Immunohistochemical identification of Propionibacterium acnes in granuloma and inflammatory cells of myocardial tissues obtained from cardiac sarcoidosis patients

Asakawa, Naoya; Uchida, Keiji; Sakakibara, Mamoru; Omote, Kazunori; Noguchi, Keiji; Tokuda, Yusuke; Kamiya, Kiwamu; Hatanaka, Kanako C.; Matsuno, Yoshihiro; Yamada, Shiro; Asakawa, Kyoko; Fukasawa, Yuichiro; Nagai, Toshiyuki; Anzai, Toshihisa; Ikeda, Yoshihiko; Ishibashi‐Ueda, Hatsue; Hirota, Masanori; Orii, Makoto; Uto, Kenta; Shingu, Yasushige; Matsui, Yoshiro; Morimoto, S; Tsutsui, Hiroyuki; Eishi, Yoshinobu

doi:10.1371/journal.pone.0179980

Cited by 32 publications

(22 citation statements)

References 28 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Odds ratios were estimated using conditional logistic models adjusted for matching factors (birth year, sex, and residential location) and further controlled for deciles of a high-dimensional propensity score for the risk of infectious disease suggesting there is no unique underlying pathophysiologic mechanism that could explain how one or more infectious agents cause sarcoidosis. Second, and contrary to previous studies on the role of propionibacteria [6][7][8][9] or mycobacteria [4,5], we did not identify any indications that these agents are implicated in the etiology of sarcoidosis. In the case of propionibacteria, we should acknowledge that acne is likely a misclassified proxy of infection by these commensal bacteria [40].…”

Section: History Of Infectious Disease N (%)contrasting

confidence: 99%

“…In fact, infectious agents gained the most research attention throughout the years largely due to the clinical and histological similarities between sarcoidosis and tuberculosis. Except mycobacteria [4,5], the role of other bacteria such as propionibacteria [6][7][8][9], as well as viruses [10], fungi [11,12] and the lung microbiome overall [13,14] has been investigated in numerous molecular studies. The causal role of these infectious agents is still obscure as results are conflicting.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Are infectious diseases risk factors for sarcoidosis or a result of reverse causation? Findings from a population-based nested case–control study

et al. 2020

View full text Add to dashboard Cite

Findings from molecular studies suggesting that several infectious agents cause sarcoidosis are intriguing yet conflicting and likely biased due to their cross-sectional design. As done in other inflammatory diseases to overcome this issue, prospectivelycollected register data could be used, but reverse causation is a threat when the onset of disease is difficult to establish. We investigated the association between infectious diseases and sarcoidosis to understand if they are etiologically related. We conducted a nested case-control study (2009-2013) using incident sarcoidosis cases from the Swedish National Patient Register (n = 4075) and matched general population controls (n = 40,688). Infectious disease was defined using inpatient/ outpatient visits and/or antimicrobial dispensations starting 3 years before diagnosis/matching. Adjusted odds ratios (aOR) of sarcoidosis were estimated using conditional logistic regression and tested for robustness assuming the presence of reverse causation bias. The aOR of sarcoidosis associated with history of infectious disease was 1.19 (95% confidence interval [CI] 1.09, 1.29; 21% vs. 16% exposed cases and controls, respectively). Upper respiratory and ocular infections conferred the highest OR. Findings were similar when we altered the infection definition or varied the infection-sarcoidosis latency period (1-7 years). In bias analyses assuming one in 10 infections occurred because of preclinical sarcoidosis, the observed association was completely attenuated (aOR 1.02; 95% CI 0.90, 1.15). Our findings, likely induced by reverse causation due to preclinical sarcoidosis, do not support the hypothesis that common symptomatic infectious diseases are etiologically linked to sarcoidosis. Caution for reverse causation bias is required when the real disease onset is unknown.

show abstract

Section: History Of Infectious Disease N (%)contrasting

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Are infectious diseases risk factors for sarcoidosis or a result of reverse causation? Findings from a population-based nested case–control study

et al. 2020

View full text Add to dashboard Cite

show abstract

“…Presence of classical granuloma in cardiac tissue is considered as the gold standard for diagnosis of sarcoidosis although infectious and immunologic causes are suggested in some cases [20,21]. Pathologists are asked to report the presence or absence of granulomas in small endocardial biopsies, and granulomas are not seen in most biopsies.…”

Section: Discussionmentioning

confidence: 99%

Indirect pathological indicators for cardiac sarcoidosis on endomyocardial biopsy

