Autoantibodies in sarcoidosis: Innocent bystander or promising biomarker for organ involvement?
Main Article Content
Keywords
saircoidosis, autoantibodies, lung diseases
Abstract
Background and aim: Sarcoidosis is a rare inflammatory disease that can affect any organ in the body, but most commonly involves lungs and lymph nodes. Sarcoidosis is often considered an autoimmune disease, attributed to many factors, including autoantigen-specific T cells, antibodies producing B lymphocytes, autoimmune inflammation, although its exact cause and classification are still under debate.The aim of our study was to evaluate the possible role of autoantibodies, such as anti-nuclear (ANA), extractable nuclear antigen (ENA) and antiphospholipids, in sarcoidosis patients.
Methods: We conduct a retrospective study on our patients with confirmed diagnosis of sarcoidosis involving lungs, lymph nodes and multiple organs, and we collected and analyzed data on blood and urine tests (C-reactive protein, CRP, amount of calcium in blood and urine, CD4/CD8 ratio, lymphocyte count), lung function, radiological patterns, ongoing treatments (steroid therapy, hydroxychloroquine or methotrexate, other immunosuppressive agents).
Results: We enrolled 328 sarcoidosis patients, and we focused our attention on 32 patients with positive ANA antibodies (11%), observing a high percentage of them with sarcoidosis involving the lungs (77%), but more specifically a significant discrepancy, in percentage terms, in the blood CD4/CD8 ratio. In the ANA-positive group we observed 26% of patients with a high blood CD4/CD8 ratio (average CD4/CD8 ratio of 2.41), whereas in the ANA-negative group, patients with a high CD4/CD8 ratio (average ratio 1.78) represented a much smaller percentage (13%). This finding may be a source of further investigation for other studies on the topic.
Conclusions: Analysis of autoantibodies expressed in our case series did not identify a specific autoantibodies pattern in sarcoidosis. Few studies have analyzed autoantibody patterns in sarcoidosis patients and involved smaller populations. In conclusion, our study evaluates a sizable population, and underlines the need for further, larger clinical studies to evaluate possible associations between sarcoidosis and autoimmunity.
References
1. Grunewald J, Grutters JC, Arkema EV, Saketkoo LA, Moller DR, Müller-Quernheim J. Sarcoidosis. Nat Rev Dis Primers. 2019;5(1):45. doi:10.1038/s41572-019-0096-x
2. d’Alessandro M, Bergantini L, Gangi S, et al. Immunological Pathways in Sarcoidosis and Autoimmune Rheumatic Disorders—Similarities and Differences in an Italian Prospective Real-Life Preliminary Study. Biomedicines. 2023;11(6):1532. doi:10.3390/biomedicines11061532
3. Sun D, Ma R, Wang J, Wang Y, Ye Q. The causal relationship between sarcoidosis and autoimmune diseases: a bidirectional Mendelian randomization study in FinnGen. Front Immunol. 2024;15:1325127. doi:10.3389/fimmu.2024.1325127
4. Rizzi L, Sabbà C, Suppressa P. Sarcoidosis and autoimmunity: In the depth of a complex relationship. Front Med. 2022;9:991394. doi:10.3389/fmed.2022.991394
5. Culver DA, Judson MA. New advances in the management of pulmonary sarcoidosis. BMJ. Published online October 22, 2019:l5553. doi:10.1136/bmj.l5553
6. Ungprasert P, Carmona EM, Utz JP, Ryu JH, Crowson CS, Matteson EL. Epidemiology of Sarcoidosis 1946-2013: A Population-Based Study. Mayo Clin Proc. 2016;91(2):183-188. doi:10.1016/j.mayocp.2015.10.024
7. Judson MA. The Clinical Features of Sarcoidosis: A Comprehensive Review. Clin Rev Allergy Immunol. 2015;49(1):63-78. doi:10.1007/s12016-014-8450-y
