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Israël-Biet D, Bernardinello N, Pastré J, Tana C, Spagnolo P. High-Risk Sarcoidosis: A Focus on Pulmonary, Cardiac, Hepatic and Renal Advanced Diseases, as Well as on Calcium Metabolism Abnormalities. Diagnostics (Basel) 2024; 14:395. [PMID: 38396434 PMCID: PMC10887913 DOI: 10.3390/diagnostics14040395] [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: 12/21/2023] [Revised: 02/02/2024] [Accepted: 02/06/2024] [Indexed: 02/25/2024] Open
Abstract
Although sarcoidosis is generally regarded as a benign condition, approximately 20-30% of patients will develop a chronic and progressive disease. Advanced pulmonary fibrotic sarcoidosis and cardiac involvement are the main contributors to sarcoidosis morbidity and mortality, with failure of the liver and/or kidneys representing additional life-threatening situations. In this review, we discuss diagnosis and treatment of each of these complications and highlight how the integration of clinical, pathological and radiological features may help predict the development of such high-risk situations in sarcoid patients.
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Affiliation(s)
- Dominique Israël-Biet
- Service de Pneumologie et Soins Intensifs, Hôpital Européen Georges Pompidou, Assistance Publique-Hôpitaux de Paris, 75015 Paris, France
| | - Nicol Bernardinello
- Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, 35128 Padova, Italy;
| | - Jean Pastré
- Service de Pneumologie et Soins Intensifs, Hôpital Européen Georges Pompidou, Assistance Publique-Hôpitaux de Paris, 75015 Paris, France
| | - Claudio Tana
- Geriatrics Clinic, SS Annunziata University-Hospital of Chieti, 66100 Chieti, Italy
| | - Paolo Spagnolo
- Section of Respiratory Diseases, University of Padova, 35121 Padova, Italy
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Zhan Y, Zhang J, Yang R, Deng Z, Chen S, Feng J, Wu J, Huang Q, Gu Y, Xie J. Blood glucose and lipids are associated with sarcoidosis: findings from observational and mendelian randomization studies. Respir Res 2024; 25:50. [PMID: 38254098 PMCID: PMC10804582 DOI: 10.1186/s12931-023-02663-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Accepted: 12/29/2023] [Indexed: 01/24/2024] Open
Abstract
BACKGROUND Several researches have demonstrated that patients with sarcoidosis accompanied with the abnormality in blood glucose and/or lipids, however, the causal relationship between them remains uncertain. To elucidate the potential association and causality of blood glucose and lipids with sarcoidosis, we conducted a propensity score matching (PSM)-based observational study combined with mendelian randomization (MR) analysis. METHODS All subjects in this study were retrospectively collected from Tongji Hospital during 2010 and 2023. 1:1 PSM was employed to control the potential confounders as appropriate. Univariable and multivariable logistic regression analyses were performed to estimate the associations of sarcoidosis with fasting glucose, high density lipoprotein cholesterol (HDLC), low density lipoprotein cholesterol (LDLC), total cholesterol (TC), and total triglyceride (TG). The further subtype analysis was also conducted. Afterwards, a bidirectional MR analysis based on public data deeply explored the causality among the 5 candidate traits and sarcoidosis, for which the inverse-variance weighted (IVW) method was utilized as the main inferring approach. RESULTS In the observational study, a total number of 756 subjects were enrolled, with 162 sarcoidosis patients and 594 non-sarcoidosis participants, while 160 pairs of subjects were matched after PSM. Multivariable logistic regression analysis indicated that HDLC (OR: 0.151; 95% CI: 0.056-0.408; P < 0.001) and TC (OR: 3.942; 95% CI: 2.644-5.877; P < 0.001) were strongly associated with sarcoidosis. Subtype analysis showed that low HDLC was independently correlated to risk of lesions in bronchus and lungs, and mediastinal lymph nodes, while high TC was to cervical lymph nodes. In MR analysis, high fasting glucose, low HDLC, and high TC were identified as the causal factors of sarcoidosis. CONCLUSION HDLC and TC had the potential to influence the risk of sarcoidosis, which could be regarded as predictors and may provide new diagnostic and therapeutic targets for sarcoidosis.
