Eishi Yoshinobu
Department of Human Pathology, Graduate School, Faculty of Medicine, Tokyo Medical and Dental University, Tokyo 113-8510, Japan.
Microorganisms. 2023 Jan 22;11(2):289. doi: 10.3390/microorganisms11020289.
The immunohistochemical detection of in sarcoid granulomas suggests its potential role in granuloma formation. is the sole microorganism ever isolated from sarcoid lesions. Histopathologic analysis of some sarcoid lymph nodes reveals latent infection and intracellular proliferation of cell-wall-deficient followed by insoluble immune-complex formation. Activation of T helper type 1 (Th1) immune responses by is generally higher in sarcoidosis patients than in healthy individuals. Pulmonary granulomatosis caused by an experimental adjuvant-induced allergic immune response to is preventable by antimicrobials, suggesting that the allergic reaction targets commensal in the lungs. is the most common bacterium detected intracellularly in human peripheral lungs and mediastinal lymph nodes. Some sarcoidosis patients have increased amounts of -derived circulating immune complexes, which suggests the proliferation of in affected organs. In predisposed individuals with hypersensitive Th1 immune responses to , granulomas may form to confine the intracellular proliferation of latent triggered by certain host-related or drug-induced conditions. Current clinical trials in patients with cardiac sarcoidosis are evaluating combined treatment with steroids and antimicrobials during active disease with continued antimicrobial therapy while tapering off steroids after the disease subsides.
在结节病肉芽肿中的免疫组化检测表明其在肉芽肿形成中可能发挥作用。是唯一从结节病病变中分离出的微生物。对一些结节病淋巴结的组织病理学分析显示存在潜伏感染以及细胞壁缺陷型的细胞内增殖，随后形成不溶性免疫复合物。结节病患者中由激活的1型辅助性T（Th1）免疫反应通常高于健康个体。实验性佐剂诱导的对的过敏性免疫反应所导致的肺部肉芽肿病可通过抗菌药物预防，这表明过敏反应的靶标是肺部共生的。是在人类外周肺和纵隔淋巴结中细胞内检测到的最常见细菌。一些结节病患者循环中源自的免疫复合物数量增加，这表明在受影响器官中增殖。在对具有超敏Th1免疫反应的易感个体中，可能会形成肉芽肿以限制由某些宿主相关或药物诱导的状况引发的潜伏的细胞内增殖。目前针对心脏结节病患者的临床试验正在评估在疾病活动期联合使用类固醇和抗菌药物进行治疗，并在疾病消退后逐渐减少类固醇用量的同时持续进行抗菌治疗。
