Shigematsu N, Kido K, Ikeda T, Kamikawaji N, Sasazuki T
Tuberculosis Prevention Center, Fukuoka.
Nihon Rinsho. 1994 Jun;52(6):1498-502.
In search for the pathogenetic factors, we have found the following: 1) Chronic bacterial foci in the upper airway is showing adverse effect on clinical course of sarcoidosis. Alpha-streptococcus is mainly detected. 2) The prevalence of chronic tonsillitis in sarcoidosis is high if compared with that among Japanese adults examined by rhinolaryngologists. 3) The development of noncaseating epithelioid granulomas is reported after injections of an aqueous suspension of alpha-streptococcal cell wall (SCW) fragments into susceptible Lewis female rats. 4) Both protracted clinical course in sarcoidosis and higher responsiveness to SCW antigen are related to HLA-DR4, DR9 and DRw8. These results suggest that in sarcoidosis significance of persistence of antigen in upper respiratory tract and the significant correlation between SCW binding to Ia and immunogenicity, implicated by Schaeffer's, are seen.
在寻找致病因素的过程中，我们发现了以下几点：1）上呼吸道的慢性细菌病灶对结节病的临床病程有不良影响。主要检测到的是α-链球菌。2）与耳鼻喉科医生检查的日本成年人相比，结节病中慢性扁桃体炎的患病率较高。3）将α-链球菌细胞壁（SCW）片段的水悬浮液注射到易感的Lewis雌性大鼠体内后，有非干酪样上皮样肉芽肿形成的报道。4）结节病的迁延临床病程和对SCW抗原的较高反应性均与HLA-DR4、DR9和DRw8相关。这些结果表明，在结节病中可观察到上呼吸道中抗原持续存在的重要性，以及Schaeffer所指出的SCW与Ia结合和免疫原性之间的显著相关性。
