What causes sarcoidosis?
Limited but encouraging progress has been made over the last several years in our understanding of the etiology of sarcoidosis as a result of recent investments in epidemiologic, immunologic, and molecular biologic studies. A recent US multicenter study of sarcoidosis found few environmental or occupational exposures associated with a two-fold or higher risk of development of sarcoidosis, suggesting noninfectious exposures play a small, if any, role in causing systemic sarcoidosis. In contrast, recent studies have linked infectious agents including mycobacterial and propionibacterial organisms with sarcoidosis. The association of sarcoidosis with the use of Th1-promoting biologic response modifiers is consistent with a central role for enhanced Th1 immune responses in the pathogenesis of sarcoidosis. Given evidence for a genetic predisposition to sarcoidosis, these findings suggest that the etiology of systemic sarcoidosis is linked to genetically determined enhanced Th1 immune responses to a limited number of microbial pathogens.
Moller
David R
DR
Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
Chen
Edward S
ES
D004781:Environmental Exposure; D020022:Genetic Predisposition to Disease; D006801:Humans; D009161:Mycobacterium; D016273:Occupational Exposure; D011424:Propionibacterium; D012507:Sarcoidosis / Q000209:etiology* / Q000276:immunology / Q000382:microbiology; D018417:Th1 Cells / Q000276:immunology