Potential Association of Cutibacterium acnes with Sarcoidosis as an Endogenous Hypersensitivity Infection.
Yoshinobu EishiPublished in: Microorganisms (2023)
The immunohistochemical detection of Cutibacterium acnes in sarcoid granulomas suggests its potential role in granuloma formation. C. acnes 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 C. acnes followed by insoluble immune-complex formation. Activation of T helper type 1 (Th1) immune responses by C. acnes is generally higher in sarcoidosis patients than in healthy individuals. Pulmonary granulomatosis caused by an experimental adjuvant-induced allergic immune response to C. acnes is preventable by antimicrobials, suggesting that the allergic reaction targets C. acnes commensal in the lungs. C. acnes is the most common bacterium detected intracellularly in human peripheral lungs and mediastinal lymph nodes. Some sarcoidosis patients have increased amounts of C. acnes -derived circulating immune complexes, which suggests the proliferation of C. acnes in affected organs. In predisposed individuals with hypersensitive Th1 immune responses to C. acnes , granulomas may form to confine the intracellular proliferation of latent C. acnes 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.
Keyphrases
- drug induced
- lymph node
- immune response
- end stage renal disease
- clinical trial
- liver injury
- newly diagnosed
- signaling pathway
- ejection fraction
- chronic kidney disease
- stem cells
- cell wall
- endothelial cells
- randomized controlled trial
- inflammatory response
- emergency department
- mesenchymal stem cells
- pulmonary hypertension
- heart failure
- ultrasound guided
- bone marrow
- patient reported outcomes
- climate change
- atrial fibrillation
- electronic health record
- phase iii