8. Sève P, Pacheco Y, Durupt F, et al. Sarcoidosis: A Clinical Overview from Symptoms to Diagnosis. Cells. 2021;10(4):766. doi:10.3390/cells10040766
9. Nadeem I, Khatana UF, Ur Rasool M, Qamar A, Azher M. Extrapulmonary Sarcoidosis: A Diagnostic Challenge. Cureus. Published online October 21, 2020. doi:10.7759/cureus.11076
10. Dua A, Manadan A. Images in clinical medicine. Heerfordt’s syndrome, or uveoparotid fever. N Engl J Med. 2013;369(5):458. doi:10.1056/NEJMicm1303454
11. Grunewald J, Eklund A. Sex-Specific Manifestations of Löfgren’s Syndrome. Am J Respir Crit Care Med. 2007;175(1):40-44. doi:10.1164/rccm.200608-1197OC
12. Darlington P, Tallstedt L, Padyukov L, et al. HLA-DRB1 alleles and symptoms associated with Heerfordt’s syndrome in sarcoidosis. Eur Respir J. 2011;38(5):1151-1157. doi:10.1183/09031936.00025011
13. Valeyre D, Prasse A, Nunes H, Uzunhan Y, Brillet PY, Müller-Quernheim J. Sarcoidosis. The Lancet. 2014;383(9923):1155-1167. doi:10.1016/S0140-6736(13)60680-7
14. Malaisamy S, Dalal B, Bimenyuy C, Soubani AO. The clinical and radiologic features of nodular pulmonary sarcoidosis. Lung. 2009;187(1):9-15. doi:10.1007/s00408-008-9118-2
15. Crouser ED, Maier LA, Wilson KC, et al. Diagnosis and Detection of Sarcoidosis. An Official American Thoracic Society Clinical Practice Guideline. Am J Respir Crit Care Med. 2020;201(8):e26-e51. doi:10.1164/rccm.202002-0251ST
16. Baughman RP, Costabel U, du Bois RM. Treatment of sarcoidosis. Clin Chest Med. 2008;29(3):533-548, ix-x. doi:10.1016/j.ccm.2008.03.012
17. Moller DR, Rybicki BA, Hamzeh NY, et al. Genetic, Immunologic, and Environmental Basis of Sarcoidosis. Ann Am Thorac Soc. 2017 Dec;14(Supplement_6):S429-S436. doi: 10.1513/AnnalsATS.201707-565OT.
18. Hofmann S, Franke A, Fischer A, et al. Genome-wide association study identifies ANXA11 as a new susceptibility locus for sarcoidosis. Nat Genet. 2008;40(9):1103-1106. doi:10.1038/ng.198
19. Cifaldi R, Salton F, Confalonieri P, et al. Pulmonary Sarcoidosis and Immune Dysregulation: A Pilot Study on Possible Correlation. Diagnostics. 2023;13(18):2899. doi:10.3390/diagnostics13182899
20. Korsten P, Tampe B, Konig MF, Nikiphorou E. Sarcoidosis and autoimmune diseases: differences, similarities and overlaps. Curr Opin Pulm Med. 2018 Sep;24(5):504-512. doi: 10.1097/MCP.0000000000000500.. doi:10.1097/MCP.0000000000000500
21. Shi TY, Wen XH, Shi XH, Meng J, Lu YW. Associations between sarcoidosis, autoimmune diseases, and autoantibodies: a single-center retrospective study in China. Clin Exp Med. 2022;22(2):277-283. doi:10.1007/s10238-021-00737-5
22. Hattori T, Konno S, Shijubo N, et al. Nationwide survey on the organ-specific prevalence and its interaction with sarcoidosis in Japan. Sci Rep. 2018;8(1):9440. doi:10.1038/s41598-018-27554-3
23. Nunes H, Uzunhan Y, Gille T, Lamberto C, Valeyre D, Brillet PY. Imaging of sarcoidosis of the airways and lung parenchyma and correlation with lung function. Eur Respir J. 2012;40(3):750-765. doi:10.1183/09031936.00025212
24. Crawshaw AP, Wotton CJ, Yeates DGR, Goldacre MJ, Ho LP. Evidence for association between sarcoidosis and pulmonary embolism from 35-year record linkage study. Thorax. 2011;66(5):447-447. doi:10.1136/thx.2010.134429
25. Selvi A, Diakou M, Giannopoulos S, Zikou AK, Argyropoulou MI, Kyritsis AP. Cerebral Venous Thrombosis in a Patient with Sarcoidosis. Intern Med. 2009;48(9):723-725. doi:10.2169/internalmedicine.48.1809
26. Swigris JJ, Olson AL, Huie TJ, et al. Increased Risk of Pulmonary Embolism Among US Decedents With Sarcoidosis From 1988 to 2007. Chest. 2011;140(5):1261-1266. doi:10.1378/chest.11-0324
