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Lackey E, Shen J, Sharma A, Eckstein C. Beyond biopsy for neurosarcoidosis: A review of blood and CSF biomarkers. J Neuroimmunol 2024; 393:578394. [PMID: 38875863 DOI: 10.1016/j.jneuroim.2024.578394] [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: 04/03/2024] [Revised: 05/09/2024] [Accepted: 06/09/2024] [Indexed: 06/16/2024]
Abstract
Neurosarcoidosis, a rare granulomatous disease, causes inflammation and damage to the central nervous system (CNS). A major diagnostic challenge in neurosarcoidosis is the absence of well-defined biomarkers. The need for biopsy to make the diagnosis can lead to delays and misdiagnosis if histopathology is inaccessible or indeterminate, highlighting the need for more accessible diagnostic indicators. The current gold standard for a "definite" neurosarcoidosis diagnosis requires biopsy of CNS tissue revealing non-caseating granulomas. However, such biopsies are inherently invasive and carry associated procedural risks. Notably, angiotensin-converting enzyme (ACE), commonly associated with systemic sarcoidosis, is recognized as a poor biomarker for neurosarcoidosis due to its lack of accuracy in the context of CNS involvement. Furthermore, imaging in neurosarcoidosis, while widely utilized and important for narrowing the diagnosis, lacks specificity. Decades of research have yielded molecular and immunologic biomarkers-soluble interleukin-2 receptor (IL-2R), serum amyloid A1, the CD4/CD8 ratio, neopterin, interferon-gamma (IFN-γ), and chemokine ligand 2 (CCL2)-that hold potential for improving diagnostic accuracy. However, these biomarkers are not yet established in clinical care as they may be difficult to obtain and are derived from small studies. They also suffer from a lack of specificity against other inflammatory and infectious central nervous system diseases. New biomarkers are needed for use alongside those previously discovered to improve diagnosis of this rare disease. This review synthesizes existing literature on neurosarcoidosis biomarkers, aiming to establish a foundation for further research in this evolving field. It also consolidates information on biomarkers of systemic sarcoidosis such as IL-8 and soluble CD40L that have not yet been studied in neurosarcoidosis but hold potential as markers of CNS disease.
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Affiliation(s)
- Elijah Lackey
- Duke University, Department of Neurology, Division of MS and Neuroimmunology, DUMC 3849, Durham, NC 27710, United States of America.
| | - Jeffrey Shen
- Duke University, Department of Neurology, Division of MS and Neuroimmunology, DUMC 3849, Durham, NC 27710, United States of America
| | - Aditya Sharma
- Duke University, Department of Neurology, Division of MS and Neuroimmunology, DUMC 3849, Durham, NC 27710, United States of America
| | - Christopher Eckstein
- Duke University, Department of Neurology, Division of MS and Neuroimmunology, DUMC 3849, Durham, NC 27710, United States of America
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2
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Casanova NG, Camp SM, Gonzalez-Garay ML, Batai K, Garman L, Montgomery CG, Ellis N, Kittles R, Bime C, Hsu AP, Holland S, Lussier YA, Karnes J, Sweiss N, Maier LA, Koth L, Moller DR, Kaminski N, Garcia JGN. Examination of eQTL Polymorphisms Associated with Increased Risk of Progressive Complicated Sarcoidosis in European and African Descent Subjects. EUROPEAN JOURNAL OF RESPIRATORY MEDICINE 2023; 5:359-371. [PMID: 38390497 PMCID: PMC10883688] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Subscribe] [Scholar Register] [Indexed: 02/24/2024]
Abstract
Background A limited pool of SNPs are linked to the development and severity of sarcoidosis, a systemic granulomatous inflammatory disease. By integrating genome-wide association studies (GWAS) data and expression quantitative trait loci (eQTL) single nuclear polymorphisms (SNPs), we aimed to identify novel sarcoidosis SNPs potentially influencing the development of complicated sarcoidosis. Methods A GWAS (Affymetrix 6.0) involving 209 African-American (AA) and 193 European-American (EA, 75 and 51 complicated cases respectively) and publicly-available GWAS controls (GAIN) was utilized. Annotation of multi-tissue eQTL SNPs present on the GWAS created a pool of ~46,000 eQTL SNPs examined for association with sarcoidosis risk and severity (Logistic Model, Plink). The most significant EA/AA eQTL SNPs were genotyped in a sarcoidosis validation cohort (n=1034) and cross-validated in two independent GWAS cohorts. Results No single GWAS SNP achieved significance (p<1x10-8), however, analysis of the eQTL/GWAS SNP pool yielded 621 eQTL SNPs (p<10-4) associated with 730 genes that highlighted innate immunity, MHC Class II, and allograft rejection pathways with multiple SNPs validated in an independent sarcoidosis cohort (105 SNPs analyzed) (NOTCH4, IL27RA, BTNL2, ANXA11, HLA-DRB1). These studies confirm significant association of eQTL/GWAS SNPs in EAs and AAs with sarcoidosis risk and severity (complicated sarcoidosis) involving HLA region and innate immunity. Conclusion Despite the challenge of deciphering the genetic basis for sarcoidosis risk/severity, these results suggest that integrated eQTL/GWAS approaches may identify novel variants/genes and support the contribution of dysregulated innate immune responses to sarcoidosis severity.
