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
ISTEX:D8855F6EA06FFEF69CB36EAD41CB721C845B5F54Le document en format XML
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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. 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<ref target="http://www.tei-c.org/">We use TEI</ref></desc></application></appInfo></encodingDesc><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><textClass><keywords xml:lang="en"><term xml:id="k1">aetiology</term><term xml:id="k2">diagnosis</term><term xml:id="k3">sarcoidosis</term><term xml:id="k4">treatment</term></keywords><keywords rend="tocHeading1"><term>REVIEW ARTICLE</term></keywords></textClass><langUsage><language ident="en"></language></langUsage></profileDesc><revisionDesc><change when="2019-12-20" who="#istex" xml:id="pub2tei">formatting</change></revisionDesc></teiHeader></istex:fulltextTEI><json:item><extension>txt</extension><original>false</original><mimetype>text/plain</mimetype><uri>https://api.istex.fr/ark:/67375/WNG-MKDM96LD-0/fulltext.txt</uri></json:item></fulltext><metadata><istex:metadataXml wicri:clean="Wiley, elements deleted: body"><istex:xmlDeclaration>version="1.0" encoding="UTF-8" standalone="yes"</istex:xmlDeclaration><istex:document><component version="2.0" type="serialArticle" xml:lang="en"><header><publicationMeta level="product"><publisherInfo><publisherName>Blackwell Publishing Ltd</publisherName><publisherLoc>Oxford, UK</publisherLoc></publisherInfo><doi origin="wiley" registered="yes">10.1111/(ISSN)1752-699X</doi><issn type="print">1752-6981</issn><issn type="electronic">1752-699X</issn><idGroup><id type="product" value="CRJ"></id><id type="publisherDivision" value="ST"></id></idGroup><titleGroup><title type="main" sort="CLINICAL RESPIRATORY JOURNAL">The Clinical Respiratory Journal</title></titleGroup></publicationMeta><publicationMeta level="part" position="12002"><doi origin="wiley">10.1111/crj.2007.1.issue-2</doi><numberingGroup><numbering type="journalVolume" number="1">1</numbering><numbering type="journalIssue" number="2">2</numbering></numberingGroup><coverDate startDate="2007-12">December 2007</coverDate></publicationMeta><publicationMeta level="unit" type="reviewArticle" position="2" status="forIssue"><doi origin="wiley">10.1111/j.1752-699X.2007.2007.00019.x</doi><idGroup><id type="unit" value="CRJ019"></id></idGroup><countGroup><count type="pageTotal" number="10"></count></countGroup><titleGroup><title type="tocHeading1">REVIEW ARTICLE</title></titleGroup><eventGroup><event type="firstOnline" date="2007-08-10"></event><event type="publishedOnlineFinalForm" date="2007-08-10"></event><event type="xmlConverted" agent="Converter:BPG_TO_WML3G version:2.3.5 mode:FullText source:FullText result:FullText" date="2010-04-08"></event><event type="xmlConverted" agent="Converter:WILEY_ML3G_TO_WILEY_ML3GV2 version:3.8.8" date="2014-01-16"></event><event type="xmlConverted" agent="Converter:WML3G_To_WML3G version:4.1.7 mode:FullText,remove_FC" date="2014-11-04"></event></eventGroup><numberingGroup><numbering type="pageFirst" number="64">64</numbering><numbering type="pageLast" number="73">73</numbering></numberingGroup><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></correspondenceTo><linkGroup><link type="toTypesetVersion" href="file:CRJ.CRJ019.pdf"></link></linkGroup></publicationMeta><contentMeta><unparsedEditorialHistory>Received: 02 May 2007Revision requested: 31 May 2007 and 22 June 2007Accepted: 02 July 2007</unparsedEditorialHistory><countGroup><count type="figureTotal" number="1"></count><count type="tableTotal" number="1"></count><count type="formulaTotal" number="0"></count><count type="referenceTotal" number="111"></count><count type="wordTotal" number="6589"></count><count type="linksPubMed" number="0"></count><count type="linksCrossRef" number="0"></count></countGroup><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><creators><creator creatorRole="author" xml:id="cr1" affiliationRef="#aff-1-1"><personName><givenNames>Johan</givenNames><familyName>Grunewald</familyName></personName></creator></creators><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></affiliation></affiliationGroup><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></keywordGroup><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></contentMeta><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></note></noteGroup></header></component></istex:document></istex:metadataXml><mods version="3.6"><titleInfo lang="en"><title>Clinical aspects and immune reactions in sarcoidosis</title></titleInfo><titleInfo type="abbreviated" lang="en"><title>Aetiology of sarcoidosis</title></titleInfo><titleInfo type="alternative" contentType="CDATA" lang="en"><title>Clinical aspects and immune reactions in sarcoidosis*</title></titleInfo><name type="personal"><namePart type="given">Johan</namePart><namePart type="family">Grunewald</namePart><affiliation>Department of Medicine, Division of Respiratory Medicine, Karolinska Institutet and Karolinska University Hospital Solna, Stockholm, Sweden</affiliation><role><roleTerm type="text">author</roleTerm></role></name><typeOfResource>text</typeOfResource><genre type="review-article" displayLabel="reviewArticle" authority="ISTEX" authorityURI="https://content-type.data.istex.fr" valueURI="https://content-type.data.istex.fr/ark:/67375/XTP-L5L7X3NF-P">review-article</genre><originInfo><publisher>Blackwell Publishing Ltd</publisher><place><placeTerm type="text">Oxford, UK</placeTerm></place><dateIssued encoding="w3cdtf">2007-12</dateIssued><edition>Received: 02 May 2007Revision requested: 31 May 2007 and 22 June 2007Accepted: 02 July 2007</edition><copyrightDate encoding="w3cdtf">2007</copyrightDate></originInfo><language><languageTerm type="code" authority="rfc3066">en</languageTerm><languageTerm type="code" authority="iso639-2b">eng</languageTerm></language><physicalDescription><extent unit="figures">1</extent><extent unit="tables">1</extent><extent unit="formulas">0</extent><extent unit="references">111</extent><extent unit="linksCrossRef">0</extent><extent unit="words">6589</extent></physicalDescription><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><subject lang="en"><genre>keywords</genre><topic>aetiology</topic><topic>diagnosis</topic><topic>sarcoidosis</topic><topic>treatment</topic></subject><relatedItem type="host"><titleInfo><title>The Clinical Respiratory Journal</title></titleInfo><genre type="journal" authority="ISTEX" authorityURI="https://publication-type.data.istex.fr" valueURI="https://publication-type.data.istex.fr/ark:/67375/JMC-0GLKJH51-B">journal</genre><identifier type="ISSN">1752-6981</identifier><identifier type="eISSN">1752-699X</identifier><identifier type="DOI">10.1111/(ISSN)1752-699X</identifier><identifier type="PublisherID">CRJ</identifier><part><date>2007</date><detail type="volume"><caption>vol.</caption><number>1</number></detail><detail type="issue"><caption>no.</caption><number>2</number></detail><extent unit="pages"><start>64</start><end>73</end><total>10</total></extent></part></relatedItem><relatedItem type="references" displayLabel="cit1"><titleInfo><title>Clinical characteristics of patients in a case control study of sarcoidosis</title></titleInfo><name type="personal"><namePart type="given">RP</namePart><namePart type="family">Baughman</namePart><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">AS</namePart><namePart type="family">Teirstein</namePart><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">MA</namePart><namePart type="family">Judson</namePart><role><roleTerm type="text">author</roleTerm></role></name><genre>journal-article</genre><note type="citation/reference">Baughman RP, Teirstein AS, Judson MA, et al. 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