systemic sarcoidosis. The administration of prednisolone alleviated the sarcoidosis-related symptoms, including skin changes. This case illustrates that skin changes on tattoos can be a presenting manifestation of systemic sarcoidosis and that skin biopsy is useful in early diagnosis.
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Affiliation(s)
- Tomoyuki Mukai
- Department of Rheumatology, Kawasaki Medical School, Okayama, Japan.,Department of Internal Medicine, Fukuyama City Hospital, Hiroshima, Japan
| | - Dan Fujiwara
- Department of Dermatology, Fukuyama City Hospital, Hiroshima, Japan
| | - Tomoko Miyake
- Department of Ophthalmology, Fukuyama City Hospital, Hiroshima, Japan
| | - Shunichi Fujita
- Department of Rheumatology, Kawasaki Medical School, Okayama, Japan
| | - Shin Morizane
- Department of Dermatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Yoshitaka Morita
- Department of Rheumatology, Kawasaki Medical School, Okayama, Japan
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Killian M, Habougit C, Monard E, Gramont B. Systemic sarcoidosis revealed by venepunctures: a very rare but rewarding cutaneous manifestation. BMJ Case Rep 2020; 13:13/9/e235784. [PMID: 32900730 DOI: 10.1136/bcr-2020-235784] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
A 67-year-old man was referred to our department for the onset of cutaneous lesions following venepunctures. His recent medical history included brief flu-like syndrome, persistent cough, dyspnoea, dry mouth, blurred vision and weight loss. The extensive clinical, biological and radiological check-up showed signs consistent with systemic sarcoidosis: right uveitis, hypercalcemia, renal failure, inflammatory syndrome, elevated levels of ACE, alveolitis with elevated CD4+/CD8+ T cell ratio, hilar and mediastinal lymphadenopathy, bilateral pulmonary infiltrates, mild bronchial obstruction and lowered diffusing capacity of the lungs for carbon monoxide. Multiple biopsy samples (bronchus, accessory salivary glands and one of the skin lesions) eventually confirmed the diagnosis. Corticosteroids resulted in skin lesions resolution in a few days and overall clinical, biological and lung function improvement. The infiltration of scars by granulomatous tissue is well recognised in sarcoidosis but its onset in venepuncture sites is a very rare but easily recognisable condition, which can be helpful for quick diagnosis purpose.
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Affiliation(s)
- Martin Killian
- Department of Internal Medicine, Centre Hospitalier Universitaire de Saint-Etienne, Saint-Etienne, Loire, France .,GIMAP, Université Jean Monnet Saint-Etienne, Saint-Etienne, Loire, France
| | - Cyril Habougit
- Laboratory of Pathology, Centre Hospitalier Universitaire de Saint-Etienne, Saint-Etienne, Loire, France
| | - Eric Monard
- Department of Internal Medicine, Centre Hospitalier Chalon sur Saone, Chalon-sur-Saone, France
| | - Baptiste Gramont
- Department of Internal Medicine, Centre Hospitalier Universitaire de Saint-Etienne, Saint-Etienne, Loire, France
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37
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Cho TA, Jones A. CNS vasculopathies: Challenging mimickers of primary angiitis of the central nervous system. Best Pract Res Clin Rheumatol 2020; 34:101569. [PMID: 32859518 DOI: 10.1016/j.berh.2020.101569] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Primary angiitis of the central nervous system (CNS) is an inflammatory vasculopathy affecting the brain and spinal cord. It is a difficult diagnosis to make because of its insidious nonspecific course and its multiple mimics. This review identifies and discusses some noninfectious mimickers of primary CNS angiitis, including: reversible cerebral vasoconstriction syndrome, Sneddon's Syndrome, amyloid-beta-related angiopathy, Susac Syndrome, and neurosarcoidosis. Each condition will be reviewed in terms of epidemiology, pathology, clinical presentation, diagnostic approach, and treatment. Distinguishing these mimics from the primary angiitis of the CNS is important for proper treatment and prognosis.
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Affiliation(s)
| | - Ann Jones
- 200 Hawkins Drive, Iowa City, IA, 52242, USA.
