Biomarkers in sarcoidosis: a review

Abstract

Sarcoidosis is a systemic granulomatous disease of undetermined etiology invariably affecting the lungs and thoracic lymph nodes. It has been termed an "immune paradox", as there is peripheral anergy despite exaggerated inflammation at disease sites. The disease is usually selflimiting, although some individuals experience unremitting inflammation that may progress into pulmonary fibrosis and death. The inflammatory process is largely a T helper-1-driven immune response. Given its heterogeneous clinical manifestations, diagnosis is usually a clinical conundrum. Clinical and radiological findings alone are often inadequate to confirm the diagnosis. At present, sarcoidosis is usually a diagnosis of exclusion, confirmed by histological evidence of noncaseating granulomas in the absence of known granulomagenic agents. This has compelled researchers to look for disease-specific biomarkers that can help diagnose sarcoidosis and delineate its disease course, severity, and prognosis. In this review we highlight various investigations used to diagnose sarcoidosis, outline proposed biomarkers, and discuss novel methods of sampling biomarkers.

The role of measuring exhaled breath biomarkers in sarcoidosis: a systematic review

“…Neopterin is a metabolite of guanosine triphosphate secreted from activated macrophages (6). Serum and urinary levels appear to correlate with disease activity, radiological stage and likelihood of spontaneous remission (6) (46) (47).…”

“…Various biomarkers have been assessed in urine, serum and bronchoalveolar lavage fluid but lack adequate sensitivity and specificity for clinical use (6). Many are not routinely available in clinical practice or require invasive sampling methods and are therefore unsuitable for serial monitoring.…”

Results of treatment and criteria of progress of respiratory organs sarkoidosis

“…Серед різноманітних патологій органів ди-хання інтерстиційні захворювання продовжують привертати пильну увагу науковців через постійне зростання захворюваності (на інтерстиційні процеси припадає близько 20 % всіх захворювань легень), проблеми діагностики та лікування [2,3].…”

Prognostic Assessment of the Inflammatory Process Activity in Sarcoidosis of Respiratory Organs: Potential Use of C-reactive Protein and TNF-α

“…The development of immune-type granulomas in sarcoidosis (because of imbalance of immunoregulatory cell subpopulation and weakening of T-cellular component of immune system) says for the supposition that this pathology is caused by immunological disorders due to the exposure to various environmental factors which change the immune status or are caused by already changed immune status [1].…”