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Affiliation(s)
- Nancy G Casanova
- Department of Molecular Medicine, Univeristy of Florida, Scripps, Jupiter FL, USA
| | - Sara M Camp
- Center for Inflammation Science and Systems Medicine, University of Florida, Wertheim Scripps Research Institute, Jupiter FL, USA
| | - Manuel L Gonzalez-Garay
- Division of Health Equities, Department of Population Sciences, City of Hope, Duarte, California, USA
| | - Ken Batai
- Cancer Prevention & Control, Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA
| | - Lori Garman
- Oklahoma Medical Research Foundation, Oklahoma City, OK, USA
| | | | - Nathan Ellis
- University of Arizona Cancer Center, Tucson, AZ, USA
| | - Rick Kittles
- Division of Health Equities, Department of Population Sciences, City of Hope, Duarte, California, USA
| | - Christian Bime
- Department of Medicine University of Arizona, Tucson, AZ, USA
| | - Amy P Hsu
- National Institute of Allergy and Infectious Diseases. National Institutes of Health, USA
| | - Steven Holland
- National Institute of Allergy and Infectious Diseases. National Institutes of Health, USA
| | - Yves A Lussier
- Department of Biomedical Informatics, University of Utah, Salt Lake City, UT, USA
| | - Jason Karnes
- Department of Pharmacology, University of Arizona, College of Pharmacy, Tucson, AZ, USA
| | - Nadera Sweiss
- Department of Medicine University of Illinois, Chicago, IL, USA
| | - Lisa A Maier
- Department of Medicine National Jewish Health, University of Colorado, Denver, CO, USA
| | - Laura Koth
- Department of Medicine University of California San Francisco, San Francisco, CA, US, USA
| | - David R Moller
- Department of Medicine Johns Hopkins University School of Medicine, Baltimore Maryland, USA
| | - Naftali Kaminski
- Department of Medicine Yale University School of Medicine, New Haven, CT, USA
| | - Joe G N Garcia
- Center for Inflammation Science and Systems Medicine, University of Florida, Wertheim Scripps Research Institute, Jupiter FL, USA
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Starshinova A, Zinchenko Y, Malkova A, Kudlay D, Kudryavtsev I, Yablonskiy P. Sarcoidosis and Autoimmune Inflammatory Syndrome Induced by Adjuvants. Life (Basel) 2023; 13:life13041047. [PMID: 37109576 PMCID: PMC10145559 DOI: 10.3390/life13041047] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Revised: 04/16/2023] [Accepted: 04/17/2023] [Indexed: 04/29/2023] Open
Abstract
Currently, sarcoidosis remains one of the diseases with unknown etiology, which significantly complicates its diagnosis and treatment. Various causes of sarcoidosis have been studied for many years. Both organic and inorganic trigger factors, provoking the development of granulomatous inflammation are considered. However, the most promising and evidence-based hypothesis is the development of sarcoidosis as an autoimmune disease, provoked by various adjuvants in genetic predisposed individuals. This concept fits into the structure of the autoimmune/inflammatory syndrome, induced by adjuvants (ASIA) that was proposed in 2011 by Professor Shoenfeld Y. In this paper, the authors reveal the presence of major and minor ASIA criteria for sarcoidosis, propose a new concept of the course of sarcoidosis within the framework of ASIA, and point out the difficulties in creating a model of the disease and the selection of therapy. It is obvious that the data obtained not only bring us closer to understanding the nature of sarcoidosis, but also potentiate new studies confirming this hypothesis by obtaining a model of the disease.