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38
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Voortman M, Stern BJ, Saketkoo LA, Drent M. The Burden of Neurosarcoidosis: Essential Approaches to Early Diagnosis and Treatment. Semin Respir Crit Care Med 2020; 41:641-651. [PMID: 32777849 DOI: 10.1055/s-0040-1710576] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Neurosarcoidosis (NS) is an often severe, destructive manifestation with a likely under-reported prevalence of 5 to 15% of sarcoidosis cases, and in its active phase demands timely treatment intervention. Clinical signs and symptoms of NS are variable and wide-ranging, depending on anatomical involvement. Cranial nerve dysfunction, cerebrospinal parenchymal disease, aseptic meningitis, and leptomeningeal disease are the most commonly recognized manifestations. However, non-organ-specific potentially neurologically driven symptoms, such as fatigue, cognitive dysfunction, and small fiber neuropathy, appear frequently.Heterogeneous clinical presentations and absence of any single conclusive test or biomarker render NS, and sarcoidosis itself, a challenging definitive diagnosis. Clinical suspicion of NS warrants a thorough systemic and neurologic evaluation hopefully resulting in supportive extraneural physical exam and/or tissue findings. Treatment targets the severity of the manifestation, with careful discernment of whether NS reflects active potentially reversible inflammatory granulomatous disease versus inactive postinflammatory damage whereby functional impairment is unlikely to be pharmacologically responsive. Non-organ-specific symptoms are poorly understood, challenging in deciphering reversibility and often identified too late to respond to conventional immunosuppressive/pharmacological treatment. Physical therapy, coping strategies, and stress reduction may benefit patients with all disease activity levels of NS.This publication provides an approach to screening, diagnosis, disease activity discernment, and pharmacological as well as nonpharmacological treatment interventions to reduce disability and protect health-related quality of life in NS.
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Affiliation(s)
- Mareye Voortman
- Division of Heart and Lungs, Department of Pulmonology, University Medical Centre Utrecht, The Netherlands.,ILD Care Foundation Research Team, Ede, The Netherlands
| | - Barney J Stern
- Department of Neurology, Johns Hopkins University, Baltimore, Maryland
| | - Lesley Ann Saketkoo
- New Orleans Scleroderma and Sarcoidosis Patient Care and Research Center, New Orleans, Louisiana.,Comprehensive Pulmonary Hypertension Center and Interstitial Lung Disease Clinic Programs, University Medical Center, New Orleans, Louisiana.,Louisiana State University and Tulane University Schools of Medicine, New Orleans, Louisiana
| | - Marjolein Drent
- ILD Care Foundation Research Team, Ede, The Netherlands.,Department of Pharmacology and Toxicology, FHML, Maastricht University, Maastricht, The Netherlands.,Department of Pulmonology, ILD Center of Excellence, St. Antonius Hospital, Nieuwegein, The Netherlands
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39
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Dhont S, Leys M, De Sutter E, Alaerts H, Van Moerkercke W. Uveitis as a window to diagnosis of sarcoidosis - case report and review of the literature. Acta Clin Belg 2020; 75:245-249. [PMID: 31057065 DOI: 10.1080/17843286.2019.1613309] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Sarcoidosis is a multisystem disease of unclear etiology with a variable clinical profile characterized by the presence of non-caseating granuloma in involved organs. The diagnosis is often challenging and based on clinical, radiological and anatomopathological data. Sarcoidosis can be benign and self-limiting, but some cases may follow a chronic, progressive course and result in severe morbidity. The disease has a predilection for the lungs and thoracic lymph nodes but can involve nearly any part of the body, possible more commonly in areas with contact to the external environment, such as the eyes and the skin. This paper is based on a case in which a recurrent uveitis led to the diagnosis of an underlying sarcoidosis.
