Soler P
INSERM U 408, Faculté Xavier-Bichat, 16, rue Henri-Huchard, BP 416, 75870 Paris Cedex 18.
Ann Med Interne (Paris). 2001 Feb;152(1):28-33.
It is now well established that sarcoidosis is a granulomatous disorder resulting from an uncontrolled cell-mediated immune reaction in response to unknown antigens. This reaction is characterized by the presence of typical granulomas at the sites of the disease, made of activated macrophages (epithelioid cells) and T lymphocytes. The interactions between both cell types lead to the production of numerous inflammatory mediators which are essential for the development of granulomas. Recently, sarcoid granulomas have been shown to express a Th1 pattern of cytokines. The modulation of the expression of some of them could be useful for the development of new therapies. The etiology of sarcoidosis remains unknown, but recent advances concerning this disorder suggest that it results from various causes involving a particular genetic background and exposure to specific environmental factors. Recent data have emphasized in some patients the expression of particular HLA haplotypes, the polymorphism of various genes, and the presence of oligoclonal T lymphocytes. The characterization of the antigenic specificity of these T cells could be helpful in identifying agents responsible for the disease. The role of mycobacterial agents is still controversial.
目前已明确，结节病是一种肉芽肿性疾病，由针对未知抗原的不受控制的细胞介导免疫反应引起。这种反应的特征是在疾病部位存在典型的肉芽肿，由活化的巨噬细胞（上皮样细胞）和T淋巴细胞组成。两种细胞类型之间的相互作用导致产生大量炎症介质，这些介质对于肉芽肿的形成至关重要。最近，已证明结节病肉芽肿表达Th1型细胞因子。调节其中一些细胞因子的表达可能有助于开发新的治疗方法。结节病的病因仍然不明，但关于这种疾病的最新进展表明，它是由涉及特定遗传背景和接触特定环境因素的多种原因引起的。最近的数据在一些患者中强调了特定HLA单倍型的表达、各种基因的多态性以及寡克隆T淋巴细胞的存在。表征这些T细胞的抗原特异性可能有助于识别导致该疾病的因素。分枝杆菌剂的作用仍存在争议。
