Clinical aspects and immune reactions in sarcoidosis
Identifieur interne : 000503 ( Istex/Corpus ); précédent : 000502; suivant : 000504Clinical aspects and immune reactions in sarcoidosis
Auteurs : Johan GrunewaldSource :
- The Clinical Respiratory Journal [ 1752-6981 ] ; 2007-12.
English descriptors
- Teeft :
- Aetiology, Baughman, Blackwell publishing, Bronchoalveolar, Bronchoalveolar lavage, Chemokine, Chronic sarcoidosis, Clin, Clinical aspects, Corticosteroid, Crit, Cytokine, Disease activity, Drent, Eklund, Good prognosis, Granuloma, Granulomatous, Grunewald, Immune, Immune response, Immunol, Issn, Japanese patients, Journal compilation, Lavage, Lymphocyte, Macrophage, Mycobacterial, Oral steroids, Pulmonary sarcoidosis, Receptor, Respir, Respir crit care, Sarcoid, Sarcoidosis, Sarcoidosis patients, Sarcoidosis vasc, Steroid, Thorax, Treg cells.
Abstract
Introduction: Sarcoidosis is a granulomatous disorder of unknown aetiology, affecting young adults and frequently involving the lungs. Objective: The aim of the present review was to give an overview of the clinical aspects in sarcoidosis. Results: The majority of patients recover, but some develop a chronic disease that may result in fibrosis and respiratory failure. Besides the lungs, peripheral lymph nodes, the skin, the liver and the eyes are commonly affected as well. The genetic background, as well as environmental factors, is of importance for developing sarcoidosis. The incidence varies in different populations, in the Nordic countries approximately with 20/100 000 new patients yearly. Sarcoidosis is diagnosed when clinical and radiological findings are supported by histological evidence in the form of non‐caseating epithelioid cell granulomas, and when other causes of these features are excluded. Patients in need of treatment are usually treated with corticosteroids, topically or as oral steroids. A clinical effect of immunomodulatory drugs blocking tumour necrosis factor (TNF)α has been suggested from several case reports, while two controlled studies showed only minor effects; however, with a tendency to a more pronounced effect on patients with a more severe disease. The immune response in sarcoidosis, with a typical accumulation of CD4+ T‐cells to the lungs, indicate the existence of specific antigens in this disease. Recently, antigens derived from infectious agents such as Mycobacteria and Proprionibacterium acnes have come into focus. Lymphocyte populations with immunoregulatory functions have recently been investigated and seem to be dysfunctional in sarcoidosis, opening the possibility of developing new treatment strategies in this disease. Conclusion: Recent technical developments have provided better tools, enabling detailed and more thorough analyses of the inflammatory process in sarcoidosis. Please cite this paper as: Grunewald J. Clinical aspects and immune reactions in sarcoidosis. The Clinical Respiratory Journal 2007; 1:64–73.
Url:
DOI: 10.1111/j.1752-699X.2007.2007.00019.x
Links to Exploration step
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<front><div type="abstract" xml:lang="en">Introduction: Sarcoidosis is a granulomatous disorder of unknown aetiology, affecting young adults and frequently involving the lungs. Objective: The aim of the present review was to give an overview of the clinical aspects in sarcoidosis. Results: The majority of patients recover, but some develop a chronic disease that may result in fibrosis and respiratory failure. Besides the lungs, peripheral lymph nodes, the skin, the liver and the eyes are commonly affected as well. The genetic background, as well as environmental factors, is of importance for developing sarcoidosis. The incidence varies in different populations, in the Nordic countries approximately with 20/100 000 new patients yearly. Sarcoidosis is diagnosed when clinical and radiological findings are supported by histological evidence in the form of non‐caseating epithelioid cell granulomas, and when other causes of these features are excluded. Patients in need of treatment are usually treated with corticosteroids, topically or as oral steroids. A clinical effect of immunomodulatory drugs blocking tumour necrosis factor (TNF)α has been suggested from several case reports, while two controlled studies showed only minor effects; however, with a tendency to a more pronounced effect on patients with a more severe disease. The immune response in sarcoidosis, with a typical accumulation of CD4+ T‐cells to the lungs, indicate the existence of specific antigens in this disease. Recently, antigens derived from infectious agents such as Mycobacteria and Proprionibacterium acnes have come into focus. Lymphocyte populations with immunoregulatory functions have recently been investigated and seem to be dysfunctional in sarcoidosis, opening the possibility of developing new treatment strategies in this disease. Conclusion: Recent technical developments have provided better tools, enabling detailed and more thorough analyses of the inflammatory process in sarcoidosis. Please cite this paper as: Grunewald J. Clinical aspects and immune reactions in sarcoidosis. The Clinical Respiratory Journal 2007; 1:64–73.</div>
