Potential mechanism of pathogen infection in sarcoidosis_West China Medical Journal

Authors：

WANG Qian , TONG Xiang ,  FAN Hong

Department of Pulmonary and Critical Care Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P. R. China;

Corresponding author：

FAN Hong, Email: fanhongfan@qq.com

Keywords：

Sarcoidosis; infection; tuberculosis

DOI：

10.7507/1002-0179.202204117

Video：

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Abstract Full text Figures/Tables Video References Cited by

Sarcoidosis is a multi-organ inflammatory disorder characterized by the presence of non-caseating granulomas primarily affecting the lungs. The pathogenesis of sarcoidosis has not been fully clarified. In recent years, studies have suggested that a variety of pathogen infections, including Mycobacterium tuberculosis, Propionibacterium acnes, fungi, viruses, may be related to the occurrence and progression of sarcoidosis. This article reviews the researches on sarcoidosis and pathogen infection, aiming to explore the potential role of pathogen infection in the pathogenesis of sarcoidosis and provide another direction for the treatment of sarcoidosis.

Citation： WANG Qian, TONG Xiang, FAN Hong. Potential mechanism of pathogen infection in sarcoidosis. West China Medical Journal, 2023, 38(1): 6-11. doi: 10.7507/1002-0179.202204117 Copy