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Affiliation(s)
- Sebastiaan Dhont
- Department of Internal Medicine, AZ Groeninge, President Kennedylaan, Kortrijk, Belgium
| | - Mathias Leys
- Department of Pneumology, AZ Groeninge, President Kennedylaan, Kortrijk, Belgium
| | | | - Herwig Alaerts
- Department of Anatomopathology, AZ Groeninge, President Kennedylaan, Kortrijk, Belgium
| | - Wouter Van Moerkercke
- Department of Gastroenterology, AZ Groeninge, President Kennedylaan, Kortrijk, Belgium
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40
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Fukui S, Morimoto S, Ichinose K, Nakashima S, Ishimoto H, Hara A, Kakugawa T, Sakamoto N, Tsuji Y, Aramaki T, Koga T, Kawashiri SY, Iwamoto N, Tamai M, Nakamura H, Origuchi T, Ueki Y, Suzuki S, Mukae H, Kawakami A. Comparison of lung microbiota between antineutrophil cytoplasmic antibody-associated vasculitis and sarcoidosis. Sci Rep 2020; 10:9466. [PMID: 32528054 PMCID: PMC7289840 DOI: 10.1038/s41598-020-66178-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2018] [Accepted: 05/14/2020] [Indexed: 12/13/2022] Open
Abstract
Microbial involvement in the pathogenesis have been suggested in both antineutrophil cytoplasmic antibody-associated vasculitis (AAV) and sarcoidosis, both of which have lung involvement. However, exhaustive research to assess the bacteria in the lung in AAV and in sarcoidosis have not been performed. We sought to elucidate the distinct dysbiotic lung microbiota between AAV and sarcoidosis. We used 16S rRNA gene high-throughput sequencing to obtain the bacterial community composition of bronchoalveolar lavage fluid (BALF) in patients with AAV (n = 16) compared to patients with sarcoidosis (n = 21). The patients had not undergone therapy with immunosuppressive medication when their BALF was acquired. No difference was observed in α-diversity between patients with AAV and patients with sarcoidosis when using all the detected taxa. We defined the taxa of the oral cavity by using the data of oral microbiota of healthy individuals from the Human Microbiome Project (HMP). The analysis using only oral taxa made the difference in α-diversity between AAV and sarcoidosis clearer compared with those using all the detected taxa. Besides, the analysis using detected taxa except for oral taxa also made the difference in α-diversity between AAV and sarcoidosis clearer compared with those using all the detected taxa. A linear negative relationship between the α-diversity and Birmingham vasculitis activity score (BVAS) was detected in the AAV group. The observed p-value for the effect of the disease groups on the ß-diversity was small while the effect of other factors including sex and smoking status did not have small p-values. By excluding oral taxa from all the detected taxa, we found a cluster mainly consisted of sarcoidosis patients which was characterized with microbial community monopolized by Erythrobacteraceae family. Our results suggested the importance of considering the influence of oral microbiota in evaluating lung microbiota.
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Affiliation(s)
- Shoichi Fukui
- Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
- Department of Community Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Shimpei Morimoto
- Innovation Platform & Office for Precision Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Kunihiro Ichinose
- Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan.
| | - Shota Nakashima
- Department of Respiratory Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Hiroshi Ishimoto
- Department of Respiratory Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Atsuko Hara
- Department of Respiratory Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Tomoyuki Kakugawa
- Department of Respiratory Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Noriho Sakamoto
- Department of Respiratory Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Yoshika Tsuji
- Rheumatic and Collagen Disease Center, Sasebo Chuo Hospital, Sasebo, Japan
| | - Toshiyuki Aramaki
- Rheumatic and Collagen Disease Center, Sasebo Chuo Hospital, Sasebo, Japan
| | - Tomohiro Koga
- Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
- Center for Bioinformatics and Molecular Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Shin-Ya Kawashiri
- Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
- Department of Community Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Naoki Iwamoto
- Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Mami Tamai
- Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Hideki Nakamura
- Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Tomoki Origuchi
- Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
- Department of Rehabilitation Sciences, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Yukitaka Ueki
- Rheumatic and Collagen Disease Center, Sasebo Chuo Hospital, Sasebo, Japan
| | - Shino Suzuki
- Kochi Institute for Core Sample Research, X-star, Japan Agency for Marine-Earth Science and Technology (JAMSTEC), Nankoku, Japan
| | - Hiroshi Mukae
- Department of Respiratory Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Atsushi Kawakami
- Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
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41
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Jonsson E, Järvholm B, Andersson M. Silica dust and sarcoidosis in Swedish construction workers. Occup Med (Lond) 2020; 69:482-486. [PMID: 31504840 PMCID: PMC6913734 DOI: 10.1093/occmed/kqz118] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Abstract
Background The aetiology of sarcoidosis is not well established. In previous studies, smoking has been negatively associated with sarcoidosis and there are some indications of an association between exposure to silica dust and sarcoidosis. Aims To study the risk of sarcoidosis in relation to silica dust exposure. Methods A longitudinal cohort of construction workers linked with a registry of Swedish inpatient diagnoses. Workers were designated as exposed or unexposed to silica based on job titles in a job–exposure matrix. The relative risk (RR) was analysed with Poisson regression adjusting for age and smoking. Results We identified 371 cases of sarcoidosis among 297 917 male workers. There was an increased risk of sarcoidosis in the medium- to high-exposure group [RR 1.83 (95% confidence interval {CI} 1.14–2.95)]. A stratified analysis according to smoking showed that ever-smoking workers had an increased risk of sarcoidosis if highly exposed to silica dust [RR 2.44 (95% CI 1.37–4.33)] compared to non-exposed ever-smokers. The risk of non-smokers highly exposed to silica was not significantly increased [RR 1.07 (95% CI 0.72–1.58)] compared to non-exposed non-smokers. Conclusion The study indicates an increased risk of developing sarcoidosis in ever-smoking men exposed to silica.
