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结节病的感染性和非感染性诱发因素。

Infectious and non-infectious precipitants of sarcoidosis.

作者信息

Chioma Ozioma S, Wiggins ZaDarreyal, Rea Samantha, Drake Wonder P

机构信息

Division of Infectious Disease, Department of Medicine, Vanderbilt University School of Medicine, Nashville, TN, USA.

Department of Medicine, University of Maryland School of Medicine, Baltimore, MD, USA.

出版信息

J Autoimmun. 2024 Dec;149:103239. doi: 10.1016/j.jaut.2024.103239. Epub 2024 May 31.

Abstract

Sarcoidosis is a chronic inflammatory disease that can affect any organ in the body. Its exact cause remains unknown, but it is believed to result from a combination of genetic and environmental factors. Some potential causes of sarcoidosis include genetics, environmental triggers, immune system dysfunction, the gut microbiome, sex, and race/ethnicity. Genetic mutations are associated with protection against disease progression or an increased susceptibility to more severe disease, while exposure to certain chemicals, bacteria, viruses, or allergens can trigger the formation of immune cell congregations (granulomas) in different organs. Dysfunction of the immune system, including autoimmune reactions, may also contribute. The gut microbiome and factors such as being female or having African American, Scandinavian, Irish, or Puerto Rican heritage are additional contributors to disease outcome. Recent research has suggested that certain drugs, such as anti-Programmed Death-1 (PD-1) and antibiotics such as tuberculosis (TB) drugs, may raise the risk of developing sarcoidosis. Hormone levels, particularly higher levels of estrogen and progesterone in women, have also been linked to an increased likelihood of sarcoidosis. The diagnosis of sarcoidosis involves a comprehensive assessment that includes medical history, physical examination, laboratory tests, and imaging studies. While there is no cure for sarcoidosis, the symptoms can often be effectively managed through various treatment options. Treatment may involve the use of medications, surgical interventions, or lifestyle changes. These disparate factors suggests that sarcoidosis has multiple positive and negative exacerbants on disease severity, some of which can be ameliorated and others which cannot.

摘要

结节病是一种慢性炎症性疾病,可影响身体的任何器官。其确切病因尚不清楚,但据信是遗传和环境因素共同作用的结果。结节病的一些潜在病因包括遗传、环境触发因素、免疫系统功能障碍、肠道微生物群、性别以及种族/民族。基因突变与预防疾病进展或增加对更严重疾病的易感性有关,而接触某些化学物质、细菌、病毒或过敏原可触发不同器官中免疫细胞聚集(肉芽肿)的形成。免疫系统功能障碍,包括自身免疫反应,也可能起作用。肠道微生物群以及女性或具有非裔美国人、斯堪的纳维亚人、爱尔兰人或波多黎各血统等因素也是影响疾病结果的额外因素。最近的研究表明,某些药物,如抗程序性死亡1(PD-1)药物和抗结核药物等抗生素,可能会增加患结节病的风险。激素水平,特别是女性体内较高水平的雌激素和孕激素,也与结节病的发病可能性增加有关。结节病的诊断需要进行全面评估,包括病史、体格检查、实验室检查和影像学检查。虽然结节病无法治愈,但通常可以通过各种治疗方案有效控制症状。治疗可能包括使用药物、手术干预或生活方式改变。这些不同的因素表明,结节病在疾病严重程度方面有多种正负加重因素,其中一些可以改善,而另一些则无法改善。

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