Quantitative Analysis of Mycobacterial and Propionibacterial DNA in Lymph Nodes of Japanese and European Patients with Sarcoidosis

Abstract

The cause(s) of sarcoidosis is unknown. Mycobacterium spp. are suspected in Europe and Propionibacterium spp. are suspected in Japan. The present international collaboration evaluated the possible etiological links between sarcoidosis and the suspected bacterial species. Formalin-fixed and paraffin-embedded sections of biopsy samples of lymph nodes, one from each of 108 patients with sarcoidosis and 65 patients with tuberculosis, together with 86 control samples, were collected from two institutes in Japan and three institutes in Italy, Germany, and England. Genomes of Propionibacterium acnes, Propionibacterium granulosum, Mycobacterium tuberculosis, Mycobacterium avium subsp. paratuberculosis, and Escherichia coli (as the control) were counted by quantitative real-time PCR. Either P. acnes or P. granulosum was found in all but two of the sarcoid samples. M. avium subsp. paratuberculosis was found in no sarcoid sample. M. tuberculosis was found in 0 to 9% of the sarcoid samples but in 65 to 100% of the tuberculosis samples. In sarcoid lymph nodes, the total numbers of genomes of P. acnes or P. granulosum were far more than those of M. tuberculosis. P. acnes or P. granulosum was found in 0 to 60% of the tuberculosis and control samples, but the total numbers of genomes of P. acnes or P. granulosum in such samples were less than those in sarcoid samples. Propionibacterium spp. are more likely than Mycobacteria spp. to be involved in the etiology of sarcoidosis, not only in Japanese but also in European patients with sarcoidosis.

Requirement for TLR9 in the Immunomodulatory Activity of Propionibacterium acnes

“…In this case, mutations in tlr9 resulting in suppression or enhancement of P. acnes reactivity may impair natural resistance to infections and tumor development or may lower the threshold of incidence of oral and bowel inflammatory diseases, respectively. P. acnes is associated with various human pathologies, such as acne vulgaris (53), endophtalmitis (54), endocarditis (55), osteomyelitis (56), sarcoidosis (57), and prosthetic hip infections (58), often together with other bacteria. The identification of TLR9 as an essential factor of P. acnes-induced hypersensitivity to TLR4-and TLR2-dependent microbial components demonstrates that the signaling events through one TLR can lead to a drastic enhancement of the degree of responsiveness of other TLRs.…”

State of the Art. Potential Etiologic Agents in Sarcoidosis

“…Correspondence and requests for reprints should be addressed to David R. Moller control tissues (4,5). The completed ACCESS (A Case Control Etiologic Study of Sarcoidosis) study provides data that support possible disease associations with select microbially rich environments (6).…”

Sarcoid Myositis with Anti-Ku Antibody Consistent with both Sarcoidosis and Polymyositis

“…The etiology of sarcoidosis is currently unknown. Genetic susceptibility to environmental agents and endogenous infection of pathogens such as Propionibacterium acnes may be involved in the etiology of sarcoidosis (23). Further studies are needed to define the etiology and mechanisms of sarcoidosis.…”