Hiramatsu Jun-ichi, Kataoka Mikio, Nakata Yasunari, Okazaki Kazunori, Tada Shinya, Tanimoto Mitsune, Eishi Yoshinobu
Second Department of Internal Medicine, Okayama University Medical School, Okayama, Japan.
Sarcoidosis Vasc Diffuse Lung Dis. 2003 Oct;20(3):197-203.
The causes of sarcoidosis are unknown. Propionibacterium acnes is so far the only bacterium to be found in sarcoid lymph nodes. We attempted to detect P. acnes DNA in cells recovered by bronchoalveolar lavage (BAL) from patients with sarcoidosis.
BAL cells from 30 patients with histologically proven sarcoidosis and 30 controls with other lung diseases were examined by a nested polymerase chain reaction (PCR) for 16S rRNA of P. acnes. BAL cells from three recent sarcoid patients and two control patients were also examined by in situ PCR to locate P. acnes DNA. Clinical findings in sarcoid patients with and without positive results by PCR were compared.
P. acnes DNA was detected in BAL cells from 21 (70%) sarcoid patients and 7 (23%) control patients. In situ signals of P. acnes DNA were detected in the cytoplasm of 0.2% to 2.8% of alveolar macrophages from sarcoid patients, but from no cells of the control patients. Gallium-67 uptake by lung parenchyma was found in about half of the sarcoid patients with P. acnes DNA, but in none of the other sarcoid patients. More of these patients with such DNA had lung parenchymal shadows in chest X-ray films and were in more advanced stages of the disease than the other sarcoid patients.
Detection of P. acnes DNA in BAL cells was significantly more common in the patients with confirmed sarcoidosis. Detection was associated with some indices of disease activity in the lung.
结节病的病因尚不清楚。痤疮丙酸杆菌是迄今为止在结节病淋巴结中发现的唯一细菌。我们试图在结节病患者支气管肺泡灌洗（BAL）回收的细胞中检测痤疮丙酸杆菌DNA。
对30例经组织学证实为结节病的患者和30例患有其他肺部疾病的对照者的BAL细胞进行巢式聚合酶链反应（PCR）检测痤疮丙酸杆菌的16S rRNA。还对3例近期结节病患者和2例对照患者的BAL细胞进行原位PCR检测以定位痤疮丙酸杆菌DNA。比较PCR结果为阳性和阴性的结节病患者的临床特征。
在21例（70%）结节病患者和7例（23%）对照者的BAL细胞中检测到痤疮丙酸杆菌DNA。在结节病患者0.2%至2.8%的肺泡巨噬细胞胞质中检测到痤疮丙酸杆菌DNA的原位信号，但在对照患者的细胞中未检测到。约一半痤疮丙酸杆菌DNA阳性的结节病患者肺实质有镓-67摄取，但其他结节病患者均无。与其他结节病患者相比，这些DNA阳性患者在胸部X光片上肺部有实质阴影且疾病处于更晚期。
在确诊的结节病患者中，BAL细胞中检测到痤疮丙酸杆菌DNA的情况明显更常见。检测结果与肺部疾病活动的一些指标相关。
