Sarcoidosis and autoimmunity

Abstract

Purpose of reviewSarcoidosis is a poorly understood multisystem granulomatous disease that frequently involves the lungs but can affect any organ system. In this review, we summarize recent developments in the understanding of the immune dysregulation seen in sarcoidosis and propose a new expanded definition of human autoimmunity in sarcoidosis, and the implications it would have on treating sarcoidosis with targeted immunotherapy regimens in the future. Recent findingsSarcoidosis has been linked to infectious organisms like Mycobacterium and Cutibacterium, and certain manifestations of sarcoidosis have been linked to specific HLA alleles, but the overall pathogenesis remains uncertain. Sarcoidosis patients have similar patterns of cellular immune dysregulation seen in other autoimmune diseases like rheumatoid arthritis, and recent large-scale population studies show that sarcoidosis frequently presents with other autoimmune diseases. SummaryAdvancements in the understanding of sarcoidosis support its consideration as an autoimmune disease. Sarcoidosis patients carry a higher risk of comorbid autoimmune conditions which offers an excellent opportunity to further understand autoimmunity and explore biologic therapies in sarcoidosis treatment, and furthermore will better targeted immunotherapy regimens for sarcoidosis patients in the future.

Autoimmune Disease Classification Based on PubMed Text Mining

“…Figure 2 clusters sarcoidosis with predominantly female AIDs affecting multiple systems and could share a common etiology. Sarcoidosis has been linked to infectious organisms such as mycobacterium and cutibacterium, and certain manifestations of sarcoidosis have been linked to specific HLA alleles, but the overall pathogenesis remains uncertain [ 70 ].…”

Sjögren’s Syndrome Complicated With Sarcoidosis With a Repetitive, Prolonged, Non-productive Cough

“…Important implications of this case report are that Sjögren's syndrome and sarcoidosis should be considered in patients with chronic cough of uncertain cause and the gum test should be used as a screening test because both diseases may present with Sicca symptoms such as the dry mouth. [8][9][10] In clinical practice for chronic cough, we can inexpensively screen for sicca symptoms by performing a gum test. [7,8] Although it is difficult to distinguish clearly whether the cause was sarcoidosis or Sjögren's syndrome at the time of recurrent cough in this patient, based on the results of the gum test and the stable condition of sarcoidosis, the sicca symptoms due to Sjögren's syndrome may have more impact on the recurrent cough.…”

“…Important implications of this case report are that Sjögren's syndrome and sarcoidosis should be considered in patients with chronic cough of uncertain cause and the gum test should be used as a screening test because both diseases may present with Sicca symptoms such as the dry mouth. [ 8 - 10 ]…”

Atypical and uncommon presentation of sarcoidosis with long segment involvement of the pharynx and larynx: Case report and review of literature

“…Sarcoidosis is a noncaseating granulomatous disease that most commonly affects the lungs and can affect any organ in the body causing chronic inflammation [1] . The exact cause of sarcoidosis is unknown, however smoking, obesity and occupational silica exposure are known risk factors [2] .…”