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<profileDesc><abstract xml:lang="en" style="main"><head>Abstract</head>
<p><hi rend="bold">Introduction: </hi>
Sarcoidosis is a granulomatous disorder of unknown aetiology, affecting young adults and frequently involving the lungs.</p>
<p><hi rend="bold">Objective: </hi>
The aim of the present review was to give an overview of the clinical aspects in sarcoidosis.</p>
<p><hi rend="bold">Results: </hi>
The majority of patients recover, but some develop a chronic disease that may result in fibrosis and respiratory failure. Besides the lungs, peripheral lymph nodes, the skin, the liver and the eyes are commonly affected as well. The genetic background, as well as environmental factors, is of importance for developing sarcoidosis. The incidence varies in different populations, in the Nordic countries approximately with 20/100 000 new patients yearly. Sarcoidosis is diagnosed when clinical and radiological findings are supported by histological evidence in the form of non‐caseating epithelioid cell granulomas, and when other causes of these features are excluded. Patients in need of treatment are usually treated with corticosteroids, topically or as oral steroids. A clinical effect of immunomodulatory drugs blocking tumour necrosis factor (TNF)α has been suggested from several case reports, while two controlled studies showed only minor effects; however, with a tendency to a more pronounced effect on patients with a more severe disease.</p>
<p>The immune response in sarcoidosis, with a typical accumulation of CD4+ T‐cells to the lungs, indicate the existence of specific antigens in this disease. Recently, antigens derived from infectious agents such as <hi rend="italic">Mycobacteria</hi>
and <hi rend="italic">Proprionibacterium acnes</hi>
have come into focus. Lymphocyte populations with immunoregulatory functions have recently been investigated and seem to be dysfunctional in sarcoidosis, opening the possibility of developing new treatment strategies in this disease.</p>
<p><hi rend="bold">Conclusion: </hi>
Recent technical developments have provided better tools, enabling detailed and more thorough analyses of the inflammatory process in sarcoidosis.</p>
<p>Please cite this paper as: Grunewald J. Clinical aspects and immune reactions in sarcoidosis. <hi rend="italic">The Clinical Respiratory Journal</hi>
2007; 1:64–73.</p>
</abstract>
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<correspondenceTo>Johan Grunewald, MD, PhD,
Department of Medicine, Division of
Respiratory Medicine, Karolinska Institutet
Lung Research Laboratory L4:01, Karolinska
University Hospital Solna
S‐171 76 Stockholm, Sweden.
Tel: 0046 8 51775117
Fax: 0046 8 51775451
email: <email>johan.grunewald@ki.se</email>
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<contentMeta><unparsedEditorialHistory>Received: 02 May 2007Revision requested: 31 May 2007 and 22 June 2007Accepted: 02 July 2007</unparsedEditorialHistory>
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<titleGroup><title type="main">Clinical aspects and immune reactions in sarcoidosis<link href="#fn1">*</link>
</title>
<title type="shortAuthors">Grunewald</title>
<title type="short">Aetiology of sarcoidosis</title>
</titleGroup>
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<affiliationGroup><affiliation xml:id="aff-1-1" countryCode="SE"><unparsedAffiliation>Department of Medicine, Division of Respiratory Medicine, Karolinska Institutet and Karolinska University Hospital Solna, Stockholm, Sweden</unparsedAffiliation>
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<keywordGroup xml:lang="en"><keyword xml:id="k1">aetiology</keyword>
<keyword xml:id="k2">diagnosis</keyword>
<keyword xml:id="k3">sarcoidosis</keyword>
<keyword xml:id="k4">treatment</keyword>
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<abstractGroup><abstract type="main" xml:lang="en"><title type="main">Abstract</title>
<p><b>Introduction: </b>
Sarcoidosis is a granulomatous disorder of unknown aetiology, affecting young adults and frequently involving the lungs.</p>
<p><b>Objective: </b>
The aim of the present review was to give an overview of the clinical aspects in sarcoidosis.</p>
<p><b>Results: </b>
