Moving Target - Shifting the Focus to Pulmonary Sarcoidosis as an Autoimmune Spectrum Disorder.

Authors:
Ylva Kaiser
Ylva Kaiser
Solna and Center for Molecular Medicine
Anders Eklund
Anders Eklund
UmeƄ University
Sweden
Johan Grunewald
Johan Grunewald
Karolinska Institutet
Sweden

Eur Respir J 2019 Apr 18. Epub 2019 Apr 18.

Respiratory Medicine Unit, Department of Medicine, Solna and Center for Molecular Medicine, Karolinska Institutet and Karolinska University Hospital Solna, Stockholm, Sweden.

Despite over a century of research, the causative agent(s) in sarcoidosis, a heterogeneous granulomatous disorder mainly affecting the lungs, remain elusive. Following identification of genetic factors underlying different clinical phenotypes, increased understanding of CD4 T-cell immunology, which is believed to be central to sarcoid pathogenesis, as well as the role of B-cells and other cells bridging innate and adaptive immunity, is now contributing to novel insights into the mechanistic pathways influencing disease resolution or chronicity. Hopefully, new perspectives and state-of-the-art technology may help to shed light on the still-elusive enigma of sarcoid aetiology. This perspective article highlights a number of recent advances in the search for antigenic targets in sarcoidosis, as well as the main arguments for sarcoidosis as a spectrum of autoimmune conditions, either as a result of an external (microbial) trigger and/or due to defective control mechanisms regulating the balance between T-cell activation and inhibition.

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Source
http://erj.ersjournals.com/lookup/doi/10.1183/13993003.02153
Publisher Site
http://dx.doi.org/10.1183/13993003.021532018DOI Listing
April 2019
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