Jin

Seo²,

et al. 2020

J Pathol Transl Med

View full text Add to dashboard Cite

Cardiac sarcoidosis is a myocardial inflammatory disease with non-caseating granulomas [1]. Cardiac sarcoidosis may be cardiac involvement of systemic sarcoidosis, although the heart may be the only organ involved. In contrast to pulmonary sarcoidosis, cardiac involvement of sarcoidosis is often associated with fatal outcome because of ventricular arrhythmia and ventricular dysfunction [2,3]. Clinical studies reveal cardiac involvement in 5%-10% of systemic sarcoidosis cases [4] but others suggest this involvement to be very rare (0.7%) [5] or very common (40%) based on symptomology [6]. The incidence in autopsy series was 20% in a 1952 study [7], but recent studies have demonstrated variable incidences of 27% [8], 76% in Caucasian patients [4], and 80% in Japanese patients [9]. This variability in incidence may be real; partly due to racial differences in prevalence and due to the development of diagnostic techniques such as the endobronchial ultrasound or cardiac positron emission tomography (PET) [10]. But it may also be related to the variable application of the current diagnostic criteria [1,11]. With respect to the pathologic diagnosis of cardiac involvement in systemic sarcoidosis, "the presence of non-caseating granuloma on histological examination of myocardial tissue with no alternative cause identified" is the current consensus by the Heart

show abstract

“…Results showed that P. acnes showed significantly high positive reactivity in the cardiac sarcoidosis group, with massive inflammation. In contrast, no reactivity was noted in the myocarditis and cardiomyopathy samples [ 23 ]. This repeated presence of P. acnes in sarcoid granulomas suggests that this commensal bacterium may be implicated in causing the granulomas in many patients with cardiac sarcoidosis.…”

Section: Reviewmentioning

confidence: 99%

The Role of Propionibacterium acnes in the Pathogenesis of Sarcoidosis and Ulcerative Colitis: How This Connection May Inspire Novel Management of These Conditions

Sakhamuru

Kambampati

Wasim

et al. 2020

Cureus

View full text Add to dashboard Cite

A lesser-acknowledged role of Propionibacterium acnes is its effect on the development of sarcoidosis. This literature review not only further explores this association but also that of Propionibacterium acnes and other inflammatory conditions, such as ulcerative colitis and pyoderma gangrenosum, acne, ulcerative colitis syndrome (PAC syndrome). This article reviews the effect that isotretinoin, a commonly used treatment of acne, has on the pathogenesis of ulcerative colitis, and the immune dysregulation and genetic susceptibility of individuals prone to developing acne, sarcoidosis, and ulcerative colitis. Literature for this article review was obtained from PubMed by utilizing both regular keywords and medical subject heading (MeSH) subheadings for data gathering. Regular keywords were: Propionibacterium acnes, sarcoidosis, ulcerative colitis, and isotretinoin. MeSH subheadings used were: Propionibacterium acnes/immunology, Propionibacterium acnes/pathogenicity, Propionibacterium acnes/genetics, sarcoidosis/immunology, and sarcoidosis/genetics. Following the application of inclusion and exclusion criteria, a total of 5172 publications were obtained. A total of 5086 publications were removed due to a lack of relevancy to outcomes of interest. The remaining 86 publications from all the regular and MeSH keywords were selected due to relevancy to outcomes of interest. Following this, a refined manual search was done, with the removal of duplicates, and 33 publications from PubMed were selected for review. Following a review of these records, Propionibacterium acnes was repeatedly concluded to be a causative agent of sarcoidosis. Variable results for the association between Propionibacterium acnes and ulcerative colitis were found. Most studies showed no significant association between the use of isotretinoin and the development of ulcerative colitis. A strong overlapping role of genetic susceptibility and immune dysregulation in the pathogeneses of sarcoidosis, ulcerative colitis, and Propionibacterium acnes was found.

show abstract

Immunohistochemical identification of Propionibacterium acnes in granuloma and inflammatory cells of myocardial tissues obtained from cardiac sarcoidosis patients

Cited by 32 publications

References 28 publications

Are infectious diseases risk factors for sarcoidosis or a result of reverse causation? Findings from a population-based nested case–control study

Are infectious diseases risk factors for sarcoidosis or a result of reverse causation? Findings from a population-based nested case–control study

Indirect pathological indicators for cardiac sarcoidosis on endomyocardial biopsy

The Role of Propionibacterium acnes in the Pathogenesis of Sarcoidosis and Ulcerative Colitis: How This Connection May Inspire Novel Management of These Conditions

Contact Info

Product

Resources

About