New laboratory criteria of the autoimmune inflammation in pulmonary sarcoidosis and tuberculosis

Малкова, Анна; Старшинова, Анна; Zinchenko, Yulia; Gavrilova, Natalia; Kudryavtsev, I. V.; Лапин, С. В.; Мазинг, А. В.; Суркова, Елена; Pavlova, Maria; Belaeva, E.; Stepanenko, Т.; Yablonskiy, Piotr; Shoenfeld, Yehuda

doi:10.1016/j.clim.2021.108724

Cited by 14 publications

(11 citation statements)

References 52 publications

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“…Although no direct inciting factor has been attributed to the onset of sarcoidosis, immunologic studies have shown that the disease is associated with elevated levels of CD4+ T cells, Th1 helper T cells, and macrophages at disease sites and circulating immune complexes [6]. In recent years, sarcoidosis has been linked to bacterial antigens from Mycobacteria and Propionibacteria, as well as MHC-II activating auto-antibodies against vimentin, b-actin, hemoglobin, and macroglobulin antigens, supporting an autoimmune pathogenesis theory [7,8]. Studies have also shown that even inhaled materials such as silicone, inorganic dust, and copy machine emissions can trigger an autoimmune response and the onset of local and systemic symptoms of sarcoidosis.…”

Section: Discussionmentioning

confidence: 99%

Orofacial sarcoidosis: report of three cases

Koutrakis

Sahu

Vasilyeva

et al. 2022

J Oral Med Oral Surg

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Introduction: Sarcoidosis is a systemic non-caseating granulomatous disorder of unknown etiology that may affect multiple organ systems. Head and neck involvement can present in unusual and often nonspecific ways. Observations: We report three cases of sarcoidosis with orofacial manifestations: one African American patient with an existing diagnosis who presented with perioral cutaneous involvement by sarcoidosis, and two Caucasian patients with cases where the initial oral presentation – diffusely affected gingiva in one and intraosseous jaw involvement with resultant dental implant failure in the other – led to workup and establishment of the diagnosis of sarcoidosis. The patients were referred to rheumatology and dermatology for appropriate treatment. Conclusion: Although oral lesions of sarcoidosis are not common, they may be the first clinical manifestation of sarcoidosis. The practitioner should be aware of the possible manifestations and be able to formulate an informed clinical differential diagnosis.

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Section: Discussionmentioning

confidence: 99%

Orofacial sarcoidosis: report of three cases

Koutrakis

Sahu

Vasilyeva

et al. 2022

J Oral Med Oral Surg

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“…2). Так, для пациентов с хроническим и острым дебютами саркоидоза наблюдалось увеличение доли DP Th17 c 23,72% (19,(24)(25)(26)(27)(28)(29)(30)(31)(32)(33)(34)(35)(36)90) до 31,83% (24,05-41,00) и 36,12% (27,01)) соответственно (в обоих случаях р < 0,001), а также снижения «не классических» Th17 c 45,89% (41,96-51,87) до 34,86% (28,52-43,77) и 41,57% (31,86) соответственно (при р < 0,001 и р = 0,015 соответственно). При остром дебюте заболевания имело место снижение DN Th17 относительно контроля (р = 0,004), тогда как уровень «классических» Th17 был достоверно ниже не только при сравнении с контрольными показателями (18,54% (13,08-27,16) против 24,71% (20,(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30)43), р = 0,004), но и значений, полученных для пациентов с хроническим саркоидозом (18,54% (13,08-27,16) против 26,67% (18,(16)(17)…”

Section: Note As For Tableunclassified

“…Ряд авторов отмечают также нарушения в субпопуляционном составе [11,19], фенотипических характеристиках [21] и функциональной активности регуляторных Т-лимфоцитов (Treg), что может сопровождаться снижением эффективности в регуляции реакций врожденного и приобретенного иммунитета в целом, а также приводить к хронической форме течения саркоидоза и развитию фиброзу [8]. Более того, существенные нарушения отмечаются и в регуляции специфического гуморального иммунитета, что выражается не только в изменении состава циркулирующих в крови В-лимфоцитов [4,27], но изменениями в функциональной активности фолликулярных Т-хелперов, которые контролируют все процессы дифференцировки и активации В-лимфоцитов в пределах лимфоидной ткани [20,26].…”