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Affiliation(s)
- Yuan Zhan
- Department of Respiratory and Critical Care Medicine, National Clinical Research Center of Respiratory Disease, Key Laboratory of Pulmonary Diseases of Health Ministry, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, Hubei, China
| | - Jiaheng Zhang
- Department of Respiratory and Critical Care Medicine, National Clinical Research Center of Respiratory Disease, Key Laboratory of Pulmonary Diseases of Health Ministry, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, Hubei, China
| | - Ruonan Yang
- Department of Respiratory and Critical Care Medicine, National Clinical Research Center of Respiratory Disease, Key Laboratory of Pulmonary Diseases of Health Ministry, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, Hubei, China
| | - Zhesong Deng
- Department of Respiratory and Critical Care Medicine, National Clinical Research Center of Respiratory Disease, Key Laboratory of Pulmonary Diseases of Health Ministry, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, Hubei, China
| | - Shanshan Chen
- Department of Respiratory and Critical Care Medicine, National Clinical Research Center of Respiratory Disease, Key Laboratory of Pulmonary Diseases of Health Ministry, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, Hubei, China
| | - Jie Feng
- Department of Social Medicine and Health Management, School of Public Health, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Jixing Wu
- Department of Respiratory and Critical Care Medicine, National Clinical Research Center of Respiratory Disease, Key Laboratory of Pulmonary Diseases of Health Ministry, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, Hubei, China
| | - Qian Huang
- Department of Respiratory and Critical Care Medicine, National Clinical Research Center of Respiratory Disease, Key Laboratory of Pulmonary Diseases of Health Ministry, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, Hubei, China
| | - Yiya Gu
- Department of Respiratory and Critical Care Medicine, National Clinical Research Center of Respiratory Disease, Key Laboratory of Pulmonary Diseases of Health Ministry, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, Hubei, China
| | - Jungang Xie
- Department of Respiratory and Critical Care Medicine, National Clinical Research Center of Respiratory Disease, Key Laboratory of Pulmonary Diseases of Health Ministry, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, Hubei, China.
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Weeratunga P, Moller DR, Ho LP. Immune mechanisms of granuloma formation in sarcoidosis and tuberculosis. J Clin Invest 2024; 134:e175264. [PMID: 38165044 PMCID: PMC10760966 DOI: 10.1172/jci175264] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2024] Open
Abstract
Sarcoidosis is a complex immune-mediated disease characterized by clusters of immune cells called granulomas. Despite major steps in understanding the cause of this disease, many questions remain. In this Review, we perform a mechanistic interrogation of the immune activities that contribute to granuloma formation in sarcoidosis and compare these processes with its closest mimic, tuberculosis, highlighting shared and divergent immune activities. We examine how Mycobacterium tuberculosis is sensed by the immune system; how the granuloma is initiated, formed, and perpetuated in tuberculosis compared with sarcoidosis; and the role of major innate and adaptive immune cells in shaping these processes. Finally, we draw these findings together around several recent high-resolution studies of the granuloma in situ that utilized the latest advances in single-cell technology combined with spatial methods to analyze plausible disease mechanisms. We conclude with an overall view of granuloma formation in sarcoidosis.