27. Marc K, Bourkadi JE, Benamor J, Iraqi G. Thrombose veineuse thoracique au cours de la sarcoïdose. Rev Mal Respir. 2008;25(1):105-106. doi:10.1016/S0761-8425(08)70477-7
28. Silvariño R, Danza Á, Mérola V, et al. Venous thromboembolic disease in systemic autoimmune diseases: An association to keep in mind. Autoimmunity Reviews. 2012;12(2):289-294. doi:10.1016/j.autrev.2012.05.002
29. Turetz M, Sideris A, Friedman O, Triphathi N, Horowitz J. Epidemiology, Pathophysiology, and Natural History of Pulmonary Embolism. Semin intervent Radiol. 2018;35(02):92-98. doi:10.1055/s-0038-1642036
30. Larsson J, Graff P, Bryngelsson IL, Vihlborg P. Sarcoidosis and increased risk of comorbidities and mortality in sweden. Sarcoidosis Vasc Diffuse Lung Dis. 2020;37(2):104-135. doi:10.36141/svdld.v37i2.9142
31. Baratella E, Bussani R, Zanconati F, et al. Radiological-pathological signatures of patients with COVID-19-related pneumomediastinum: is there a role for the Sonic hedgehog and Wnt5a pathways? ERJ Open Res. 2021;7(3):00346-2021. doi:10.1183/23120541.00346-2021
32. Kolluri N, Elwazir MY, Rosenbaum AN, et al. corticosteroid therapy in patients with cardiac sarcoidosis on frequency of venous thromboembolism. Am J Cardiol. 2021;149:112-118. doi:10.1016/j.amjcard.2021.03.017
33. Johannesdottir SA, Horváth-Puhó E, Dekkers OM, et al. Use of glucocorticoids and risk of venous thromboembolism: A nationwide population-based case-control study. JAMA Intern Med. 2013;173(9):743. doi:10.1001/jamainternmed.2013.122
34. Meduri GU, Annane D, Confalonieri M, et al. Pharmacological principles guiding prolonged glucocorticoid treatment in ARDS. Intensive Care Med. 2020;46(12):2284-2296. doi:10.1007/s00134-020-06289-8
35. Nicolosi S, Chernovsky M, Angoni D, et al. Gastrointestinal Manifestations of Sarcoidosis: A State-of-the-Art, Comprehensive Review of the Literature-Practical Clinical Insights and Many Unmet Needs on Diagnosis and Treatment. Pharmaceuticals (Basel). 2024;17(9):1106. doi:10.3390/ph17091106
36. Reitsma PH, Rosendaal FR. Activation of innate immunity in patients with venous thrombosis: the Leiden Thrombophilia Study. Journal of Thrombosis and Haemostasis. 2004;2(4):619-622. doi:10.1111/j.1538-7836.2004.00689.x
37. Ruaro B, Confalonieri P, Santagiuliana M, et al. Correlation between Potential Risk Factors and Pulmonary Embolism in Sarcoidosis Patients Timely Treated. J Clin Med. 2021;10(11):2462. doi:10.3390/jcm10112462
38. Takizawa H, Satoh M, Okazaki H, et al. Increased IL-6 and IL-8 in bronchoalveolar lavage fluids (BALF) from patients with sarcoidosis: correlation with the clinical parameters. Clinical and Experimental Immunology. 2003;107(1):175-181. doi:10.1046/j.1365-2249.1997.d01-905.x
39. Goljan-Geremek A, Geremek M, Puscinska E, Sliwinski P. Venous thromboembolism and sarcoidosis: co-incidence or coexistence? cejoi. 2015;4:477-480. doi:10.5114/ceji.2015.56972
40. Zia A, Russell J, Sarode R, et al. Markers of coagulation activation, inflammation and fibrinolysis as predictors of poor outcomes after pediatric venous thromboembolism: A systematic review and meta-analysis. Thrombosis Research. 2017;160:1-8. doi:10.1016/j.thromres.2017.10.003
41. Ina Y, Takada K, Yamamoto M, Sato T, Ito S, Sato S. Antiphospholipid Antibodies. Chest. 1994;105(4):1179-1183. doi:10.1378/chest.105.4.1179
42. Carragoso A, Silva JR, Capelo J, Faria B, Gaspar O. A patient with sarcoidosis and antiphospholipid syndrome. European Journal of Internal Medicine. 2008;19(8):e80-e81. doi:10.1016/j.ejim.2008.01.020
43. Baughman RP, Hurtubise PE. Systemic immune response of patients with active pulmonary sarcoidosis. Clin Exp Immunol. 1985;61(3):535-541.