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Affiliation(s)
- Anna Starshinova
- Almazov National Medical Research Centre, 197341 Saint-Petersburg, Russia
| | - Yulia Zinchenko
- Saint-Petersburg Research Institute of Phthisiopulmonology, 194064 Saint-Petersburg, Russia
| | - Anna Malkova
- Laboratory of the Mosaic of Autoimmunity, Saint-Petersburg State University, 199034 Saint-Petersburg, Russia
| | - Dmitriy Kudlay
- Medical Department, Sechenov First Moscow State Medical University, 119435 Moscow, Russia
- Institute of Immunology, 115478 Moscow, Russia
| | - Igor Kudryavtsev
- Almazov National Medical Research Centre, 197341 Saint-Petersburg, Russia
- Department of Immunology, Institution of Experimental Medicine, 197022 Saint-Petersburg, Russia
| | - Piotr Yablonskiy
- Saint-Petersburg Research Institute of Phthisiopulmonology, 194064 Saint-Petersburg, Russia
- Laboratory of the Mosaic of Autoimmunity, Saint-Petersburg State University, 199034 Saint-Petersburg, Russia
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4
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Byg KE, Illes Z, Sejbaek T, Lambertsen KL, Ellingsen T, Nielsen HH. Inflammatory profiles in plasma and cerebrospinal fluid of patients with neurosarcoidosis. J Neuroimmunol 2022; 367:577849. [DOI: 10.1016/j.jneuroim.2022.577849] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2021] [Revised: 03/04/2022] [Accepted: 03/22/2022] [Indexed: 10/18/2022]
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Malkova A, Starshinova A, Zinchenko Y, Basantsova N, Mayevskaya V, Yablonskiy P, Shoenfeld Y. The opposite effect of human leukocyte antigen genotypes in sarcoidosis and tuberculosis: a narrative review of the literature. ERJ Open Res 2020; 6:00155-2020. [PMID: 32802825 PMCID: PMC7418820 DOI: 10.1183/23120541.00155-2020] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2019] [Accepted: 05/13/2020] [Indexed: 12/14/2022] Open
Abstract
Sarcoidosis and tuberculosis share several similar clinical and pathogenic characteristics that make some researchers consider a common pathogenesis for these diseases. Human leukocyte antigen (HLA) genotypes are studied both in sarcoidosis and tuberculosis patients, but to our knowledge, there are no comparative studies of genetic predisposition for sarcoidosis and tuberculosis development. The aim of this review was to analyse the relationship between HLA genotypes and the development of sarcoidosis and tuberculosis. Original and review articles published in various online databases from 1960 to 2019 were studied. The search results showed opposite effects of the HLA genotypes on predisposition to sarcoidosis or tuberculosis. It was revealed that the genotypes predisposing to the development of sarcoidosis (HLA-DRB1*03/07/15) have protective properties against the development of tuberculosis. Moreover, genotypes causing the development of tuberculosis (HLA-DRB1*04) have a protective effect on the development of sarcoidosis. The results of this narrative review of the literature may allude to the existence of genetic predispositions that lead to the development of an antibacterial or autoimmune response to mycobacteria. The HLA-DRB1*03/07/15 genotypes predispose to the development of sarcoidosis and have protective properties against the development of tuberculosis, while the HLA-DRB1*04 genotype has an opposite effect on the development of these diseaseshttps://bit.ly/2Tl2rj1
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Affiliation(s)
- Anna Malkova
- Saint Petersburg State University, Saint Petersburg, Russia
| | - Anna Starshinova
- Almazov National Medical Research Centre, Saint Petersburg, Russia
| | - Yulia Zinchenko
- Saint Petersburg State University, Saint Petersburg, Russia.,Saint Petersburg Research Institute of Phthisiopulmonology, Saint Petersburg, Russia