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Affiliation(s)
- Praveen Weeratunga
- MRC Translational Immunology Discovery Unit, Weatherall Institute of Molecular Medicine, University of Oxford, Oxford, United Kingdom
| | | | - Ling-Pei Ho
- MRC Translational Immunology Discovery Unit, Weatherall Institute of Molecular Medicine, University of Oxford, Oxford, United Kingdom
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4
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Darlington P, Melin J, Rivera N, Grunewald J, Eklund A, Kullberg S. Peripheral blood lymphopenia in sarcoidosis associates with HLA-DRB1 alleles but not with lung immune cells and organ involvement. Clin Exp Immunol 2023; 213:357-362. [PMID: 37161980 PMCID: PMC10570991 DOI: 10.1093/cei/uxad052] [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: 02/01/2023] [Revised: 04/04/2023] [Accepted: 05/09/2023] [Indexed: 05/11/2023] Open
Abstract
Different human leukocyte antigen (HLA) alleles associate with disease phenotypes in sarcoidosis. Peripheral blood (PB) lymphopenia is reported as more common in sarcoidosis patients with worse prognosis. The mechanisms behind are unrecognized but a PB depletion due to lymphocytes migrating to lung and/or extra pulmonary organs has been suggested. Insights into associations between HLA alleles, lung immune cells, clinical phenotype including extra pulmonary manifestations (EPM), and PB lymphopenia may provide mechanistic clues and enable adequate intervention in this patient group. In this situdy,141 treatment naïve, newly diagnosed patients were retrospectively identified in a Swedish cohort of sarcoidosis patients. Data on HLA-DRB1 alleles, lung immune cells from bronchoalveolar lavage fluid (BALF), PB lymphocytes and clinical parameters including treatment and disease course (chronic vs. resolving) were collected. The patients were followed for 2 years. PB lymphopenia associated with male sex, development of non-resolving disease, a need for first- and second-line systemic immunosuppressant treatment and HLA- DRB1*07. No correlation between BALF and PB lymphocytes, and no difference in EPM was detected between patients with and without PB lymphopenia. In conclusion, PB lymphopenia is associated with a more severe disease phenotype and carriage of the HLA-DRB1*07 allele. The results do not lend support to the hypothesis about sarcoidosis PB lymphopenia being due to a migration of PB lymphocytes to other organs. Rather, they provide a basis for future studies on the connection between HLA-DRB1*07 and PB lymphopenia mechanisms.
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Affiliation(s)
- Pernilla Darlington
- Department of Internal Medicine, Södersjukhuset, Sweden
- Department of Clinical Science and Education, Södersjukhuset and Karolinska Institutet, Stockholm, Sweden
| | - Jonas Melin
- Department of Internal Medicine, Södersjukhuset, Sweden
| | - Natalia Rivera
- Respiratory Medicine Division, Department of Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Johan Grunewald
- Respiratory Medicine Division, Department of Medicine, Karolinska Institutet, Stockholm, Sweden
- Department of Respiratory Medicine, Theme Inflammation and Ageing, Karolinska University Hospital, Stockholm, Sweden
| | - Anders Eklund
- Respiratory Medicine Division, Department of Medicine, Karolinska Institutet, Stockholm, Sweden
- Department of Respiratory Medicine, Theme Inflammation and Ageing, Karolinska University Hospital, Stockholm, Sweden
| | - Susanna Kullberg
- Respiratory Medicine Division, Department of Medicine, Karolinska Institutet, Stockholm, Sweden
- Department of Respiratory Medicine, Theme Inflammation and Ageing, Karolinska University Hospital, Stockholm, Sweden
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5
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Arkema EV, Rossides M, Cozier YC. Sarcoidosis and its relation to other immune-mediated diseases: Epidemiological insights. J Autoimmun 2023:103127. [PMID: 37816661 DOI: 10.1016/j.jaut.2023.103127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Revised: 09/27/2023] [Accepted: 10/04/2023] [Indexed: 10/12/2023]
Abstract
Several epidemiological studies show a co-occurrence of sarcoidosis with other immune-mediated diseases (IMD). There are many similarities between sarcoidosis and IMDs in their geographical distribution and risk factors. Understanding these similarities and identifying the differences can help us to better understand sarcoidosis and put it into context with other IMDs. In this review, we present the current knowledge about the overlap between sarcoidosis and other IMDs derived from epidemiological studies. Epidemiologic methods utilize study design and statistical analysis to describe the patterns in data and, ideally, identify causal relationships between an exposure and a health outcome. We discuss how study design and analysis may affect the interpretation of epidemiological studies on this topic and highlight some theories that attempt to explain the relation between sarcoidosis and other IMDs.