44. Sweiss NJ, Salloum R, Ghandi S, et al. Significant CD4, CD8, and CD19 Lymphopenia in Peripheral Blood of Sarcoidosis Patients Correlates with Severe Disease Manifestations. Zimmer J, ed. PLoS ONE. 2010;5(2):e9088. doi:10.1371/journal.pone.0009088
45. Vorselaars ADM, Snijder RJ, Grutters JC. Increased Number of Pulmonary Embolisms in Sarcoidosis Patients. Chest. 2012;141(3):826-827. doi:10.1378/chest.11-2514
46. Takahashi F, Toba M, Takahashi K, et al. Pulmonary sarcoidosis and antiphospholipid syndrome. Respirology. 2006;11(4):506-508. doi:10.1111/j.1440-1843.2006.00880.x
47. Gerke AK. Morbidity and mortality in sarcoidosis: Current Opinion in Pulmonary Medicine. 2014;20(5):472-478. doi:10.1097/MCP.0000000000000080
48. Cattelan F, Hysa E, Gotelli E, et al. Microvascular capillaroscopic abnormalities and occurrence of antinuclear autoantibodies in patients with sarcoidosis. Rheumatol Int. 2022;42(12):2199-2210. doi:10.1007/s00296-022-05190-5
49. Kobak S, Yilmaz H, Sever F, Duran A, Sen N, Karaarslan A. The Prevalence of Antinuclear Antibodies in Patients with Sarcoidosis. Autoimmune Diseases. 2014;2014:1-4. doi:10.1155/2014/351852
50. Weinberg I, Vasiliev L, Gotsman I. Anti-dsDNA antibodies in sarcoidosis. Seminars in Arthritis and Rheumatism. 2000;29(5):328-331. doi:10.1016/S0049-0172(00)80019-0
51. Starshinova AA, Malkova AM, Basantsova NY, et al. Sarcoidosis as an Autoimmune Disease. Front Immunol. 2020;10:2933. doi:10.3389/fimmu.2019.02933
52. Vitali C. Classification criteria for Sjogren’s syndrome: a revised version of the European criteria proposed by the American-European Consensus Group. Annals of the Rheumatic Diseases. 2002;61(6):554-558. doi:10.1136/ard.61.6.554
53. Santiago T, Santiago M, Rovisco J, et al. Coexisting primary Sjögren’s syndrome and sarcoidosis: coincidence, mutually exclusive conditions or syndrome? Rheumatol Int. 2014;34(11):1619-1622. doi:10.1007/s00296-014-3024-0
54. Wesemann D, Costenbader K, Coblyn J. Co-existing sarcoidosis, systemic lupus erythematosus and the antiphospholipid antibody syndrome: Case Reports and Discussion from the Brigham and Women’s Hospital Lupus Center. Lupus. 2009;18(3):202-205. doi:10.1177/0961203308100483
55. Kobak S, Sever F, Sivrikoz O, Karaarslan A. Coexistence of Ankylosing Spondylitis and Löfgren’s Syndrome. Case Reports in Rheumatology. 2014;2014:1-3. doi:10.1155/2014/747698
56. Linke M, Pham HTT, Katholnig K, et al. Chronic signaling via the metabolic checkpoint kinase mTORC1 induces macrophage granuloma formation and marks sarcoidosis progression. Nat Immunol. 2017;18(3):293-302. doi:10.1038/ni.3655
57. d’Alessandro M, Conticini E, Bergantini L, et al. PD1, CTLA4 and TIGIT Expression on T and NK Cells in Granulomatous Diseases: Sarcoidosis and ANCA-Associated Vasculitis. IJMS. 2022;24(1):256. doi:10.3390/ijms24010256
58. Farinha I, Ferreira PG. Salvage use of tofacitinib in sarcoidosis patient with refractory multiorgan involvement. Sarcoidosis, Vasculitis and Diffuse Lung Diseases. 2024;41(2):e2024019. doi:10.36141/svdld.v41i2.15655
59. Baughman RP, Niranjan V, Walker G, et al. Efzofitimod: a novel anti-inflammatory agent for sarcoidosis. Sarcoidosis, Vasculitis and Diffuse Lung Diseases. 2023;40(1):e2023011. doi:10.36141/svdld.v40i1.14396
60. Culver DA, Aryal S, Barney J, et al. Efzofitimod for the Treatment of Pulmonary Sarcoidosis. Chest. 2023;163(4):881-890. doi:10.1016/j.chest.2022.10.037
61. Kiani A, Eslaminejad A, Shafeipour M, et al. Spirometry, cardiopulmonary exercise testing and the six-minute walk test results in sarcoidosis patients. Sarcoidosis Vasc Diffuse Lung Dis. 2019;36(3):185-194. doi:10.36141/svdld.v36i3.7663
