Loke Wei Sheng Joshua, Herbert Cristan, Thomas Paul S
Inflammation and Infection Research Centre, Faculty of Medicine, University of New South Wales, Sydney, NSW 2052, Australia ; Department of Respiratory Medicine, Prince of Wales Hospital, Randwick, NSW 2031, Australia.
Inflammation and Infection Research Centre, Faculty of Medicine, University of New South Wales, Sydney, NSW 2052, Australia.
Int J Chronic Dis. 2013;2013:928601. doi: 10.1155/2013/928601. Epub 2013 Jul 25.
Sarcoidosis is a multisystem granulomatous disorder invariably affecting the lungs. It is a disease with noteworthy variations in clinical manifestation and disease outcome and has been described as an "immune paradox" with peripheral anergy despite exaggerated inflammation at disease sites. Despite extensive research, sarcoidosis remains a disease with undetermined aetiology. Current evidence supports the notion that the immune response in sarcoidosis is driven by a putative antigen in a genetically susceptible individual. Unfortunately, there currently exists no reliable biomarker to delineate the disease severity and prognosis. As such, the diagnosis of sarcoidosis remains a vexing clinical challenge. In this review, we outline the immunological features of sarcoidosis, discuss the evidence for and against various candidate etiological agents (infective and noninfective), describe the exhaled breath condensate, a novel method of identifying immunological biomarkers, and suggest other possible immunological biomarkers to better characterise the immunopathogenesis of sarcoidosis.
结节病是一种多系统肉芽肿性疾病，总是累及肺部。它是一种临床表现和疾病转归存在显著差异的疾病，被描述为一种“免疫悖论”，尽管疾病部位存在炎症加剧，但外周存在无反应性。尽管进行了广泛研究，结节病的病因仍未明确。目前的证据支持这样一种观点，即在遗传易感个体中，结节病的免疫反应由一种假定的抗原驱动。不幸的是，目前尚无可靠的生物标志物来界定疾病的严重程度和预后。因此，结节病的诊断仍然是一个棘手的临床挑战。在这篇综述中，我们概述了结节病的免疫学特征，讨论了支持和反对各种候选病因（感染性和非感染性）的证据，描述了呼出气冷凝物这一识别免疫生物标志物的新方法，并提出了其他可能的免疫生物标志物，以更好地描述结节病的免疫发病机制。