| | - Natalia Basantsova
- Saint Petersburg State University, Saint Petersburg, Russia.,Saint Petersburg Research Institute of Phthisiopulmonology, Saint Petersburg, Russia
| | - Vera Mayevskaya
- Saint Petersburg University of Economics, Saint Petersburg, Russia
| | - Piotr Yablonskiy
- Saint Petersburg State University, Saint Petersburg, Russia.,Saint Petersburg Research Institute of Phthisiopulmonology, Saint Petersburg, Russia
| | - Yehuda Shoenfeld
- Saint Petersburg State University, Saint Petersburg, Russia.,Zabludowicz Center for Autoimmune Diseases, Sheba Medical Center, Tel Hashomer, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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Bhargava M, Viken KJ, Barkes B, Griffin TJ, Gillespie M, Jagtap PD, Sajulga R, Peterson EJ, Dincer HE, Li L, Restrepo CI, O'Connor BP, Fingerlin TE, Perlman DM, Maier LA. Novel protein pathways in development and progression of pulmonary sarcoidosis. Sci Rep 2020; 10:13282. [PMID: 32764642 PMCID: PMC7413390 DOI: 10.1038/s41598-020-69281-8] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2020] [Accepted: 06/17/2020] [Indexed: 12/15/2022] Open
Abstract
Pulmonary involvement occurs in up to 95% of sarcoidosis cases. In this pilot study, we examine lung compartment-specific protein expression to identify pathways linked to development and progression of pulmonary sarcoidosis. We characterized bronchoalveolar lavage (BAL) cells and fluid (BALF) proteins in recently diagnosed sarcoidosis cases. We identified 4,306 proteins in BAL cells, of which 272 proteins were differentially expressed in sarcoidosis compared to controls. These proteins map to novel pathways such as integrin-linked kinase and IL-8 signaling and previously implicated pathways in sarcoidosis, including phagosome maturation, clathrin-mediated endocytic signaling and redox balance. In the BALF, the differentially expressed proteins map to several pathways identified in the BAL cells. The differentially expressed BALF proteins also map to aryl hydrocarbon signaling, communication between innate and adaptive immune response, integrin, PTEN and phospholipase C signaling, serotonin and tryptophan metabolism, autophagy, and B cell receptor signaling. Additional pathways that were different between progressive and non-progressive sarcoidosis in the BALF included CD28 signaling and PFKFB4 signaling. Our studies demonstrate the power of contemporary proteomics to reveal novel mechanisms operational in sarcoidosis. Application of our workflows in well-phenotyped large cohorts maybe beneficial to identify biomarkers for diagnosis and prognosis and therapeutically tenable molecular mechanisms.
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Affiliation(s)
- Maneesh Bhargava
- Division of Pulmonary, Critical Care and Sleep Medicine, University of Minnesota, MMC 276, 420 Delaware St SE, Minneapolis, MN, USA.
| | - K J Viken
- Division of Pulmonary, Critical Care and Sleep Medicine, University of Minnesota, MMC 276, 420 Delaware St SE, Minneapolis, MN, USA
| | - B Barkes
- Division of Environmental and Occupational Health Sciences, National Jewish Health, Denver, CO, USA
| | - T J Griffin
- Biochemistry, Molecular Biology and Biophysics, College of Biological Sciences, University of Minnesota, Minneapolis, MN, USA
| | - M Gillespie
- Division of Environmental and Occupational Health Sciences, National Jewish Health, Denver, CO, USA
| | - P D Jagtap
- Biochemistry, Molecular Biology and Biophysics, College of Biological Sciences, University of Minnesota, Minneapolis, MN, USA
| | - R Sajulga
- Biochemistry, Molecular Biology and Biophysics, College of Biological Sciences, University of Minnesota, Minneapolis, MN, USA
| | - E J Peterson
- Center for Immunology, University of Minnesota, Minneapolis, MN, USA