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Affiliation(s)
- E Jonsson
- Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine, Umeå University, Umeå, Sweden
| | - B Järvholm
- Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine, Umeå University, Umeå, Sweden
| | - M Andersson
- Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine, Umeå University, Umeå, Sweden
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42
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Aryal S, Nathan SD. Contemporary optimized practice in the management of pulmonary sarcoidosis. Ther Adv Respir Dis 2020; 13:1753466619868935. [PMID: 31409257 PMCID: PMC6696842 DOI: 10.1177/1753466619868935] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Pulmonary sarcoidosis is the most common form of sarcoidosis, accounting for the initial presentation in over 70% patients and with eventual presence in 90% of patients with sarcoidosis. However, the course of the disease is often unpredictable; its manifestations can be highly variable and its treatment may not be effective in all patients. As such, the optimized treatment of pulmonary sarcoidosis often requires a thoughtful personalized approach with the need to get the patient involved in decisions of management. In many patients with pulmonary sarcoidosis, the disease is self-limited and nonprogressive, thus treatment is not necessary. In other patients, the presence of significant symptoms or functional limitation often associated with worsening radiological changes and pulmonary function tests warrants treatment. Corticosteroids are the first-line treatment for pulmonary sarcoidosis; antimetabolites are second-line agents, with methotrexate being most commonly employed. Antitumor necrosis alpha antibodies, especially infliximab, are emerging as potential third-line agents. A high index of suspicion should be held for pulmonary hypertension and other comorbidities that may complicate the course of patients with advanced sarcoidosis. Lung transplantation may be the only option for patients who have refractory disease despite maximal medical therapy.
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Affiliation(s)
| | - Steven D Nathan
- Inova Fairfax Hospital, 3300 Gallows Rd, Falls Church, VA 22042-3300, USA
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43
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Masoud S, Mihan P, Hamed M, Mehdi M, Mohamad RM. The presence of mycobacterial antigens in sarcoidosis associated granulomas. SARCOIDOSIS VASCULITIS AND DIFFUSE LUNG DISEASES 2020; 34:236-241. [PMID: 32476851 PMCID: PMC7170105 DOI: 10.36141/svdld.v34i3.5739] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/08/2016] [Accepted: 12/22/2016] [Indexed: 01/30/2023]
Abstract
Background: Sarcoidosis is a multi-organ disorder with unknown etiology. The role of bacteria in pathogenesis of sarcoidosis is still controversial. This study analyses new aspects of Mycobacterium Tuberculosis (MTB) presence in sarcoidosis diseases. Objectives: To find MTB in paraffin embedded tissues of sarcoidosis patients, samples of 10 sarcoidosis, 12 confirmed pulmonary tuberculosis (PTB) and 5 controls associated with granulomatous tissues were analysed. Methods: The paraffin embedded tissue specimens of the selected patients from the pathology archive of a subspecialty pulmonary hospital in IRAN were evaluated by Real Time PCR for MTB DNA using IS6110. Immunohistochemistry (IHC) method using MTB purified protein derivative (PPD) antibody was used to detect mycobacterial antigens. Results: All sarcoidosis patients had negative MTB DNA results in Real time PCR analysis. This analysis resulted in 10 (83.3%) positive cases for TB patients. The IHC analysis for MTB anti-PPD antibody showed positive diffused cytoplasmic staining for all TB patients whereas this staining was positive for 3 sarcoidosis patients (30%). Conclusion: Amplification of the IS6110 DNA sequence that is the most common target used for MTB diagnosis is not sensitive method to detect MTB in sarcoidosis granuloma. However, tissue IHC for anti-PPD antibody shows higher performance to detect MTB in sarcoidal granulomas reveals a mycobacterial signature in sarcoidosis tissue with negative IS6110 assay. This finding supports Mycobacterium tuberculosis may have an etiologic role in sarcoidosis. (Sarcoidosis Vasc Diffuse Lung Dis 2017; 34: 236-241)
