Health Dictionary
Reliable, easy-to-read patient information on common medical conditions — written in plain language, free of jargon, and grounded in current evidence. Browse the most frequent diagnoses, understand what they mean for everyday life, and learn which steps and questions help you have a focused conversation with your doctor.
Sarcoidosis causes
Introduction
Overview
Overview
Although sarcoidosis was first introduced as a clinical entity 140 years ago, the main cause of the disease remains elusive. The contributory factors are believed to be a combination of: antigens(environment), genetic factors, and the immune system.
Causes
Causes
Environmental factors
Because sarcoidosis commonly involves lung, eyes, and skin, several environmental/occupational exposures are believed to be associated with the risk for sarcoidosis:
- Rural setting, emmisions from wood-burning stove & firplace, tree pollen[1][2]
- Inorganic particles[3]
- Pesticides[4]
- Mold exposure[5]
- Navy personnel[6]
- Firefighters and first responders involved in World Trade Center disaster[7][8][9][10]
- Metalworking (especially tittanium)[5]
- Photocopier exposure[11]
- Hairdressers[12]
- Healthcare workers[13]
Genetic factors
Sarcoidosis is the result of environmental triggers acting upon an immunogenetically susceptible host[19]. The importance of genetic factors in pathophysiology of sarcoidosis is supported by familial clusters of sarcoidosis[20][21].
- The first-degree relatives are belived to be have 5 fold increased risk of developing sarcoidosis[22].
- HLA-DRB1*1101 is associated with cardiac sarcoidosis and hypercalcemia[23].
- HLA-DRB1*01 and HLA-DRB1*04 are protective against sarcoidosis[24].
- In patients diagnosed with Lofgren’s Syndrome, HLA-DRB1*03 is 4 times higher than normal individuals[25].[26][27].
- BTNL-2(butyrophilin-like 2) gene, is associated with 23% of sarcoidosis risk in German individuals[28].
Immune System
Sarcoidosis is the result of environmental triggers acting upon an immunogenetically susceptible host[19].
- Higher expression of serum amyloid A which originates from macrophages and giant cells, is observed in sarcoidosis granuloma[29].
- Immune system exhaustion and failure of effective antigen clearence, is proposed as a contributing mechanism for the disease. NK T-cells are depleted in sarcoidosis[30].
Drug side effect
- Ipilimumab[34]
- Infliximab[35]
References
References
- ↑ Bresnitz EA, Strom BL. Epidemiology of sarcoidosis. Epidemiol Rev 1983;5:124-56.
- ↑ Kajdasz DK, Lackland DT, Mohr LC, Judson MA: A current assessment of rurally linked exposures as potential risk factors for sarcoidosis. Ann Epidemiol 11(2):111–117, 2001.
- ↑ Rybicki BA, Amend KL, Maliarik MJ, Iannuzzi MC. Photocopier exposure and risk of sarcoidosis in African-American sibs. Sarcoidosis Vasc Diffuse Lung Dis 2004;21:49-55.
- ↑ Newman LS, Rose CS, Bresnitz EA, et al. A case control etiologic study of sarcoidosis: environmental and occupational risk factors. Am J Respir Crit Care Med 2004;170:1324-30.
- ↑ 5.0 5.1 Kucera GP, Rybicki BA, Kirkey KL, et al. Occupational risk factors for sarcoidosis in African-American siblings. Chest 2003;123:1527-35.
- ↑ Gorham ED, Garland CF, Garland FC, Kaiser K, Travis WD, Centeno JA. Trends and occupational associations in incidence of hospitalized pulmonary sarcoidosis and other lung diseases in Navy personnel: a 27-year historical prospective study, 1975-2001. Chest 2004;126:1431-8
- ↑ Prezant DJ, Dhala A, Goldstein A, et al. The incidence, prevalence, and severity of sarcoidosis in New York City firefighters. Chest 1999;116:1183-93.
- ↑ Izbicki G, Chavko R, Banauch GI, et al: World Trade Center “sarcoidlike” granulomatous pulmonary disease in New York City Fire Department rescue workers. Chest 131(5):1414–1423, 2007.
- ↑ Jordan HT, Stellman SD, Prezant D, et al: Sarcoidosis diagnosed after September 11, 2001, among adults exposed to the World Trade Center disaster. J Occup Environ Med 53(9):966–974, 2011.
- ↑ Crowley LE, Herbert R, Moline JM, et al: “Sarcoid like” granulomatous pulmonary disease in World Trade Center disaster responders. Am J Ind Med 54:175–184, 2011.
- ↑ Rybicki BA, Amend KL, Maliarik MJ, Iannuzzi MC: Photocopier exposure and risk of sarcoidosis in African-American sibs. Sarcoidosis Vasc Diffuse Lung Dis 21(1):49–55, 2004.
- ↑ Gowdy JM, Wagstaff MJ: Pulmonary iniltration due to aerosol thesaurosis. A survey of hairdressers. Arch Environ Health 25(2):101–108, 1972.
- ↑ Bresnitz EA, Stolley PD, Israel HL, Soper K: Possible risk factors for sarcoidosis. A case-control study. Ann N Y Acad Sci 465:632–642, 1986.