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2.	Spagnolo P, Rossi G, Trisolini R, et al. Pulmonary sarcoidosis. Lancet Respir Med, 2018, 6(5): 389-402.
3.	Brito-Zerón P, Kostov B, Superville D, et al. Geoepidemiological big data approach to sarcoidosis: geographical and ethnic determinants. Clin Exp Rheumatol, 2019, 37(6): 1052-1064.
4.	Ma X, Zhu L, Kurche JS, et al. Global and regional burden of interstitial lung disease and pulmonary sarcoidosis from 1990 to 2019: results from the global burden of disease study 2019. Thorax, 2022, 77(6): 596-605.
5.	Zhang S, Tong X, Zhang T, et al. Prevalence of sarcoidosis-associated pulmonary hypertension: a systematic review and meta-analysis. Front Cardiovasc Med, 2022, 8: 809594.
6.	Ma Y, Gal A, Koss M. Reprint of: the pathology of pulmonary sarcoidosis: update. Semin Diagn Pathol, 2018, 35(5): 324-333.
7.	Cohen Aubart F, Lhote R, Amoura A, et al. Drug-induced sarcoidosis: an overview of the WHO pharmacovigilance database. J Intern Med, 2020, 288(3): 356-362.
8.	Bewley AP, Maleki S. Systemic sarcoidosis reactions as a result of tumour necrosis factor-alpha treatment for patients with psoriasis. Clin Exp Dermatol, 2021, 46(8): 1548-1550.
9.	Chopra A, Nautiyal A, Kalkanis A, et al. Drug-induced sarcoidosis-like reactions. Chest, 2018, 154(3): 664-677.
10.	Apalla Z, Kemanetzi C, Papageorgiou C, et al. Challenges in sarcoidosis and sarcoid-like reactions associated to immune checkpoint inhibitors: a narrative review apropos of a case. Dermatol Ther, 2021, 34(1): e14618.
11.	Cornejo CM, Haun P, English J 3rd, et al. Immune checkpoint inhibitors and the development of granulomatous reactions. J Am Acad Dermatol, 2019, 81(5): 1165-1175.
12.	Gupta D, Agarwal R, Aggarwal AN, et al. Sarcoidosis and tuberculosis: the same disease with different manifestations or similar manifestations of different disorders. Curr Opin Pulm Med, 2012, 18(5): 506-516.
13.	Luetkens JA, Zoghi S, Rockstroh JK, et al. Pulmonary sarcoidosis shortly after spinal tuberculosis infection: a diagnostic challenge. BMJ Case Rep, 2014, 2014: bcr2013203333.
14.	Maalioune S, Corhay JL, Delvenne P, et al. Sarcoidosis following tuberculosis. Is there a link between these granulomatous diseases?. Rev Med Liege, 2019, 74(7/8): 394-400.
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17.	Mandal SK, Ghosh S, Mondal SS, et al. Coexistence of pulmonary tuberculosis and sarcoidosis: a diagnostic dilemma. BMJ Case Rep, 2014, 2014: bcr2014206016.
18.	Danila E, Zurauskas E. Diagnostic value of epithelioid cell granulomas in bronchoscopic biopsies. Intern Med, 2008, 47(24): 2121-2126.
19.	中华医学会呼吸病学分会间质性肺疾病学组, 中国医师协会呼吸医师分会间质性肺疾病工作委员会. 中国肺结节病诊断和治疗专家共识. 中华结核和呼吸杂志, 2019, 42(9): 685-693.
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21.	Fité E, Fernández-Figueras MT, Prats R, et al. High prevalence of Mycobacterium tuberculosis DNA in biopsies from sarcoidosis patients from Catalonia, Spain. Respiration, 2006, 73(1): 20-26.
22.	Yamaguchi T, Costabel U, McDowell A, et al. Immunohistochemical detection of potential microbial antigens in granulomas in the diagnosis of sarcoidosis. J Clin Med, 2021, 10(5): 983.
23.	Dubaniewicz A. Mycobacterium tuberculosis heat shock proteins and autoimmunity in sarcoidosis. Autoimmun Rev, 2010, 9(6): 419-424.
24.	Dubaniewicz A, Trzonkowski P, Dubaniewicz-Wybieralska M, et al. Mycobacterial heat shock protein-induced blood T lymphocytes subsets and cytokine pattern: comparison of sarcoidosis with tuberculosis and healthy controls. Respirology, 2007, 12(3): 346-354.
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26.	Morgenthau AS, Iannuzzi MC. Recent advances in sarcoidosis. Chest, 2011, 139(1): 174-182.
27.	Oswald-Richter K, Sato H, Hajizadeh R, et al. Mycobacterial ESAT-6 and katG are recognized by sarcoidosis CD4⁺ T cells when presented by the American sarcoidosis susceptibility allele, DRB11101*. J Clin Immunol, 2010, 30(1): 157-166.