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Affiliation(s)
- Shamaei Masoud
- Clinical Tuberculosis and Epidemiology Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Pourabdollah Mihan
- Chronic Respiratory Diseases Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mousaei Hamed
- Centre for Bacterial Cell Biology, Institute for Cell and Molecular Biosciences, Newcastle University, Newcastle upon Tyne, NE2 4AX, UK
| | - Mirsaeidi Mehdi
- Division of Pulmonary and Critical Care, Department of Medicine, University of Miami, FL, US
| | - Reza Masjedi Mohamad
- Tobacco Prevention and Control Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences,Tehran, Iran
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44
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Arbustini E, Narula N, Giuliani L, Di Toro A. Genetic Basis of Myocarditis: Myth or Reality? MYOCARDITIS 2020. [PMCID: PMC7122345 DOI: 10.1007/978-3-030-35276-9_4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
The genetic basis of myocarditis remains an intriguing concept, at least as long as the definition of myocarditis constitutes the definitive presence of myocardial inflammation sufficient to cause the observed ventricular dysfunction in the setting of cardiotropic infections. Autoimmune or immune-mediated myocardial inflammation constitutes a complex area of clinical interest, wherein numerous and not yet fully understood role of hereditary auto-inflammatory diseases can result in inflammation of the pericardium and myocardium. Finally, myocardial involvement in hereditary immunodeficiency diseases, cellular and humoral, is a possible trigger for infections which may complicate the diseases themselves. Whether the role of constitutional genetics can make the patient susceptible to myocardial inflammation remains yet to be explored.
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45
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Caires N, Campos Silva S, Moreira MI, Gerardo R, Borba A, Santos Silva J, Barata R, Pinto E, Cardoso J. A disease with many faces. Breathe (Sheff) 2019; 15:e77-e83. [PMID: 31777568 PMCID: PMC6876142 DOI: 10.1183/20734735.0161-2019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Can you diagnose this man with progressively worsening shortness of breath, mucous productive cough, weight loss, fatigue and a history of suspected pulmonary tuberculosis? http://bit.ly/2VUdnTr.
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Affiliation(s)
- Nídia Caires
- Pulmonology Dept, Hospital Santa Marta, Centro Hospitalar Universitário Lisboa Central, Lisbon, Portugal
| | - Sara Campos Silva
- Pulmonology Dept, Hospital Santa Marta, Centro Hospitalar Universitário Lisboa Central, Lisbon, Portugal
| | - Maria Inês Moreira
- Pulmonology Dept, Hospital Santa Marta, Centro Hospitalar Universitário Lisboa Central, Lisbon, Portugal
| | - Rita Gerardo
- Pulmonology Dept, Hospital Santa Marta, Centro Hospitalar Universitário Lisboa Central, Lisbon, Portugal
| | - Alexandra Borba
- Pulmonology Dept, Hospital Santa Marta, Centro Hospitalar Universitário Lisboa Central, Lisbon, Portugal
| | - João Santos Silva
- Cardiothoracic Surgery Dept, Hospital Santa Marta, Centro Hospitalar Universitário Lisboa Central, Lisbon, Portugal
| | - Rita Barata
- Cardiothoracic Surgery Dept, Hospital Santa Marta, Centro Hospitalar Universitário Lisboa Central, Lisbon, Portugal
| | - Eugénia Pinto
- Pathology Dept, Hospital São José, Centro Hospitalar Universitário Lisboa Central, Lisbon, Portugal
| | - João Cardoso
- Pulmonology Dept, Hospital Santa Marta, Centro Hospitalar Universitário Lisboa Central, Lisbon, Portugal
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46
