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Sarcoidosis

  • Ralph J. Panos
  • Andrew P. Fontenot
Chapter
Part of the Respiratory Medicine book series (RM)

Abstract

Sarcoidosis is a chronic multisystemic disorder of unknown cause that is characterized histopathologically by noncaseating granulomas and aggregation of T lymphocytes. Although sarcoidosis may affect any organ system including skin, kidneys, heart, brain and nerves, eyes, and endocrine tissues, the lungs are most frequently involved. Approximately one-third of patients will experience extrapulmonary manifestations during the course of their disease. Despite significant insight into the cellular interactions and cytokines involved in the pathogenesis of sarcoidosis, the primary inciting event(s) remains elusive. Experiments of nature and biological therapies including the near-complete absence of sarcoid in individuals with HIV infection and reduced T helper cells and the profound increase in sarcoid prevalence during the immune reconstitution syndrome or during interferon therapy for hepatitis, and amelioration of disease by inhibitors of TNF-α confirm an essential role for various cells and cytokines in the development of sarcoid. The predominance of a limited number of Vβ-expressing T lymphocyte subsets in the lungs of certain sarcoidosis subjects suggests that the dominant immune response may be directed against only a few antigens or epitopes. Clinical observations suggest a hereditary predilection to the development of sarcoid and it is likely that multiple genes, rather than a single gene, comprise the genetic predisposition to disease.

Keywords

sarcoid sarcoidosis granuloma lymphocyte T-cell receptor 

Notes

Acknowledgments

The authors thank Faye Warner-Jones for her expert secretarial assistance.

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Copyright information

© Springer Science+Business Media, LLC 2010

Authors and Affiliations

  • Ralph J. Panos
    • 1
  • Andrew P. Fontenot
    • 2
  1. 1.Department of Internal MedicineUniversity of Cincinnati School of Medicine, Cincinnati VA Medical CenterCincinnatiUSA
  2. 2.Department of MedicineUniversity of Colorado Health Sciences CenterDenverUSA

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