| | - H E Dincer
- Division of Pulmonary, Critical Care and Sleep Medicine, University of Minnesota, MMC 276, 420 Delaware St SE, Minneapolis, MN, USA
| | - L Li
- Division of Environmental and Occupational Health Sciences, National Jewish Health, Denver, CO, USA
| | - C I Restrepo
- Division of Environmental and Occupational Health Sciences, National Jewish Health, Denver, CO, USA
| | - B P O'Connor
- Center for Genes, Environment and Health, National Jewish Health, Denver, CO, USA
| | - T E Fingerlin
- Center for Genes, Environment and Health, National Jewish Health, Denver, CO, USA
| | - D M Perlman
- Division of Pulmonary, Critical Care and Sleep Medicine, University of Minnesota, MMC 276, 420 Delaware St SE, Minneapolis, MN, USA
| | - L A Maier
- Division of Environmental and Occupational Health Sciences, National Jewish Health, Denver, CO, USA
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7
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Abedini A, Naderi Z, Kiani A, Marjani M, Mortaz E, Ghorbani F. The evaluation of interleukin-4 and interleukin-13 in the serum of pulmonary sarcoidosis and tuberculosis patients. JOURNAL OF RESEARCH IN MEDICAL SCIENCES 2020; 25:24. [PMID: 32419781 PMCID: PMC7213005 DOI: 10.4103/jrms.jrms_74_19] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/26/2019] [Revised: 07/14/2019] [Accepted: 12/20/2019] [Indexed: 12/19/2022]
Abstract
Background: Sarcoidosis and tuberculosis (TB) are two granulomatous inflammatory diseases with several common symptoms. The aim of the present study was to compare the serum levels of biomarkers including interleukin-4 (IL-4) and IL-13, calcium (Ca), hemoglobin, sedimentation rate, and lymphocyte-to-neutrophil ratio between patients with pulmonary TB, patients with sarcoidosis, and control group. Materials and Methods: This case–control study was performed on patients referred to the Masih Daneshvari Hospital, Tehran, from April 2017 to 2018. In this study, 24 newly diagnosed patients with active pulmonary TB, 34 patients with pulmonary sarcoidosis, and 30 healthy individuals as the control group were enrolled. Demographic data, erythrocyte sedimentation rate (ESR), the ratio of neutrophil-to-lymphocyte (NLR), serum Ca level, hemoglobin (Hb), and IL-4 and IL-13 were compared between the study groups. Receiver operating characteristic (ROC) curve analysis, sensitivity, and specificity were also calculated using SPSS 16.0 software. Results: The mean age was 47.71 ± 10.88 and 55.25 ± 21.58 years in the sarcoidosis and TB. The mean ESR in sarcoidosis patients was 21.45 ± 13.37 mm/h and 41.4 ± 17 mm/h in the TB group. The percentage of peripheral blood lymphocytes in sarcoidosis and TB patients was 28.02 ± 12.20 and 21.41 ± 12.49, respectively, which was significantly higher among patients with sarcoidosis. NLR was also 2.4 ± 1.6 and 4.4 ± 2.9 in sarcoidosis and TB patients, respectively, which showed a significant difference among the groups. Regarding the evaluation of the level of IL-4 and IL-13 in patients, it is worth noting that IL-4 in patients with sarcoidosis was 90 pg/ml compared to 20 pg/ml for TB patients (P < 0.001). There was no significant difference in the levels of IL-13 in the TB and control groups, which varied between 20 and 80 pg/ml (P = 0.35). However, its value was significantly higher in patients with sarcoidosis (P = 0.01) than in the healthy control group and TB (P = 0.01). The ROC curves showed that the diagnostic cutoff of ESR level, Ca, NLR, and Hb could be valuable due to the area under the curves. The cutpoint of 34 mm/h for ESR had a sensitivity of 86% as well as 80% specificity to distinguish TB from the sarcoidosis. Conclusion: Serum levels of the biomarkers indicated a stronger immunological background in sarcoidosis using NLR, Ca, ESR, and Hb.