- ↑ Yamada T, Eishi Y, Ikeda S, et al: In situ localization of Propionibacterium acnes DNA in lymph nodes from sarcoidosis patients by signal ampliication with catalysed reporter deposition. J Pathol 198(4):541–547, 2002.
- ↑ Chen ES, Wahlstrom J, Song Z, et al: T cell responses to mycobacterial catalase-peroxidase proile a pathogenic antigen in systemic sarcoidosis. J Immunol 181(12):8784–8796, 2008.
- ↑ Gupta D, Agarwal R, Aggarwal AN, Jindal SK: Molecular evidence for the role of mycobacteria in sarcoidosis: a meta-analysis. Eur Respir J 30(3):508–516, 2007.
- ↑ Schurmann M, Reichel P, Muller-Myhsok B, et al: Angiotensinconverting enzyme (ACE) gene polymorphisms and familial occurrence of sarcoidosis. J Intern Med 249(1):77–83, 2001.
- ↑ Ramos-Casals M, Mana J, Nardi N, et al. Sarcoidosis in patients with chronic hepatitis C virus infection: analysis of 68 cases. Medicine(Baltimore) 2005;84:69-80.
- ↑ 19.0 19.1 McGrath DS, Goh N, Foley PJ, du Bois RM: Sarcoidosis genes and microbes—soil or seed. Sarcoidosis Vasc Diffuse Lung Dis 18:149–164, 2001.
- ↑ McGrath DS, Daniil Z, Foley P, et al: Epidemiology of familial sarcoidosis in the UK. Thorax 55(Sep):751–754, 2000
- ↑ Rybicki BA, Iannuzzi MC, Frederick MM, et al: Familial aggregation of sarcoidosis: a case-control etiologic study of sarcoidosis (ACCESS). Am J Respir Crit Care Med 164:2085–2091, 2001
- ↑ Rybicki BA, Iannuzzi MC, Frederick MM, et al. Familial aggregation of sarcoidosis: A Case-Control Etiologic Study of Sarcoidosis(ACCESS). Am J Respir Crit Care Med 2001;164:2085-91.
- ↑ Rossman MD, et al: HLA and environmental interactions in sarcoidosis. Sarcoidosis Vasc Diffuse Lung Dis 25:125–132, 2008.
- ↑ Fischer A, et al: Genetics of sarcoidosis. Semin Respir Cri Care Med 35:296–306, 2014.
- ↑ Wysoczanska B, et al: Combined association between IFN-gamma 3,3 homozygosity and DRB1*03 in Löfgren’s syndrome patients. Immunol Lett 91:127–131, 2004.
- ↑ Grunewald J, Eklund A: Lofgren’s syndrome: human leukocyte antigen strongly inluences the disease course. Am J Respir Crit Care Med 179(4):307–312, 2009.
- ↑ Grunewald J, Brynedal B, Darlington P, et al: Different HLA-DRB1 allele distributions in distinct clinical subgroups of sarcoidosis patients. Respir Res 11:25, 2010
- ↑ Valentonyte R, Hampe J, Huse K, et al: Sarcoidosis is associated with a truncating splice site mutation in BTNL2. Nat Genet 37(4):357–364, 2005.
- ↑ Chen ES, Song Z, Willett MH, et al: Serum amyloid A regulates granulomatous inlammation in sarcoidosis through Toll-like receptor-2. Am J Respir Crit Care Med 181(4):360–373, 2010.
- ↑ Snyder-Cappione JE, Nixon DF, Chi JC, et al: Invariant natural killer T (iNKT) cell exhaustion in sarcoidosis. Eur J Immunol 43(8):2194–2205, 2013.
- ↑ Bhargava S, Perlman DM, Allen TL, Ritter JH, Bhargava M. Adalimumab induced pulmonary sarcoid reaction. Respiratory Medicine Case Reports. 2013;10:53-55. doi:10.1016/j.rmcr.2013.07.002.
- ↑ Burns AM, Green PJ, Pasternak S: Etanercept-induced cutaneous and pulmonary sarcoid-like granulomas resolving with adalimumab. Journal of cutaneous pathology 2012, 39(2):289-293.
- ↑ Fonollosa A, Artaraz J, Les I, Martinez-Berriotxoa A, Izquierdo JP, Lopez AS, Gardeazaba J, Berasategui B, Martinez-Alday N: Sarcoid intermediate uveitis following etanercept treatment: a case report and review of the literature. Ocular immunology and inflammation 2012, 20(1):44-48.
- ↑ Berthod G, Lazor R, Letovanec I, Romano E, Noirez L, Mazza Stalder J, Speiser DE, Peters S, Michielin O: Pulmonary sarcoid-like granulomatosis induced by ipilimumab. Journal of clinical oncology : official journal of the American Society of Clinical Oncology 2012, 30(17):e156-159.
- ↑ Olivier A, Gilson B, Lafontaine S, Pautot JX, Bindi P: [Pulmonary and renal involvement in a TNFalpha antagonist drug-induced sarcoidosis]. La Revue de medecine interne 2012, 33(5):e25-27
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