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Affiliation(s)
- Elizabeth V Arkema
- Karolinska Institutet, Department of Medicine Solna, Clinical Epidemiology Division, Stockholm, Sweden.
| | - Marios Rossides
- Department of Respiratory Medicine and Allergy, Theme Inflammation and Ageing, Karolinska University Hospital, Stockholm, Sweden; Unit of Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Yvette C Cozier
- Boston University School of Public Health, Department of Epidemiology, Boston, MA, USA; Slone Epidemiology Center, Boston University School of Medicine, Boston, MA, USA
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Cocconcelli E, Bernardinello N, Castelli G, Petrarulo S, Bellani S, Saetta M, Spagnolo P, Balestro E. Molecular Mechanism in the Development of Pulmonary Fibrosis in Patients with Sarcoidosis. Int J Mol Sci 2023; 24:10767. [PMID: 37445947 DOI: 10.3390/ijms241310767] [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: 05/23/2023] [Revised: 06/21/2023] [Accepted: 06/26/2023] [Indexed: 07/15/2023] Open
Abstract
Sarcoidosis is a multisystemic disease of unknown etiology characterized by the formation of granulomas in various organs, especially lung and mediastinal hilar lymph nodes. The clinical course and manifestations are unpredictable: spontaneous remission can occur in approximately two thirds of patients; up to 20% of patients have chronic course of the lung disease (called advanced pulmonary sarcoidosis, APS) resulting in progressive loss of lung function, sometimes life-threatening that can lead to respiratory failure and death. The immunopathology mechanism leading from granuloma formation to the fibrosis in APS still remains elusive. Recent studies have provided new insights into the genetic factors and immune components involved in the clinical manifestation of the disease. In this review we aim to summarize the clinical-prognostic characteristics and molecular pathways which are believed to be associated with the development of APS.
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Affiliation(s)
- Elisabetta Cocconcelli
- Respiratory Disease Unit, Department of Cardiac, Thoracic, Vascular Sciences and Public Health, Padova University Hospital, 35128 Padova, Italy
| | - Nicol Bernardinello
- Respiratory Disease Unit, Department of Cardiac, Thoracic, Vascular Sciences and Public Health, Padova University Hospital, 35128 Padova, Italy
| | - Gioele Castelli
- Respiratory Disease Unit, Department of Cardiac, Thoracic, Vascular Sciences and Public Health, Padova University Hospital, 35128 Padova, Italy
| | - Simone Petrarulo
- Respiratory Disease Unit, Department of Cardiac, Thoracic, Vascular Sciences and Public Health, Padova University Hospital, 35128 Padova, Italy
| | - Serena Bellani
- Respiratory Disease Unit, Department of Cardiac, Thoracic, Vascular Sciences and Public Health, Padova University Hospital, 35128 Padova, Italy
| | - Marina Saetta
- Respiratory Disease Unit, Department of Cardiac, Thoracic, Vascular Sciences and Public Health, Padova University Hospital, 35128 Padova, Italy
| | - Paolo Spagnolo
- Respiratory Disease Unit, Department of Cardiac, Thoracic, Vascular Sciences and Public Health, Padova University Hospital, 35128 Padova, Italy
| | - Elisabetta Balestro
- Respiratory Disease Unit, Department of Cardiac, Thoracic, Vascular Sciences and Public Health, Padova University Hospital, 35128 Padova, Italy
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Papiris SA, Kolilekas L, Rivera N, Spanos M, Li G, Gokulnath P, Chatterjee E, Georgakopoulos A, Kallieri M, Papaioannou AI, Raptakis T, Apollonatou V, Antonogiannaki EM, Gialafos E, Chatziioannou S, Grunewald J, Manali ED. From Karl Wurm and Guy Scadding's staging to 18F-FDG PET/CT scan phenotyping and far beyond: perspective in the evading history of phenotyping in sarcoidosis. Front Med (Lausanne) 2023; 10:1174518. [PMID: 37234239 PMCID: PMC10206027 DOI: 10.3389/fmed.2023.1174518] [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] [Received: 02/26/2023] [Accepted: 04/05/2023] [Indexed: 05/27/2023] Open