28.	Agrawal R, Kee AR, Ang L, et al. Tuberculosis or sarcoidosis: opposite ends of the same disease spectrum?. Tuberculosis (Edinb), 2016, 98: 21-26.
29.	Gupta D, Agarwal R, Aggarwal AN, et al. Molecular evidence for the role of mycobacteria in sarcoidosis: a meta-analysis. Eur Respir J, 2007, 30(3): 508-516.
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31.	Lee H, Eom M, Kim SH, et al. Identification of Mycobacterium tuberculosis and non-tuberculous mycobacteria from cutaneous sarcoidosis lesions by reverse blot hybridization assay. J Dermatol, 2019, 46(10): 917-921.
32.	Xu H, Li H. Acne, the skin microbiome, and antibiotic treatment. Am J Clin Dermatol, 2019, 20(3): 335-344.
33.	Portillo ME, Corvec S, Borens O, et al. Propionibacterium acnes: an underestimated pathogen in implant-associated infections. Biomed Res Int, 2013, 2013: 804391.
34.	Davidsson S, Mölling P, Rider JR, et al. Erratum to: frequency and typing of Propionibacterium acnes in prostate tissue obtained from men with and without prostate cancer. Infect Agent Cancer, 2016, 11: 36.
35.	Leheste JR, Ruvolo KE, Chrostowski JE, et al. P.acnes-driven disease pathology:current knowledge and future directions. Front Cell Infect Microbiol, 2017, 7: 81.
36.	Homma JY, Abe C, Chosa H, et al. Bacteriological investigation on biopsy specimens from patients with sarcoidosis. Jpn J Exp Med, 1978, 48(3): 251-255.
37.	Suzuki Y, Uchida K, Takemura T, et al. Propionibacterium acnes-derived insoluble immune complexes in sinus macrophages of lymph nodes affected by sarcoidosis. PLoS One, 2018, 13(2): e0192408.
38.	Schupp JC, Tchaptchet S, Lützen N, et al. Immune response to Propionibacterium acnes in patients with sarcoidosis-in vivo and in vitro. BMC Pulm Med, 2015, 15: 75.
39.	Werner JL, Escolero SG, Hewlett JT, et al. Induction of pulmonary granuloma formation by Propionibacterium acnes is regulated by MyD88 and Nox2. Am J Respir Cell Mol Biol, 2017, 56(1): 121-130.
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1. Iannuzzi MC, Rybicki BA, Teirstein AS. Sarcoidosis. N Engl J Med, 2007, 357(21): 2153-2165.
2. Spagnolo P, Rossi G, Trisolini R, et al. Pulmonary sarcoidosis. Lancet Respir Med, 2018, 6(5): 389-402.
3. Brito-Zerón P, Kostov B, Superville D, et al. Geoepidemiological big data approach to sarcoidosis: geographical and ethnic determinants. Clin Exp Rheumatol, 2019, 37(6): 1052-1064.
4. Ma X, Zhu L, Kurche JS, et al. Global and regional burden of interstitial lung disease and pulmonary sarcoidosis from 1990 to 2019: results from the global burden of disease study 2019. Thorax, 2022, 77(6): 596-605.
5. Zhang S, Tong X, Zhang T, et al. Prevalence of sarcoidosis-associated pulmonary hypertension: a systematic review and meta-analysis. Front Cardiovasc Med, 2022, 8: 809594.
6. Ma Y, Gal A, Koss M. Reprint of: the pathology of pulmonary sarcoidosis: update. Semin Diagn Pathol, 2018, 35(5): 324-333.
7. Cohen Aubart F, Lhote R, Amoura A, et al. Drug-induced sarcoidosis: an overview of the WHO pharmacovigilance database. J Intern Med, 2020, 288(3): 356-362.
8. Bewley AP, Maleki S. Systemic sarcoidosis reactions as a result of tumour necrosis factor-alpha treatment for patients with psoriasis. Clin Exp Dermatol, 2021, 46(8): 1548-1550.
9. Chopra A, Nautiyal A, Kalkanis A, et al. Drug-induced sarcoidosis-like reactions. Chest, 2018, 154(3): 664-677.
10. Apalla Z, Kemanetzi C, Papageorgiou C, et al. Challenges in sarcoidosis and sarcoid-like reactions associated to immune checkpoint inhibitors: a narrative review apropos of a case. Dermatol Ther, 2021, 34(1): e14618.
11. Cornejo CM, Haun P, English J 3rd, et al. Immune checkpoint inhibitors and the development of granulomatous reactions. J Am Acad Dermatol, 2019, 81(5): 1165-1175.
12. Gupta D, Agarwal R, Aggarwal AN, et al. Sarcoidosis and tuberculosis: the same disease with different manifestations or similar manifestations of different disorders. Curr Opin Pulm Med, 2012, 18(5): 506-516.
