Potential Association of with Sarcoidosis as an Endogenous Hypersensitivity Infection.

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.