Abstract
Sarcoidosis is an inflammatory granulomatous disease of unknown etiology involving any organ or tissue along with any combination of active sites, even the most silent ones clinically. The unpredictable nature of the sites involved in sarcoidosis dictates the highly variable natural history of the disease and the necessity to cluster cases at diagnosis based on clinical and/or imaging common characteristics in an attempt to classify patients based on their more homogeneous phenotypes, possibly with similar clinical behavior, prognosis, outcome, and therefore with therapeutic requirements. In the course of the disease's history, this attempt relates to the availability of a means of detection of the sites involved, from the Karl Wurm and Guy Scadding's chest x-ray staging through the ACCESS, the WASOG Sarcoidosis Organ Assessment Instruments, and the GenPhenReSa study to the 18F-FDG PET/CT scan phenotyping and far beyond to new technologies and/or the current "omics." The hybrid molecular imaging of the 18F-FDG PET/CT scan, by unveiling the glucose metabolism of inflammatory cells, can identify high sensitivity inflammatory active granulomas, the hallmark of sarcoidosis-even in clinically and physiologically silent sites-and, as recently shown, is successful in identifying an unexpected ordered stratification into four phenotypes: (I) hilar-mediastinal nodal, (II) lungs and hilar-mediastinal nodal, (III) an extended nodal supraclavicular, thoracic, abdominal, inguinal, and (IV) all the above in addition to systemic organs and tissues, which is therefore the ideal phenotyping instrument. During the "omics era," studies could provide significant, distinct, and exclusive insights into sarcoidosis phenotypes linking clinical, laboratory, imaging, and histologic characteristics with molecular signatures. In this context, the personalization of treatment for sarcoidosis patients might have reached its goal.
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Affiliation(s)
- Spyros A. Papiris
- 2nd Pulmonary Medicine Department, Medical School, General University Hospital Attikon, National and Kapodistrian University of Athens, Athens, Greece
| | | | - Natalia Rivera
- Respiratory Medicine Division, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden
| | - Michail Spanos
- Cardiovascular Research Center, Simches 3 Massachusetts General Hospital, Boston, MA, United States
| | - Guoping Li
- Cardiovascular Research Center, Simches 3 Massachusetts General Hospital, Boston, MA, United States
| | - Priyanka Gokulnath
- Cardiovascular Research Center, Simches 3 Massachusetts General Hospital, Boston, MA, United States
| | - Emeli Chatterjee
- Cardiovascular Research Center, Simches 3 Massachusetts General Hospital, Boston, MA, United States
| | - Alexandros Georgakopoulos
- 2nd Department of Radiology, Nuclear Medicine Section, Medical School, General University Hospital “Attikon”, National and Kapodistrian University of Athens, Athens, Greece
| | - Maria Kallieri
- 2nd Pulmonary Medicine Department, Medical School, General University Hospital Attikon, National and Kapodistrian University of Athens, Athens, Greece
| | - Andriana I. Papaioannou
- 1st Respiratory Medicine Department, Athens Medical School, Sotiria Chest Hospital of Athens, National and Kapodistrian University of Athens, Athens, Greece
| | - Thomas Raptakis
- 2nd Pulmonary Medicine Department, Medical School, General University Hospital Attikon, National and Kapodistrian University of Athens, Athens, Greece
| | - Vasiliki Apollonatou
- 2nd Pulmonary Medicine Department, Medical School, General University Hospital Attikon, National and Kapodistrian University of Athens, Athens, Greece
| | | | - Elias Gialafos
- Department of Cardiology, Medical School, General University Hospital “Attikon”, National and Kapodistrian University of Athens, Athens, Greece