13. Luetkens JA, Zoghi S, Rockstroh JK, et al. Pulmonary sarcoidosis shortly after spinal tuberculosis infection: a diagnostic challenge. BMJ Case Rep, 2014, 2014: bcr2013203333.
14. Maalioune S, Corhay JL, Delvenne P, et al. Sarcoidosis following tuberculosis. Is there a link between these granulomatous diseases?. Rev Med Liege, 2019, 74(7/8): 394-400.
15. Wang SH, Chung CH, Huang TW, et al. Bidirectional association between tuberculosis and sarcoidosis. Respirology, 2019, 24(5): 467-474.
16. Mortaz E, Adcock IM, Barnes PJ. Sarcoidosis: role of non-tuberculosis mycobacteria and Mycobacterium tuberculosis. Int J Mycobacteriol, 2014, 3(4): 225-229.
17. Mandal SK, Ghosh S, Mondal SS, et al. Coexistence of pulmonary tuberculosis and sarcoidosis: a diagnostic dilemma. BMJ Case Rep, 2014, 2014: bcr2014206016.
18. Danila E, Zurauskas E. Diagnostic value of epithelioid cell granulomas in bronchoscopic biopsies. Intern Med, 2008, 47(24): 2121-2126.
19. 中华医学会呼吸病学分会间质性肺疾病学组, 中国医师协会呼吸医师分会间质性肺疾病工作委员会. 中国肺结节病诊断和治疗专家共识. 中华结核和呼吸杂志, 2019, 42(9): 685-693.
20. Kaur H, Singh D, Pandhi N. Co-existence of pulmonary tuberculosis with sarcoidosis. Int J Mycobacteriol, 2021, 10(3): 341-343.
21. Fité E, Fernández-Figueras MT, Prats R, et al. High prevalence of Mycobacterium tuberculosis DNA in biopsies from sarcoidosis patients from Catalonia, Spain. Respiration, 2006, 73(1): 20-26.
22. Yamaguchi T, Costabel U, McDowell A, et al. Immunohistochemical detection of potential microbial antigens in granulomas in the diagnosis of sarcoidosis. J Clin Med, 2021, 10(5): 983.
23. Dubaniewicz A. Mycobacterium tuberculosis heat shock proteins and autoimmunity in sarcoidosis. Autoimmun Rev, 2010, 9(6): 419-424.
24. Dubaniewicz A, Trzonkowski P, Dubaniewicz-Wybieralska M, et al. Mycobacterial heat shock protein-induced blood T lymphocytes subsets and cytokine pattern: comparison of sarcoidosis with tuberculosis and healthy controls. Respirology, 2007, 12(3): 346-354.
25. Moller DR. Potential etiologic agents in sarcoidosis. Proc Am Thorac Soc, 2007, 4(5): 465-468.
26. Morgenthau AS, Iannuzzi MC. Recent advances in sarcoidosis. Chest, 2011, 139(1): 174-182.
27. Oswald-Richter K, Sato H, Hajizadeh R, et al. Mycobacterial ESAT-6 and katG are recognized by sarcoidosis CD4⁺ T cells when presented by the American sarcoidosis susceptibility allele, DRB1*1101. J Clin Immunol, 2010, 30(1): 157-166.
28. Agrawal R, Kee AR, Ang L, et al. Tuberculosis or sarcoidosis: opposite ends of the same disease spectrum?. Tuberculosis (Edinb), 2016, 98: 21-26.
29. Gupta D, Agarwal R, Aggarwal AN, et al. Molecular evidence for the role of mycobacteria in sarcoidosis: a meta-analysis. Eur Respir J, 2007, 30(3): 508-516.
30. Judson MA. Environmental risk factors for sarcoidosis. Front Immunol, 2020, 11: 1340.
31. Lee H, Eom M, Kim SH, et al. Identification of Mycobacterium tuberculosis and non-tuberculous mycobacteria from cutaneous sarcoidosis lesions by reverse blot hybridization assay. J Dermatol, 2019, 46(10): 917-921.
32. Xu H, Li H. Acne, the skin microbiome, and antibiotic treatment. Am J Clin Dermatol, 2019, 20(3): 335-344.
33. Portillo ME, Corvec S, Borens O, et al. Propionibacterium acnes: an underestimated pathogen in implant-associated infections. Biomed Res Int, 2013, 2013: 804391.
34. Davidsson S, Mölling P, Rider JR, et al. Erratum to: frequency and typing of Propionibacterium acnes in prostate tissue obtained from men with and without prostate cancer. Infect Agent Cancer, 2016, 11: 36.
35. Leheste JR, Ruvolo KE, Chrostowski JE, et al. P.acnes-driven disease pathology:current knowledge and future directions. Front Cell Infect Microbiol, 2017, 7: 81.
36. Homma JY, Abe C, Chosa H, et al. Bacteriological investigation on biopsy specimens from patients with sarcoidosis. Jpn J Exp Med, 1978, 48(3): 251-255.
37. Suzuki Y, Uchida K, Takemura T, et al. Propionibacterium acnes-derived insoluble immune complexes in sinus macrophages of lymph nodes affected by sarcoidosis. PLoS One, 2018, 13(2): e0192408.