62. Torregiani C, Reale M, Confalonieri M, et al. Cardiopulmonary exercise testing complements both spirometry and nuclear imaging for assessing sarcoidosis stage and for monitoring disease activity. Sarcoidosis, Vasculitis and Diffuse Lung Diseases. 2024;41(1):e2024017. doi:10.36141/svdld.v41i1.15125
63. Vorselaars ADM, Wuyts WA, Vorselaars VMM, et al. Methotrexate vs Azathioprine in Second-line Therapy of Sarcoidosis. Chest. 2013;144(3):805-812. doi:10.1378/chest.12-1728
64. Santiago T, Santiago M, Ruaro B, Salvador MJ, Cutolo M, da Silva JAP. Ultrasonography for the Assessment of Skin in Systemic Sclerosis: A Systematic Review. Arthritis Care Res (Hoboken). 2019;71(4):563-574. doi:10.1002/acr.23597
65. Jamilloux Y, El Jammal T, Bert A, Sève P. L’hydroxychloroquine pour la sarcoïdose extra-pulmonaire non-sévère. La Revue de Médecine Interne. 2022;43(7):406-411. doi:10.1016/j.revmed.2022.04.030
2. d’Alessandro M, Bergantini L, Gangi S, et al. Immunological Pathways in Sarcoidosis and Autoimmune Rheumatic Disorders—Similarities and Differences in an Italian Prospective Real-Life Preliminary Study. Biomedicines. 2023;11(6):1532. doi:10.3390/biomedicines11061532
3. Sun D, Ma R, Wang J, Wang Y, Ye Q. The causal relationship between sarcoidosis and autoimmune diseases: a bidirectional Mendelian randomization study in FinnGen. Front Immunol. 2024;15:1325127. doi:10.3389/fimmu.2024.1325127
4. Rizzi L, Sabbà C, Suppressa P. Sarcoidosis and autoimmunity: In the depth of a complex relationship. Front Med. 2022;9:991394. doi:10.3389/fmed.2022.991394
5. Culver DA, Judson MA. New advances in the management of pulmonary sarcoidosis. BMJ. Published online October 22, 2019:l5553. doi:10.1136/bmj.l5553
6. Ungprasert P, Carmona EM, Utz JP, Ryu JH, Crowson CS, Matteson EL. Epidemiology of Sarcoidosis 1946-2013: A Population-Based Study. Mayo Clin Proc. 2016;91(2):183-188. doi:10.1016/j.mayocp.2015.10.024
7. Judson MA. The Clinical Features of Sarcoidosis: A Comprehensive Review. Clin Rev Allergy Immunol. 2015;49(1):63-78. doi:10.1007/s12016-014-8450-y
8. Sève P, Pacheco Y, Durupt F, et al. Sarcoidosis: A Clinical Overview from Symptoms to Diagnosis. Cells. 2021;10(4):766. doi:10.3390/cells10040766
9. Nadeem I, Khatana UF, Ur Rasool M, Qamar A, Azher M. Extrapulmonary Sarcoidosis: A Diagnostic Challenge. Cureus. Published online October 21, 2020. doi:10.7759/cureus.11076
10. Dua A, Manadan A. Images in clinical medicine. Heerfordt’s syndrome, or uveoparotid fever. N Engl J Med. 2013;369(5):458. doi:10.1056/NEJMicm1303454
11. Grunewald J, Eklund A. Sex-Specific Manifestations of Löfgren’s Syndrome. Am J Respir Crit Care Med. 2007;175(1):40-44. doi:10.1164/rccm.200608-1197OC
12. Darlington P, Tallstedt L, Padyukov L, et al. HLA-DRB1 alleles and symptoms associated with Heerfordt’s syndrome in sarcoidosis. Eur Respir J. 2011;38(5):1151-1157. doi:10.1183/09031936.00025011
13. Valeyre D, Prasse A, Nunes H, Uzunhan Y, Brillet PY, Müller-Quernheim J. Sarcoidosis. The Lancet. 2014;383(9923):1155-1167. doi:10.1016/S0140-6736(13)60680-7
14. Malaisamy S, Dalal B, Bimenyuy C, Soubani AO. The clinical and radiologic features of nodular pulmonary sarcoidosis. Lung. 2009;187(1):9-15. doi:10.1007/s00408-008-9118-2
15. Crouser ED, Maier LA, Wilson KC, et al. Diagnosis and Detection of Sarcoidosis. An Official American Thoracic Society Clinical Practice Guideline. Am J Respir Crit Care Med. 2020;201(8):e26-e51. doi:10.1164/rccm.202002-0251ST
16. Baughman RP, Costabel U, du Bois RM. Treatment of sarcoidosis. Clin Chest Med. 2008;29(3):533-548, ix-x. doi:10.1016/j.ccm.2008.03.012
17. Moller DR, Rybicki BA, Hamzeh NY, et al. Genetic, Immunologic, and Environmental Basis of Sarcoidosis. Ann Am Thorac Soc. 2017 Dec;14(Supplement_6):S429-S436. doi: 10.1513/AnnalsATS.201707-565OT.