Section: Introductionunclassified

Peripheral blood T helper cell subsets in Löfgren’s and non-Löfgren’s syndrome patients

et al. 2022

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Sarcoidosis is a multisystemic granulomatous disorder of unknown cause, characterized by formation of immune granulomas in various organs, mainly in lungs. Currently, two main phenotypes of pulmonary sarcoidosis are described, i.e., Lofgren’s syndrome (LS) is an acute form with favorable outcome, and non-Lofgren’s syndrome (nLS) is a chronic type of disease with a high risk of pulmonary fibrosis. Our study was aimed to investigate the balance of main “polarized” CD4+ central and effector memory T cells from treatment-naive patients with pulmonary sarcoidosis (LS (n = 19) and nLS (n = 63)) compared to healthy volunteers (HC, n = 48). This marker might be used as immunological markers for predicting severity of this disorder. Multicolor flow cytometry analysis demonstrated that the patients with nLS showed significantly low levels of relative and absolute numbers of CD3+CD4+ lymphocytes if compared to patients with LS and control group (38.94% (31.33-44.24) versus 48.96% (43.34-53.54) and 47.63% (43.82-52.73), p < 0.001 in both cases). Moreover, patients with nLS had reduced frequencies and absolute numbers of “naive”, CM and EM Th cells if compared with healthy controls. Furthermore, the patients with LS showed increased relative and absolute numbers of peripheral blood EM Th cells, capable for migration to peripheral inflamed tissues, when compared with nLS. Finally, patients with LS had increased frequencies and absolute numbers of effector TEMRA Th cells as compared to HC and nLS. Next, significant differences Th1 and Th2 cells frequencies were shown between the patients with nLS and HC (9.64% (7.06-13.65) versus 13.80% (11.24-18.03) with p < 0.001, and 11.96% (9.86-14.78) versus 10.67% (9.13-12.98) with p = 0.048, respectively). But there were no significant differences in the relative numbers of CXCR5-CCR6+Th17 and CXCR5+ follicular T helper cells (Tfh) between the groups. Finally, both groups of patients with pulmonary sarcoidosis contained low proportions of “non-classical” Th17 and DN Th17 cell, but increased levels of DP Th17 cells within total CXCR5-CCR6+ CM Th if compared with HC. Nevertheless, patients with nLS had increased frequency of “classical” Th17 in comparison with healthy controls. A very similar imbalance between different Th17 cell subsets was observed within total CXCR5CCR6+ effector memory Th, that were able to migrate from the bloodstream to the sites of infection, or tissue injury. Taken together, the data suggest that the proportions of Th17 cell subsets in pulmonary sarcoidosis can be evaluated as a diagnostic and/or prognostic marker in clinical practice and these cells could serve as a new therapeutic target.

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“…Sarcoidosis can often be cured without medication. Sarcoidosis is a clinically similar disease to tuberculosis with an unknown cause [ 9 ]. Sarcoidosis and PTB are both granulomatous diseases with comparable clinical-radiological presentations, making differentiation challenging in regions where they occur often [ 6 ].…”

Section: Introductionmentioning

confidence: 99%

“…Differentiating tuberculosis and sarcoidosis can be difficult, especially in cases of mediastinal lymphadenopathy, because both diseases have similar clinical presentations and histopathologically identical granulomatous inflammation [ 12 ]. Tuberculosis diagnoses are now based mostly on microbiological confirmation, which is only attainable in 50% of cases [ 9 ]. As a result, better diagnostic approaches are needed to reduce morbidity as a result of delayed or inefficient treatment [ 13 ].…”

Section: Introductionmentioning

confidence: 99%

Reliable Sarcoidosis Detection Using Chest X-rays with EfficientNets and Stain-Normalization Techniques

Baghdadi

Maklad

Malki

et al. 2022

Sensors

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Sarcoidosis is frequently misdiagnosed as tuberculosis (TB) and consequently mistreated due to inherent limitations in radiological presentations. Clinically, to distinguish sarcoidosis from TB, physicians usually employ biopsy tissue diagnosis and blood tests; this approach is painful for patients, time-consuming, expensive, and relies on techniques prone to human error. This study proposes a computer-aided diagnosis method to address these issues. This method examines seven EfficientNet designs that were fine-tuned and compared for their abilities to categorize X-ray images into three categories: normal, TB-infected, and sarcoidosis-infected. Furthermore, the effects of stain normalization on performance were investigated using Reinhard’s and Macenko’s conventional stain normalization procedures. This procedure aids in improving diagnostic efficiency and accuracy while cutting diagnostic costs. A database of 231 sarcoidosis-infected, 563 TB-infected, and 1010 normal chest X-ray images was created using public databases and information from several national hospitals. The EfficientNet-B4 model attained accuracy, sensitivity, and precision rates of 98.56%, 98.36%, and 98.67%, respectively, when the training X-ray images were normalized by the Reinhard stain approach, and 97.21%, 96.9%, and 97.11%, respectively, when normalized by Macenko’s approach. Results demonstrate that Reinhard stain normalization can improve the performance of EfficientNet -B4 X-ray image classification. The proposed framework for identifying pulmonary sarcoidosis may prove valuable in clinical use.

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New laboratory criteria of the autoimmune inflammation in pulmonary sarcoidosis and tuberculosis

Cited by 14 publications

References 52 publications

Orofacial sarcoidosis: report of three cases

Orofacial sarcoidosis: report of three cases

Peripheral blood T helper cell subsets in Löfgren’s and non-Löfgren’s syndrome patients

Reliable Sarcoidosis Detection Using Chest X-rays with EfficientNets and Stain-Normalization Techniques

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