- First Department of Neurology, Medical School, Aeginition Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Sofia Chatziioannou
- 2nd Department of Radiology, Nuclear Medicine Section, Medical School, General University Hospital “Attikon”, National and Kapodistrian University of Athens, Athens, Greece
- Division of Nuclear Medicine, Biomedical Research Foundation of the Academy of Athens, Athens, Greece
| | - Johan Grunewald
- Respiratory Medicine Division, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden
| | - Effrosyni D. Manali
- 2nd Pulmonary Medicine Department, Medical School, General University Hospital Attikon, National and Kapodistrian University of Athens, Athens, Greece
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Abstract
Sarcoidosis is characterized by noncaseating granulomas which form in almost any part of the body, primarily in the lungs and/or thoracic lymph nodes. Environmental exposures in genetically susceptible individuals are believed to cause sarcoidosis. There is variation in incidence and prevalence by region and race. Males and females are almost equally affected, although disease peaks at a later age in females than in males. The heterogeneity of presentation and disease course can make diagnosis and treatment challenging. Diagnosis is suggestive in a patient if one or more of the following is present: radiologic signs of sarcoidosis, evidence of systemic involvement, histologically confirmed noncaseating granulomas, sarcoidosis signs in bronchoalveolar lavage fluid (BALF), and low probability or exclusion of other causes of granulomatous inflammation. No sensitive or specific biomarkers for diagnosis and prognosis exist, but there are several that can be used to support clinical decisions, such as serum angiotensin-converting enzyme levels, human leukocyte antigen types, and CD4 Vα2.3+ T cells in BALF. Corticosteroids remain the mainstay of treatment for symptomatic patients with severely affected or declining organ function. Sarcoidosis is associated with a range of adverse long-term outcomes and complications, and with great variation in prognosis between populations. New data and technologies have moved sarcoidosis research forward, increasing our understanding of the disease. However, there is still much left to be discovered. The pervading challenge is how to account for patient variability. Future studies should focus on how to optimize current tools and develop new approaches so that treatment and follow-up can be targeted to individuals with more precision.
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Affiliation(s)
- Marios Rossides
- Department of Respiratory Medicine and Allergy, Theme Inflammation and Ageing, Karolinska University Hospital, Stockholm, Sweden.,Unit of Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Pernilla Darlington
- Department of Clinical Science and Education, Södersjukhuset and Karolinska Institutet, Stockholm, Sweden.,Department of Internal Medicine, Södersjukhuset, Stockholm, Sweden
| | - Susanna Kullberg
- Department of Respiratory Medicine and Allergy, Theme Inflammation and Ageing, Karolinska University Hospital, Stockholm, Sweden.,Department of Medicine Solna, Respiratory Medicine Division & Center for Molecular Medicine (CMM), Karolinska Institutet, Stockholm, Sweden
| | - Elizabeth V Arkema
- Department of Medicine Solna, Clinical Epidemiology Division, Karolinska Institutet, Stockholm, Sweden
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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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Johnson C, Schiffenbauer AI, Miller FW, Perin J, Danoff SK, Diwadkar AR, Joo J, Himes BE, Meyer NJ. Human Leukocyte Antigen Alleles Associated with Interstitial Lung Disease in North Americans with Idiopathic Inflammatory Myopathy. Am J Respir Crit Care Med 2023; 207:619-622. [PMID: 36269757 DOI: 10.1164/rccm.202206-1116le] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