18. Hofmann S, Franke A, Fischer A, et al. Genome-wide association study identifies ANXA11 as a new susceptibility locus for sarcoidosis. Nat Genet. 2008;40(9):1103-1106. doi:10.1038/ng.198
19. Cifaldi R, Salton F, Confalonieri P, et al. Pulmonary Sarcoidosis and Immune Dysregulation: A Pilot Study on Possible Correlation. Diagnostics. 2023;13(18):2899. doi:10.3390/diagnostics13182899
20. Korsten P, Tampe B, Konig MF, Nikiphorou E. Sarcoidosis and autoimmune diseases: differences, similarities and overlaps. Curr Opin Pulm Med. 2018 Sep;24(5):504-512. doi: 10.1097/MCP.0000000000000500.. doi:10.1097/MCP.0000000000000500
21. Shi TY, Wen XH, Shi XH, Meng J, Lu YW. Associations between sarcoidosis, autoimmune diseases, and autoantibodies: a single-center retrospective study in China. Clin Exp Med. 2022;22(2):277-283. doi:10.1007/s10238-021-00737-5
22. Hattori T, Konno S, Shijubo N, et al. Nationwide survey on the organ-specific prevalence and its interaction with sarcoidosis in Japan. Sci Rep. 2018;8(1):9440. doi:10.1038/s41598-018-27554-3
23. Nunes H, Uzunhan Y, Gille T, Lamberto C, Valeyre D, Brillet PY. Imaging of sarcoidosis of the airways and lung parenchyma and correlation with lung function. Eur Respir J. 2012;40(3):750-765. doi:10.1183/09031936.00025212
24. Crawshaw AP, Wotton CJ, Yeates DGR, Goldacre MJ, Ho LP. Evidence for association between sarcoidosis and pulmonary embolism from 35-year record linkage study. Thorax. 2011;66(5):447-447. doi:10.1136/thx.2010.134429
25. Selvi A, Diakou M, Giannopoulos S, Zikou AK, Argyropoulou MI, Kyritsis AP. Cerebral Venous Thrombosis in a Patient with Sarcoidosis. Intern Med. 2009;48(9):723-725. doi:10.2169/internalmedicine.48.1809
26. Swigris JJ, Olson AL, Huie TJ, et al. Increased Risk of Pulmonary Embolism Among US Decedents With Sarcoidosis From 1988 to 2007. Chest. 2011;140(5):1261-1266. doi:10.1378/chest.11-0324
27. Marc K, Bourkadi JE, Benamor J, Iraqi G. Thrombose veineuse thoracique au cours de la sarcoïdose. Rev Mal Respir. 2008;25(1):105-106. doi:10.1016/S0761-8425(08)70477-7
28. Silvariño R, Danza Á, Mérola V, et al. Venous thromboembolic disease in systemic autoimmune diseases: An association to keep in mind. Autoimmunity Reviews. 2012;12(2):289-294. doi:10.1016/j.autrev.2012.05.002
29. Turetz M, Sideris A, Friedman O, Triphathi N, Horowitz J. Epidemiology, Pathophysiology, and Natural History of Pulmonary Embolism. Semin intervent Radiol. 2018;35(02):92-98. doi:10.1055/s-0038-1642036
30. Larsson J, Graff P, Bryngelsson IL, Vihlborg P. Sarcoidosis and increased risk of comorbidities and mortality in sweden. Sarcoidosis Vasc Diffuse Lung Dis. 2020;37(2):104-135. doi:10.36141/svdld.v37i2.9142