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Affiliation(s)
- Atefeh Abedini
- Chronic Respiratory Research Center, National Research Institute of Tuberculosis and Lung Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Zohre Naderi
- Department of Pulmonology, University of Medical Science, Isfahan University, Isfahan, Iran.,Clinical Tuberculosis and Epidemiology Research Center, National Research Institute of Tuberculosis and Lung Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Arda Kiani
- Chronic Respiratory Research Center, National Research Institute of Tuberculosis and Lung Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Majid Marjani
- Clinical Tuberculosis and Epidemiology Research Center, National Research Institute of Tuberculosis and Lung Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Esmaeil Mortaz
- Clinical Tuberculosis and Epidemiology Research Center, National Research Institute of Tuberculosis and Lung Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Fariba Ghorbani
- Tracheal Diseases Research Center, National Research Institute of Tuberculosis and Lung Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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8
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Landi C, Carleo A, Cillis G, Rottoli P. Sarcoidosis: proteomics and new perspectives for improving personalized medicine. Expert Rev Proteomics 2018; 15:829-835. [DOI: 10.1080/14789450.2018.1528148] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Affiliation(s)
- Claudia Landi
- Laboratory of Functional Proteomics, Department of Life Sciences, University of Siena. Siena, Italy
- UOC Respiratory Diseases and Lung Transplantation, Department Internal and Specialist Medicine, University of Siena, Siena, Italy
| | - Alfonso Carleo
- UOC Respiratory Diseases and Lung Transplantation, Department Internal and Specialist Medicine, University of Siena, Siena, Italy
- Department of Pulmonology, Hannover Medical School, Hannover, Germany
| | - Giuseppe Cillis
- UOC Respiratory Diseases and Lung Transplantation, Department Internal and Specialist Medicine, University of Siena, Siena, Italy
| | - Paola Rottoli
- UOC Respiratory Diseases and Lung Transplantation, Department Internal and Specialist Medicine, University of Siena, Siena, Italy
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9
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White donor, younger donor and double lung transplant are associated with better survival in sarcoidosis patients. Sci Rep 2018; 8:6968. [PMID: 29725035 PMCID: PMC5934355 DOI: 10.1038/s41598-018-25144-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2017] [Accepted: 04/11/2018] [Indexed: 01/03/2023] Open
Abstract
Sarcoidosis commonly affects the lung. Lung transplantation (LT) is required when there is a severe and refractory involvement. We compared post-transplant survival rates of sarcoidosis patients with chronic obstructive pulmonary disease (COPD) and idiopathic pulmonary fibrosis (IPF). We also explored whether the race and age of the donor, and double lung transplant have any effect on the survival in the post transplant setting. We analyzed 9,727 adult patients with sarcoidosis, COPD, and IPF who underwent LT worldwide between 2005–2015 based on United Network for Organ Sharing (UNOS) database. Survival rates were compared with Kaplan-Meier, and risk factors were investigated by Cox-regression analysis. 469 (5%) were transplanted because of sarcoidosis, 3,688 (38%) for COPD and 5,570 (57%) for IPF. Unadjusted survival analysis showed a better post-transplant survival rate for patients with sarcoidosis (p < 0.001, Log-rank test). In Cox-regression analysis, double lung transplant and white race of the lung donor showed to have a significant survival advantage. Since double lung transplant, those who are younger and have lower Lung Allocation Score (LAS) at the time of transplant have a survival advantage, we suggest double lung transplant as the procedure of choice, especially in younger sarcoidosis subjects and with lower LAS scores.
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Zhou T, Casanova N, Pouladi N, Wang T, Lussier Y, Knox KS, Garcia JGN. Identification of Jak-STAT signaling involvement in sarcoidosis severity via a novel microRNA-regulated peripheral blood mononuclear cell gene signature. Sci Rep 2017; 7:4237. [PMID: 28652588 PMCID: PMC5484682 DOI: 10.1038/s41598-017-04109-6] [Citation(s) in RCA: 53] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2016] [Accepted: 05/10/2017] [Indexed: 11/28/2022] Open
Abstract
Sarcoidosis is a granulomatous lung disorder of unknown cause. The majority of individuals with sarcoidosis spontaneously achieve full remission (uncomplicated sarcoidosis), however, ~20% of sarcoidosis-affected individuals experience progressive lung disease or cardiac and nervous system involvement (complicated sarcoidosis). We investigated peripheral blood mononuclear cell (PBMC) microRNA and protein-coding gene expression data from healthy controls and patients with uncomplicated or complicated sarcoidosis. We identified 46 microRNAs and 1,559 genes that were differentially expressed across a continuum of sarcoidosis severity (healthy control → uncomplicated sarcoidosis → complicated sarcoidosis). A total of 19 microRNA-mRNA regulatory pairs were identified within these deregulated microRNAs and mRNAs, which consisted of 17 unique protein-coding genes yielding a 17-gene signature. Pathway analysis of the 17-gene signature revealed Jak-STAT signaling pathway as the most significantly represented pathway. A severity score was assigned to each patient based on the expression of the 17-gene signature and a significant increasing trend in the severity score was observed from healthy control, to uncomplicated sarcoidosis, and finally to complicated sarcoidosis. In addition, this microRNA-regulated gene signature differentiates sarcoidosis patients from healthy controls in independent validation cohorts. Our study suggests that PBMC gene expression is useful in diagnosis of sarcoidosis.