| | | | | | - Jamie Perin
- Johns Hopkins University Baltimore, Maryland
| | | | | | - Jaehyun Joo
- University of Pennsylvania Philadelphia, Pennsylvania
| | | | - Nuala J Meyer
- University of Pennsylvania Philadelphia, Pennsylvania
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11
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Polanía D, Reyes-Guanes J, Rojas-Carabali W, Pardo-Pizza D, Barraquer-Lopez D, Cifuentes-González C, Neira-Segura N, de-la-Torre A. A new look into uveitis in Colombia: changes in distribution patterns and clinical characteristics over the last 25 years. Graefes Arch Clin Exp Ophthalmol 2023; 261:561-573. [PMID: 35994112 PMCID: PMC9836979 DOI: 10.1007/s00417-022-05796-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Revised: 07/20/2022] [Accepted: 08/01/2022] [Indexed: 01/17/2023] Open
Abstract
PURPOSE To describe the distribution patterns and clinical characteristics of patients diagnosed with uveitis at a specialized uveitis center in Bogotá, Colombia, from 2013 to 2021 and compare these patterns with the previously reported between 1996 and 2006. METHODS We performed an observational descriptive cross-sectional study systematically reviewing clinical records of patients attending between 2013 and 2021. Data were analyzed and compared with previous reports. RESULTS Of the 489 patients with uveitis, 310 were females (63.4%). The mean age of onset was 38.7, with a range between 1 and 83 years. Bilateral (52.8%), anterior (45.8%), non-granulomatous (90.8%), and recurrent (47.6%) were the most common types of uveitis found in our population sample. The most common cause of uveitis in this study was idiopathic, followed by toxoplasmosis and HLA-B27 + associated uveitis, which differs from the previous Colombian study where ocular toxoplasmosis was the most frequent cause. This highlights a significant shift from infectious etiologies to more immune-mediated processes as the cause of uveitis in Colombia nowadays. CONCLUSION The results of this study provide a comparison between the clinical patterns of presentation of uveitis from 1996 to 2006 and the patterns observed from 2013 to 2021, enhancing awareness about the changing dynamics of uveitis in Colombia to guide a better understanding of the diagnosis, classification, and correlation with other systemic conditions of the disease.
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Affiliation(s)
- Diego Polanía
- Neuroscience Research Group (NEUROS), Escuela de Medicina Y Ciencias de La Salud, Universidad del Rosario, Bogotá, Colombia
- Ophthalmology Interest Group, Escuela de Medicina Y Ciencias de La Salud, Universidad del Rosario, Bogotá, Colombia
| | - Juliana Reyes-Guanes
- Neuroscience Research Group (NEUROS), Escuela de Medicina Y Ciencias de La Salud, Universidad del Rosario, Bogotá, Colombia
| | - William Rojas-Carabali
- Neuroscience Research Group (NEUROS), Escuela de Medicina Y Ciencias de La Salud, Universidad del Rosario, Bogotá, Colombia
| | - Daniella Pardo-Pizza
- Neuroscience Research Group (NEUROS), Escuela de Medicina Y Ciencias de La Salud, Universidad del Rosario, Bogotá, Colombia
- Ophthalmology Interest Group, Escuela de Medicina Y Ciencias de La Salud, Universidad del Rosario, Bogotá, Colombia
| | - Doménico Barraquer-Lopez
- Neuroscience Research Group (NEUROS), Escuela de Medicina Y Ciencias de La Salud, Universidad del Rosario, Bogotá, Colombia
- Ophthalmology Interest Group, Escuela de Medicina Y Ciencias de La Salud, Universidad del Rosario, Bogotá, Colombia
| | - Carlos Cifuentes-González
- Neuroscience Research Group (NEUROS), Escuela de Medicina Y Ciencias de La Salud, Universidad del Rosario, Bogotá, Colombia
| | - Natalia Neira-Segura
- Neuroscience Research Group (NEUROS), Escuela de Medicina Y Ciencias de La Salud, Universidad del Rosario, Bogotá, Colombia
| | - Alejandra de-la-Torre
- Neuroscience Research Group (NEUROS), Escuela de Medicina Y Ciencias de La Salud, Universidad del Rosario, Bogotá, Colombia.