31. Baratella E, Bussani R, Zanconati F, et al. Radiological-pathological signatures of patients with COVID-19-related pneumomediastinum: is there a role for the Sonic hedgehog and Wnt5a pathways? ERJ Open Res. 2021;7(3):00346-2021. doi:10.1183/23120541.00346-2021
32. Kolluri N, Elwazir MY, Rosenbaum AN, et al. corticosteroid therapy in patients with cardiac sarcoidosis on frequency of venous thromboembolism. Am J Cardiol. 2021;149:112-118. doi:10.1016/j.amjcard.2021.03.017
33. Johannesdottir SA, Horváth-Puhó E, Dekkers OM, et al. Use of glucocorticoids and risk of venous thromboembolism: A nationwide population-based case-control study. JAMA Intern Med. 2013;173(9):743. doi:10.1001/jamainternmed.2013.122
34. Meduri GU, Annane D, Confalonieri M, et al. Pharmacological principles guiding prolonged glucocorticoid treatment in ARDS. Intensive Care Med. 2020;46(12):2284-2296. doi:10.1007/s00134-020-06289-8
35. Nicolosi S, Chernovsky M, Angoni D, et al. Gastrointestinal Manifestations of Sarcoidosis: A State-of-the-Art, Comprehensive Review of the Literature-Practical Clinical Insights and Many Unmet Needs on Diagnosis and Treatment. Pharmaceuticals (Basel). 2024;17(9):1106. doi:10.3390/ph17091106
36. Reitsma PH, Rosendaal FR. Activation of innate immunity in patients with venous thrombosis: the Leiden Thrombophilia Study. Journal of Thrombosis and Haemostasis. 2004;2(4):619-622. doi:10.1111/j.1538-7836.2004.00689.x
37. Ruaro B, Confalonieri P, Santagiuliana M, et al. Correlation between Potential Risk Factors and Pulmonary Embolism in Sarcoidosis Patients Timely Treated. J Clin Med. 2021;10(11):2462. doi:10.3390/jcm10112462
38. Takizawa H, Satoh M, Okazaki H, et al. Increased IL-6 and IL-8 in bronchoalveolar lavage fluids (BALF) from patients with sarcoidosis: correlation with the clinical parameters. Clinical and Experimental Immunology. 2003;107(1):175-181. doi:10.1046/j.1365-2249.1997.d01-905.x
39. Goljan-Geremek A, Geremek M, Puscinska E, Sliwinski P. Venous thromboembolism and sarcoidosis: co-incidence or coexistence? cejoi. 2015;4:477-480. doi:10.5114/ceji.2015.56972
40. Zia A, Russell J, Sarode R, et al. Markers of coagulation activation, inflammation and fibrinolysis as predictors of poor outcomes after pediatric venous thromboembolism: A systematic review and meta-analysis. Thrombosis Research. 2017;160:1-8. doi:10.1016/j.thromres.2017.10.003
41. Ina Y, Takada K, Yamamoto M, Sato T, Ito S, Sato S. Antiphospholipid Antibodies. Chest. 1994;105(4):1179-1183. doi:10.1378/chest.105.4.1179
42. Carragoso A, Silva JR, Capelo J, Faria B, Gaspar O. A patient with sarcoidosis and antiphospholipid syndrome. European Journal of Internal Medicine. 2008;19(8):e80-e81. doi:10.1016/j.ejim.2008.01.020
43. Baughman RP, Hurtubise PE. Systemic immune response of patients with active pulmonary sarcoidosis. Clin Exp Immunol. 1985;61(3):535-541.