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Yang IV, Konigsberg I, MacPhail K, Li L, Davidson EJ, Mroz PM, Hamzeh N, Gillespie M, Silveira LJ, Fingerlin TE, Maier LA. DNA Methylation Changes in Lung Immune Cells Are Associated with Granulomatous Lung Disease. Am J Respir Cell Mol Biol 2019; 60:96-105. [PMID: 30141971 DOI: 10.1165/rcmb.2018-0177oc] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Epigenetic marks are likely to explain variability of response to antigen in granulomatous lung disease. The objective of this study was to identify DNA methylation and gene expression changes associated with chronic beryllium disease (CBD) and sarcoidosis in lung cells obtained by BAL. BAL cells from CBD (n = 8), beryllium-sensitized (n = 8), sarcoidosis (n = 8), and additional progressive sarcoidosis (n = 9) and remitting (n = 15) sarcoidosis were profiled on the Illumina 450k methylation and Affymetrix/Agilent gene expression microarrays. Statistical analyses were performed to identify DNA methylation and gene expression changes associated with CBD, sarcoidosis, and disease progression in sarcoidosis. DNA methylation array findings were validated by pyrosequencing. We identified 52,860 significant (P < 0.005 and q < 0.05) CpGs associated with CBD; 2,726 CpGs near 1,944 unique genes have greater than 25% methylation change. A total of 69% of differentially methylated genes are significantly (q < 0.05) differentially expressed in CBD, with many canonical inverse relationships of methylation and expression in genes critical to T-helper cell type 1 differentiation, chemokines and their receptors, and other genes involved in immunity. Testing of these CBD-associated CpGs in sarcoidosis reveals that methylation changes only approach significance, but are methylated in the same direction, suggesting similarities between the two diseases with more heterogeneity in sarcoidosis that limits power with the current sample size. Analysis of progressive versus remitting sarcoidosis identified 15,215 CpGs (P < 0.005 and q < 0.05), but only 801 of them have greater than 5% methylation change, demonstrating that DNA methylation marks of disease progression changes are more subtle. Our study highlights the significance of epigenetic marks in lung immune response in granulomatous lung disease.
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Affiliation(s)
- Ivana V Yang
- 1 Department of Medicine, University of Colorado School of Medicine, Aurora, Colorado.,2 Department of Epidemiology, Colorado School of Public Health, Aurora, Colorado.,3 Center for Genes, Environment, and Health
| | - Iain Konigsberg
- 1 Department of Medicine, University of Colorado School of Medicine, Aurora, Colorado
| | | | - Li Li
- 4 Department of Medicine, and
| | - Elizabeth J Davidson
- 1 Department of Medicine, University of Colorado School of Medicine, Aurora, Colorado
| | | | | | | | | | - Tasha E Fingerlin
- 1 Department of Medicine, University of Colorado School of Medicine, Aurora, Colorado.,3 Center for Genes, Environment, and Health.,5 Department of Biomedical Research, National Jewish Health, Denver, Colorado; and.,6 Department of Biostatistics and Bioinformatics and
| | - Lisa A Maier
- 1 Department of Medicine, University of Colorado School of Medicine, Aurora, Colorado.,4 Department of Medicine, and.,7 Department of Environmental and Occupational Health, Colorado School of Public Health, Aurora, Colorado
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47
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Vietri L, Fui A, Bergantini L, d'Alessandro M, Cameli P, Sestini P, Rottoli P, Bargagli E. Serum amyloid A: A potential biomarker of lung disorders. Respir Investig 2019; 58:21-27. [PMID: 31708467 DOI: 10.1016/j.resinv.2019.09.005] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2019] [Revised: 08/29/2019] [Accepted: 09/20/2019] [Indexed: 12/27/2022]
Abstract
Serum amyloid A is an acute-phase protein with multiple immunological functions. Serum amyloid A is involved in lipid metabolism, inflammatory reactions, granuloma formation, and cancerogenesis. Additionally, serum amyloid A is involved in the pathogenesis of different autoimmune lung diseases. The levels of serum amyloid A has been evaluated in biological fluids of patients with different lung diseases, including autoimmune disorders, chronic obstructive pulmonary diseases, obstructive sleep apnea syndrome, sarcoidosis, asthma, lung cancer, and other lung disorders, such as idiopathic pulmonary fibrosis, tuberculosis, radiation pneumonitis, and cystic fibrosis. This review focuses on the cellular and molecular interactions of serum amyloid A in different lung diseases and suggests this acute-phase protein as a prognostic marker.