- Ophthalmology Interest Group, Escuela de Medicina Y Ciencias de La Salud, Universidad del Rosario, Bogotá, Colombia.
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Factors associated with a diagnosis of sarcoidosis among US veterans of Iraq and Afghanistan. Sci Rep 2022; 12:22045. [PMID: 36543815 PMCID: PMC9772322 DOI: 10.1038/s41598-022-24853-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Accepted: 11/21/2022] [Indexed: 12/24/2022] Open
Abstract
This study evaluated risk factors of sarcoidosis among Airborne Hazards and Open Burn Pit Registry (AHOBPR) participants using a retrospective age and sex-matched case-control design of AHOBPR participants deployed to Afghanistan or Southwest Asia with and without sarcoidosis diagnosed in the Veterans Health Administration (VHA). Logistic regression models tested for associations between sarcoidosis and self-reported cumulative deployment-related exposures. 661 Veterans (0.37%) were diagnosed with sarcoidosis in VHA. Logistic regression demonstrated lower odds of sarcoidosis in Hispanic participants (OR 0.08, CI 0.04-0.15) and those who served in the Navy (OR 0.40, CI 0.21-0.72). African American veterans (OR 2.27, CI 1.66-3.11) and former smokers (OR 1.87, CI 1.33-2.62) were at elevated risk. Of the exposure variables, convoy activities had the highest odds of being associated with sarcoidosis and was marginally statistically significant (OR 1.16, CI 1.00-1.35). Sarcoidosis was an uncommon diagnosis among AHOBPR participants and was associated with only one of eight assessed cumulative deployment-related exposures.
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Hardin A, Dawkins B, Pezant N, Rasmussen A, Montgomery C. Genetics of neurosarcoidosis. J Neuroimmunol 2022; 372:577957. [PMID: 36054933 PMCID: PMC10865996 DOI: 10.1016/j.jneuroim.2022.577957] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Revised: 08/03/2022] [Accepted: 08/25/2022] [Indexed: 12/31/2022]
Abstract
Sarcoidosis is a systemic, inflammatory, granulomatous disease characterized by great variability in organ involvement, clinical course, and severity. While pulmonary manifestations are almost universal, the central and peripheral nervous systems can also be affected. Neurosarcoidosis occurs in ∼5-15% of cases and is among the manifestations with the highest morbidity and mortality. It is known that sarcoidosis has genetic underpinnings and while multiple studies aimed at identifying associations to sarcoidosis susceptibility and prognosis, very few studies have focused on neurosarcoidosis. This review summarizes the genetic studies to date, compares and contrasts those findings with other genetic effects in sarcoidosis, and offers ideas for moving the field forward.
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Affiliation(s)
- Abigail Hardin
- Genes and Human Disease Research Program, Oklahoma Medical Research Foundation, 825 NE 13(th), Research Tower, Suite 2202, Oklahoma City, OK 73104, USA
| | - Bryan Dawkins
- Genes and Human Disease Research Program, Oklahoma Medical Research Foundation, 825 NE 13(th), Research Tower, Suite 2202, Oklahoma City, OK 73104, USA
| | - Nathan Pezant
- Genes and Human Disease Research Program, Oklahoma Medical Research Foundation, 825 NE 13(th), Research Tower, Suite 2202, Oklahoma City, OK 73104, USA
| | - Astrid Rasmussen
- Genes and Human Disease Research Program, Oklahoma Medical Research Foundation, 825 NE 13(th), Research Tower, Suite 2202, Oklahoma City, OK 73104, USA
| | - Courtney Montgomery
- Genes and Human Disease Research Program, Oklahoma Medical Research Foundation, 825 NE 13(th), Research Tower, Suite 2202, Oklahoma City, OK 73104, USA.
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