38. Schupp JC, Tchaptchet S, Lützen N, et al. Immune response to Propionibacterium acnes in patients with sarcoidosis-in vivo and in vitro. BMC Pulm Med, 2015, 15: 75.
39. Werner JL, Escolero SG, Hewlett JT, et al. Induction of pulmonary granuloma formation by Propionibacterium acnes is regulated by MyD88 and Nox2. Am J Respir Cell Mol Biol, 2017, 56(1): 121-130.
40. Fischer K, Tschismarov R, Pilz A, et al. Cutibacterium acnes infection induces type i interferon synthesis through the cGAS-STING pathway. Front Immunol, 2020, 11: 571334.
41. Akimoto J, Nagai K, Ogasawara D, et al. Solitary tentorial sarcoid granuloma associated with Propionibacterium acnes infection: case report. J Neurosurg, 2017, 127(3): 687-690.
42. Yang G, Eishi Y, Raza A, et al. Propionibacterium acnes-associated neurosarcoidosis: a case report with review of the literature. Neuropathology, 2018, 38(2): 159-164.
43. Goto H, Usui Y, Umazume A, et al. Propionibacterium acnes as a possible pathogen of granuloma in patients with ocular sarcoidosis. Br J Ophthalmol, 2017, 101(11): 1510-1513.
44. Asakawa N, Uchida K, Sakakibara M, et al. Immunohistochemical identification of Propionibacterium acnes in granuloma and inflammatory cells of myocardial tissues obtained from cardiac sarcoidosis patients. PLoS One, 2017, 12(7): e0179980.
45. Beijer E, Seldenrijk K, Eishi Y, et al. Presence of Propionibacterium acnes in granulomas associates with a chronic disease course in Dutch sarcoidosis patients. ERJ Open Res, 2021, 7(1): 00486-2020.
46. Adriani A, Repici A, Hickman I, et al. Helicobacter pylori infection and respiratory diseases: actual data and directions for future studies. Minerva Med, 2014, 105(1): 1-8.
47. Ribaldone DG, Fagoonee S, Hickman I, et al. Helicobacter pylori infection and ischemic heart disease: could experimental data lead to clinical studies?. Minerva Cardioangiol, 2016, 64(6): 686-696.
48. Chmiela M, Gonciarz W. Molecular mimicry in Helicobacter pylori infections. World J Gastroenterol, 2017, 23(22): 3964-3977.
49. Malfertheiner MV, Kandulski A, Schreiber J, et al. Helicobacter pylori infection and the respiratory system: a systematic review of the literature. Digestion, 2011, 84(3): 212-220.
50. Herndon B, Quinn T, Wasson N, et al. Urease and Helicobacter spp. antigens in pulmonary granuloma. J Comp Pathol, 2013, 148(2/3): 266-277.
51. Arismendi Sosa AC, Salinas Ibáñez AG, Pérez Chaca MV, et al. Study of Helicobacter pylori infection on lung using an animal model. Microb Pathog, 2018, 123: 410-418.
52. Rivière F, Roux X, Méchaï F, et al. Cured pulmonary sarcoïdosis and Helicobacter pylori eradication: cause or coincidence?. Presse Med, 2011, 40(7/8): 765-767.
53. Herndon BL, Vlach V, Dew M, et al. Helicobacter pylori-related immunoglobulins in sarcoidosis. J Investig Med, 2004, 52(2): 137-143.
54. Durazzo M, Adriani A, Fagoonee S, et al. Helicobacter pylori and respiratory diseases: 2021 update. Microorganisms, 2021, 9(10): 2033.
55. Denning DW, Pleuvry A, Cole DC. Global burden of chronic pulmonary aspergillosis complicating sarcoidosis. Eur Respir J, 2013, 41(3): 621-626.
56. Denning DW. Sarcoidosis and aspergillosis: a tough combination. Eur Respir J, 2017, 49(6): 1700574.
57. Terčelj M, Salobir B, Harlander M, et al. Fungal exposure in homes of patients with sarcoidosis - an environmental exposure study. Environ Health, 2011, 10(1): 8.
58. Ullmann AJ, Aguado JM, Arikan-Akdagli S, et al. Diagnosis and management of aspergillus diseases: executive summary of the 2017 ESCMID-ECMM-ERS guideline. Clin Microbiol Infect, 2018, 24(Suppl 1): e1-e38.
59. Suchankova M, Paulovicova E, Paulovicova L, et al. Increased antifungal antibodies in bronchoalveolar lavage fluid and serum in pulmonary sarcoidosis. Scand J Immunol, 2015, 81(4): 259-264.
60. Clarke EL, Lauder AP, Hofstaedter CE, et al. Microbial lineages in sarcoidosis. A metagenomic analysis tailored for low-microbial content samples. Am J Respir Crit Care Med, 2018, 197(2): 225-234.
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