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Affiliation(s)
- Tong Zhou
- Department of Physiology and Cell Biology, University of Nevada, Reno School of Medicine, Reno, NV, 89557, USA
| | - Nancy Casanova
- Division of Pulmonary, Allergy, Critical Care, and Sleep Medicine, Department of Medicine, University of Arizona Health Sciences, Tucson, AZ, 78721, USA
| | - Nima Pouladi
- Center for Bioinformatics and Biostatistics, University of Arizona Health Sciences, Tucson, AZ, 78721, USA
| | - Ting Wang
- Division of Pulmonary, Allergy, Critical Care, and Sleep Medicine, Department of Medicine, University of Arizona Health Sciences, Tucson, AZ, 78721, USA
| | - Yves Lussier
- Center for Bioinformatics and Biostatistics, University of Arizona Health Sciences, Tucson, AZ, 78721, USA
| | - Kenneth S Knox
- Division of Pulmonary, Allergy, Critical Care, and Sleep Medicine, Department of Medicine, University of Arizona Health Sciences, Tucson, AZ, 78721, USA
| | - Joe G N Garcia
- Division of Pulmonary, Allergy, Critical Care, and Sleep Medicine, Department of Medicine, University of Arizona Health Sciences, Tucson, AZ, 78721, USA.
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12
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Mirsaeidi M, Mortaz E, Omar HR, Camporesi EM, Sweiss N. Association of Neutrophil to Lymphocyte Ratio and Pulmonary Hypertension in Sarcoidosis Patients. TANAFFOS 2016; 15:44-7. [PMID: 27403178 PMCID: PMC4937761] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND The neutrophil-to-lymphocyte ratio (NLR) has emerged as a new marker of inflammation associated with the severity of several respiratory and cardiac diseases. MATERIALS AND METHODS We investigated whether the degree of systemic inflammation in sarcoidosis patients as measured by the NLR is associated with pulmonary hypertension (PH). RESULTS A NLR > 3.5 occurred with a significantly higher frequency in sarcoidosis patients with PH (50% vs. 24%, P=0.016) yielding a sensitivity of 50%, specificity of 78%, positive predictive value (PPV) of 41.9% and negative predictive value (NPV) of 81.4% and remained independently associated with PH in multivariate analysis (OR: 3.254, 95% CI: 1.094-9.678, P=0.034). CONCLUSION We conclude that level of inflammation in sarcoidosis patients may be associated with the development of PH. Owing to the relatively good specificity and NPV, NLR may be a good negative test, which is a simple, inexpensive and widely available in office-based setting to predict the risk of PH in sarcoidosis patients.
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Affiliation(s)
- Mehdi Mirsaeidi
- Division of Pulmonary, Critical Care, Sleep and Allergy, Department of Medicine, University of Miami, FL, USA,Correspondence to: Mirsaeidi M, Address: Division of Pulmonary, Critical Care, Sleep and Allergy, Department of Medicine, University of Miami, Miller School of Medicine1600 NW 10th Ave # 7060A Miami, FL 33136, Email address:
| | - Esmaeil Mortaz
- Division of Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Faculty of Science, Utrecht University, Utrecht, The Netherlands,Chronic Respiratory Diseases Research Center, National Research Institute of Tuberculosis and Lung Disease (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Hesham R. Omar
- Chronic Respiratory Diseases Research Center, National Research Institute of Tuberculosis and Lung Disease (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Enrico M. Camporesi
- Professor of Surgery/Anesthesiology, Professor of Molecular Pharmacology and Physiology, University of South Florida, FGTBA and TEAM Health, Tampa, Florida, USA
| | - Nadera Sweiss
- Division of Pulmonary, Critical Care, Sleep and Allergy, Department of Medicine, University of Illinois at Chicago, IL, USA
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