Refractory Sarcoidosis Responding to Infliximab *

Roberts, Scott D.; Wilkes, David S.; Burgett, Richard A.; Knox, Kenneth S.

doi:10.1378/chest.124.5.2028

Cited by 107 publications

(56 citation statements)

References 15 publications

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“…On the contrary, in the patient with sarcoidosis, subcutaneous granulomas in the face and throat notably improved, in accordance with reports by other authors. 21 In summary, our findings indicate that the monoclonal antibody infliximab is safe and efficient for the long-term …”

Section: Discussionmentioning

confidence: 61%

Long-term treatment of refractory posterior uveitis with anti-TNFα (infliximab)

Benítez-del-Castillo

Martinez-de-la-Casa

Pato-Cour

et al. 2004

Eye

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Purpose To evaluate the long-term efficacy and safety of infliximab as treatment for noninfectious posterior uveitis. Methods An open-label clinical trial including seven patients (12 eyes) with posterior uveitis refractory to conventional treatment regimens with corticosteroids and at least one immunosuppressive agent. Three intravenous doses of 5 mg/kg of infliximab were administered at weeks 0, 2, and 6. Infliximab infusion was repeated in patients undergoing a relapse of uveitis after initial remission. Improvement was defined as amelioration of visual acuity or disappearance of retinal exudates and/or haemorrhages, decreased macular oedema and/or vitreous opacities. All patients were followed up for at least 36 months.

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Section: Discussionmentioning

confidence: 61%

Long-term treatment of refractory posterior uveitis with anti-TNFα (infliximab)

Benítez-del-Castillo

Martinez-de-la-Casa

Pato-Cour

et al. 2004

Eye

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“…TNF-␣ has strong proinflammatory activities, and its inhibition has therapeutic effects in a number of chronic inflammatory diseases (35,50,57,61). Its role in allergic inflammation has been recognized, and recent studies implicate it in severe stable asthma and COPD (25,31).…”

Section: Discussionmentioning

confidence: 99%

Rhinovirus Replication in Human Macrophages Induces NF-κB-Dependent Tumor Necrosis Factor Alpha Production

Laza-Stanca

Stanciu

Message

et al. 2006

J Virol

100

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Rhinoviruses (RV) are the major cause of acute exacerbations of asthma and chronic obstructive pulmonary disease (COPD). Rhinoviruses have been shown to activate macrophages, but rhinovirus replication in macrophages has not been reported. Tumor necrosis factor alpha (TNF-␣) is implicated in the pathogenesis of acute exacerbations, but its cellular source and mechanisms of induction by virus infection are unclear. We hypothesized that rhinovirus replication in human macrophages causes activation and nuclear translocation of NF-B, leading to TNF-␣ production. Using macrophages derived from the human monocytic cell line THP-1 and from primary human monocytes, we demonstrated that rhinovirus replication was productive in THP-1 macrophages, leading to release of infectious virus into supernatants, but was limited in monocytederived macrophages, likely due to type I interferon production, which was robust in monocyte-derived but deficient in THP-1-derived macrophages. Similar to bronchial epithelial cells, only small numbers of cells supported complete virus replication. We demonstrated RV-induced activation of NF-B and colocalization of p65/NF-B nuclear translocation with virus replication in both macrophage types. The infection induced TNF-␣ release in a time-and dose-dependent, RV serotype-and receptor-independent manner and was largely (THP-1 derived) or completely (monocyte derived) dependent upon virus replication. Finally, we established the requirement for NF-B but not p38 mitogen-activated protein kinase in induction of TNF-␣. These data suggest RV infection of macrophages may be an important source of proinflammatory cytokines implicated in the pathogenesis of exacerbations of asthma and COPD. They also confirm inhibition of NF-B as a promising target for development of new therapeutic intervention strategies.

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“…Thus, methotrexate and azathioprine are indicated in selected patients who failed, or experienced adverse effects from corticosteroids treatment. If they are ineffective, especially in patients who have progressive disease, the available therapeutic armamentarium includes cyclophosphamide, leflunomide, hydroxychloroquine and chloroquine [44][45][46][47]. Newer approaches for treatment of severe cases include administration of thalidomide as a tumor necrosis factor α (TNF-α) antagonist and monoclonal antibodies such as infliximab or adalimumab [48].…”

Section: Discussionmentioning

confidence: 99%

Cardiac sarcoidosis: A review on the work-up and management

et al. 2012

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AbstractSarcoidosis is a multisystem granulomatous disease of unknown etiology and with variable presentation. Skin, lymph nodes, lungs, eyes and the central nervous system are mostly involved. Cardiac sarcoidosis (CS) is a rare condition with clinical manifestations in about 5% of patients. Since it increases the risk of acute cardiac failure, ventricular arrhythmia, conduction disturbances and even sudden death, it aggravates markedly the prognosis. The early diagnosis of CS is difficult, requiring the use of diagnostic tools such as electrocardiographic monitoring, two-dimensional echocardiography, radionuclide scan, cardiac magnetic resonance imaging, positron emission tomography and endomyocardial biopsy. Once the diagnosis of CS is established, there is a need for early corticosteroids treatment, with or without immunosuppressive therapy, to prevent deterioration of cardiac function. In patients with refractory ventricular tachyarrhythmia, markedly reduced left ventricular ejection fraction and high risk of sudden death, prophylactic insertion of a pacemaker or implantable defibrillator is recommended. We had the opportunity to treat a patient with CS and to review the currently accepted diagnostic and treatment approach.

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Refractory Sarcoidosis Responding to Infliximab *

Cited by 107 publications

References 15 publications

Long-term treatment of refractory posterior uveitis with anti-TNFα (infliximab)

Long-term treatment of refractory posterior uveitis with anti-TNFα (infliximab)

Rhinovirus Replication in Human Macrophages Induces NF-κB-Dependent Tumor Necrosis Factor Alpha Production

Cardiac sarcoidosis: A review on the work-up and management

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