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Affiliation(s)
- Lucia Vietri
- Department of Medical and Surgical Sciences and Neurosciences, Respiratory Disease and Lung Transplant Unit, Siena University, Siena, Italy.
| | - Annalisa Fui
- Department of Medical and Surgical Sciences and Neurosciences, Respiratory Disease and Lung Transplant Unit, Siena University, Siena, Italy.
| | - Laura Bergantini
- Department of Medical and Surgical Sciences and Neurosciences, Respiratory Disease and Lung Transplant Unit, Siena University, Siena, Italy.
| | - Miriana d'Alessandro
- Department of Medical and Surgical Sciences and Neurosciences, Respiratory Disease and Lung Transplant Unit, Siena University, Siena, Italy.
| | - Paolo Cameli
- Department of Medical and Surgical Sciences and Neurosciences, Respiratory Disease and Lung Transplant Unit, Siena University, Siena, Italy.
| | - Piersante Sestini
- Department of Medical and Surgical Sciences and Neurosciences, Respiratory Disease and Lung Transplant Unit, Siena University, Siena, Italy.
| | - Paola Rottoli
- Department of Medical and Surgical Sciences and Neurosciences, Respiratory Disease and Lung Transplant Unit, Siena University, Siena, Italy.
| | - Elena Bargagli
- Department of Medical and Surgical Sciences and Neurosciences, Respiratory Disease and Lung Transplant Unit, Siena University, Siena, Italy.
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48
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Terasaki F, Azuma A, Anzai T, Ishizaka N, Ishida Y, Isobe M, Inomata T, Ishibashi-Ueda H, Eishi Y, Kitakaze M, Kusano K, Sakata Y, Shijubo N, Tsuchida A, Tsutsui H, Nakajima T, Nakatani S, Horii T, Yazaki Y, Yamaguchi E, Yamaguchi T, Ide T, Okamura H, Kato Y, Goya M, Sakakibara M, Soejima K, Nagai T, Nakamura H, Noda T, Hasegawa T, Morita H, Ohe T, Kihara Y, Saito Y, Sugiyama Y, Morimoto SI, Yamashina A. JCS 2016 Guideline on Diagnosis and Treatment of Cardiac Sarcoidosis - Digest Version. Circ J 2019; 83:2329-2388. [PMID: 31597819 DOI: 10.1253/circj.cj-19-0508] [Citation(s) in RCA: 196] [Impact Index Per Article: 39.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Fumio Terasaki
- Medical Education Center / Department of Cardiology, Osaka Medical College
| | - Arata Azuma
- Department of Pulmonary Medicine, Nippon Medical School
| | - Toshihisa Anzai
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center
| | - Nobukazu Ishizaka
- Department of Internal Medicine (III) / Department of Cardiology, Osaka Medical College
| | - Yoshio Ishida
- Department of Internal Medicine, Kaizuka City Hospital
| | - Mitsuaki Isobe
- Department of Cardiovascular Medicine, Graduate School of Medical and Dental Science, Tokyo Medical and Dental University
| | - Takayuki Inomata
- Department of Cardiology, Kitasato University Kitasato Institute Hospital
| | | | - Yoshinobu Eishi
- Department of Human Pathology, Graduate School of Medical and Dental Science, Tokyo Medical and Dental University
| | - Masafumi Kitakaze
- Department of Clinical Medicine and Development, National Cerebral and Cardiovascular Center
| | - Kengo Kusano
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center
| | - Yasushi Sakata
- Department of Cardiovascular Medicine, Osaka University Graduate School of Medicine
| | | | | | - Hiroyuki Tsutsui
- Department of Cardiovascular Medicine, Kyushu University Graduate School of Medical Sciences
| | - Takatomo Nakajima
- Division of Cardiology, Saitama Cardiovascular and Respiratory Center
| | - Satoshi Nakatani
- Division of Functional Diagnostics, Department of Health Sciences, Osaka University Graduate School of Medicine
| | - Taiko Horii
- Department of Cardiovascular Surgery, Kagawa University School of Medicine
| | | | - Etsuro Yamaguchi
- Department of Respiratory Medicine and Allergology, Aichi Medical University School of Medicine
| | | | - Tomomi Ide
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, Kyushu University
| | - Hideo Okamura
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center
| | | | - Masahiko Goya
- Department of Cardiology, Tokyo Medical and Dental University
| | - Mamoru Sakakibara
- Department of Cardiovascular Medicine, Hokkaido University Graduate School of Medicine
| | - Kyoko Soejima
- Department of Cardiology, Kyorin University Faculty of Medicine