The majority of patients recover, but some develop a chronic disease that may result in fibrosis and respiratory failure. Besides the lungs, peripheral lymph nodes, the skin, the liver and the eyes are commonly affected as well. The genetic background, as well as environmental factors, is of importance for developing sarcoidosis. The incidence varies in different populations, in the Nordic countries approximately with 20/100 000 new patients yearly. Sarcoidosis is diagnosed when clinical and radiological findings are supported by histological evidence in the form of non‐caseating epithelioid cell granulomas, and when other causes of these features are excluded. Patients in need of treatment are usually treated with corticosteroids, topically or as oral steroids. A clinical effect of immunomodulatory drugs blocking tumour necrosis factor (TNF)α has been suggested from several case reports, while two controlled studies showed only minor effects; however, with a tendency to a more pronounced effect on patients with a more severe disease.</p>
<p>The immune response in sarcoidosis, with a typical accumulation of CD4+ T‐cells to the lungs, indicate the existence of specific antigens in this disease. Recently, antigens derived from infectious agents such as <i>Mycobacteria</i>
and <i>Proprionibacterium acnes</i>
have come into focus. Lymphocyte populations with immunoregulatory functions have recently been investigated and seem to be dysfunctional in sarcoidosis, opening the possibility of developing new treatment strategies in this disease.</p>
<p><b>Conclusion: </b>
Recent technical developments have provided better tools, enabling detailed and more thorough analyses of the inflammatory process in sarcoidosis.</p>
<p>Please cite this paper as: Grunewald J. Clinical aspects and immune reactions in sarcoidosis. <i>The Clinical Respiratory Journal</i>
2007; 1:64–73.</p>
</abstract>
</abstractGroup>
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<noteGroup><note xml:id="fn1"><label>*</label>
<p>
This study was supported by the Swedish Heart–Lung Foundation, the King Oscar II Jubilee Foundation, the Swedish Medical Research Council, the Torsten and Ragnar Söderbergs Foundation, Karolinska Institutet, and the Stockholm County Council</p>
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<titleInfo type="abbreviated" lang="en"><title>Aetiology of sarcoidosis</title>
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<abstract lang="en">Introduction: Sarcoidosis is a granulomatous disorder of unknown aetiology, affecting young adults and frequently involving the lungs. Objective: The aim of the present review was to give an overview of the clinical aspects in sarcoidosis. Results: The majority of patients recover, but some develop a chronic disease that may result in fibrosis and respiratory failure. Besides the lungs, peripheral lymph nodes, the skin, the liver and the eyes are commonly affected as well. The genetic background, as well as environmental factors, is of importance for developing sarcoidosis. The incidence varies in different populations, in the Nordic countries approximately with 20/100 000 new patients yearly. Sarcoidosis is diagnosed when clinical and radiological findings are supported by histological evidence in the form of non‐caseating epithelioid cell granulomas, and when other causes of these features are excluded. Patients in need of treatment are usually treated with corticosteroids, topically or as oral steroids. A clinical effect of immunomodulatory drugs blocking tumour necrosis factor (TNF)α has been suggested from several case reports, while two controlled studies showed only minor effects; however, with a tendency to a more pronounced effect on patients with a more severe disease. The immune response in sarcoidosis, with a typical accumulation of CD4+ T‐cells to the lungs, indicate the existence of specific antigens in this disease. Recently, antigens derived from infectious agents such as Mycobacteria and Proprionibacterium acnes have come into focus. Lymphocyte populations with immunoregulatory functions have recently been investigated and seem to be dysfunctional in sarcoidosis, opening the possibility of developing new treatment strategies in this disease. Conclusion: Recent technical developments have provided better tools, enabling detailed and more thorough analyses of the inflammatory process in sarcoidosis. Please cite this paper as: Grunewald J. Clinical aspects and immune reactions in sarcoidosis. The Clinical Respiratory Journal 2007; 1:64–73.</abstract>
<note type="content">*This study was supported by the Swedish Heart–Lung Foundation, the King Oscar II Jubilee Foundation, the Swedish Medical Research Council, the Torsten and Ragnar Söderbergs Foundation, Karolinska Institutet, and the Stockholm County Council</note>
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