| | - Toshiyuki Nagai
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center
| | | | - Takashi Noda
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center
| | - Takuya Hasegawa
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center
| | | | - Tohru Ohe
- Department of Cardiology, Sakakibara Heart Institute of Okayama
| | - Yasuki Kihara
- Department of Cardiovascular Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University
| | - Yoshihiko Saito
- Department of Cardiorenal Medicine and Metabolic Disease, Nara Medical University
| | - Yukihiko Sugiyama
- Division of Pulmonary Medicine, Department of Medicine, Jichi Medical University
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Wilson JL, Mayr HK, Weichhart T. Metabolic Programming of Macrophages: Implications in the Pathogenesis of Granulomatous Disease. Front Immunol 2019; 10:2265. [PMID: 31681260 PMCID: PMC6797840 DOI: 10.3389/fimmu.2019.02265] [Citation(s) in RCA: 40] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2019] [Accepted: 09/09/2019] [Indexed: 12/16/2022] Open
Abstract
Metabolic reprogramming is rapidly gaining appreciation in the etiology of immune cell dysfunction in a variety of diseases. Tuberculosis, schistosomiasis, and sarcoidosis represent an important class of diseases characterized by the formation of granulomas, where macrophages are causatively implicated in disease pathogenesis. Recent studies support the incidence of macrophage metabolic reprogramming in granulomas of both infectious and non-infectious origin. These publications identify the mechanistic target of rapamycin (mTOR), as well as the major regulators of lipid metabolism and cellular energy balance, peroxisome proliferator receptor gamma (PPAR-γ) and adenosine monophosphate-activated protein kinase (AMPK), respectively, as key players in the pathological progression of granulomas. In this review, we present a comprehensive breakdown of emerging research on the link between macrophage cell metabolism and granulomas of different etiology, and how parallels can be drawn between different forms of granulomatous disease. In particular, we discuss the role of PPAR-γ signaling and lipid metabolism, which are currently the best-represented metabolic pathways in this context, and we highlight dysregulated lipid metabolism as a common denominator in granulomatous disease progression. This review therefore aims to highlight metabolic mechanisms of granuloma immune cell fate and open up research questions for the identification of potential therapeutic targets in the future.
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Affiliation(s)
- Jayne Louise Wilson
- Center for Pathobiochemistry and Genetics, Institute of Medical Genetics, Medical University of Vienna, Vienna, Austria
| | - Hannah Katharina Mayr
- Center for Pathobiochemistry and Genetics, Institute of Medical Genetics, Medical University of Vienna, Vienna, Austria
| | - Thomas Weichhart
- Center for Pathobiochemistry and Genetics, Institute of Medical Genetics, Medical University of Vienna, Vienna, Austria
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50
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Bennett D, Bargagli E, Refini RM, Rottoli P. New concepts in the pathogenesis of sarcoidosis. Expert Rev Respir Med 2019; 13:981-991. [DOI: 10.1080/17476348.2019.1655401] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- David Bennett
- Respiratory Diseases and Lung Transplantation Unit, Azienda Ospedaliera Universitaria Senese, Siena, Italy
| | - Elena Bargagli
- Respiratory Diseases and Lung Transplantation Unit, Azienda Ospedaliera Universitaria Senese, Siena, Italy
- Department of Medical and Surgical Sciences & Neurosciences, University of Siena, Siena, Italy
| | - Rosa Metella Refini
- Respiratory Diseases and Lung Transplantation Unit, Azienda Ospedaliera Universitaria Senese, Siena, Italy
- Department of Medical and Surgical Sciences & Neurosciences, University of Siena, Siena, Italy
| | - Paola Rottoli
- Department of Medical and Surgical Sciences & Neurosciences, University of Siena, Siena, Italy
- Regional Coordinator for Rare Respiratory Diseases for Tuscany, Azienda Ospedaliera Universitaria Senese, Siena, Italy
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