44. Sweiss NJ, Salloum R, Ghandi S, et al. Significant CD4, CD8, and CD19 Lymphopenia in Peripheral Blood of Sarcoidosis Patients Correlates with Severe Disease Manifestations. Zimmer J, ed. PLoS ONE. 2010;5(2):e9088. doi:10.1371/journal.pone.0009088
45. Vorselaars ADM, Snijder RJ, Grutters JC. Increased Number of Pulmonary Embolisms in Sarcoidosis Patients. Chest. 2012;141(3):826-827. doi:10.1378/chest.11-2514
46. Takahashi F, Toba M, Takahashi K, et al. Pulmonary sarcoidosis and antiphospholipid syndrome. Respirology. 2006;11(4):506-508. doi:10.1111/j.1440-1843.2006.00880.x
47. Gerke AK. Morbidity and mortality in sarcoidosis: Current Opinion in Pulmonary Medicine. 2014;20(5):472-478. doi:10.1097/MCP.0000000000000080
48. Cattelan F, Hysa E, Gotelli E, et al. Microvascular capillaroscopic abnormalities and occurrence of antinuclear autoantibodies in patients with sarcoidosis. Rheumatol Int. 2022;42(12):2199-2210. doi:10.1007/s00296-022-05190-5
49. Kobak S, Yilmaz H, Sever F, Duran A, Sen N, Karaarslan A. The Prevalence of Antinuclear Antibodies in Patients with Sarcoidosis. Autoimmune Diseases. 2014;2014:1-4. doi:10.1155/2014/351852
50. Weinberg I, Vasiliev L, Gotsman I. Anti-dsDNA antibodies in sarcoidosis. Seminars in Arthritis and Rheumatism. 2000;29(5):328-331. doi:10.1016/S0049-0172(00)80019-0
51. Starshinova AA, Malkova AM, Basantsova NY, et al. Sarcoidosis as an Autoimmune Disease. Front Immunol. 2020;10:2933. doi:10.3389/fimmu.2019.02933
52. Vitali C. Classification criteria for Sjogren’s syndrome: a revised version of the European criteria proposed by the American-European Consensus Group. Annals of the Rheumatic Diseases. 2002;61(6):554-558. doi:10.1136/ard.61.6.554
53. Santiago T, Santiago M, Rovisco J, et al. Coexisting primary Sjögren’s syndrome and sarcoidosis: coincidence, mutually exclusive conditions or syndrome? Rheumatol Int. 2014;34(11):1619-1622. doi:10.1007/s00296-014-3024-0
54. Wesemann D, Costenbader K, Coblyn J. Co-existing sarcoidosis, systemic lupus erythematosus and the antiphospholipid antibody syndrome: Case Reports and Discussion from the Brigham and Women’s Hospital Lupus Center. Lupus. 2009;18(3):202-205. doi:10.1177/0961203308100483
55. Kobak S, Sever F, Sivrikoz O, Karaarslan A. Coexistence of Ankylosing Spondylitis and Löfgren’s Syndrome. Case Reports in Rheumatology. 2014;2014:1-3. doi:10.1155/2014/747698
56. Linke M, Pham HTT, Katholnig K, et al. Chronic signaling via the metabolic checkpoint kinase mTORC1 induces macrophage granuloma formation and marks sarcoidosis progression. Nat Immunol. 2017;18(3):293-302. doi:10.1038/ni.3655
57. d’Alessandro M, Conticini E, Bergantini L, et al. PD1, CTLA4 and TIGIT Expression on T and NK Cells in Granulomatous Diseases: Sarcoidosis and ANCA-Associated Vasculitis. IJMS. 2022;24(1):256. doi:10.3390/ijms24010256
58. Farinha I, Ferreira PG. Salvage use of tofacitinib in sarcoidosis patient with refractory multiorgan involvement. Sarcoidosis, Vasculitis and Diffuse Lung Diseases. 2024;41(2):e2024019. doi:10.36141/svdld.v41i2.15655
59. Baughman RP, Niranjan V, Walker G, et al. Efzofitimod: a novel anti-inflammatory agent for sarcoidosis. Sarcoidosis, Vasculitis and Diffuse Lung Diseases. 2023;40(1):e2023011. doi:10.36141/svdld.v40i1.14396
60. Culver DA, Aryal S, Barney J, et al. Efzofitimod for the Treatment of Pulmonary Sarcoidosis. Chest. 2023;163(4):881-890. doi:10.1016/j.chest.2022.10.037
61. Kiani A, Eslaminejad A, Shafeipour M, et al. Spirometry, cardiopulmonary exercise testing and the six-minute walk test results in sarcoidosis patients. Sarcoidosis Vasc Diffuse Lung Dis. 2019;36(3):185-194. doi:10.36141/svdld.v36i3.7663
62. Torregiani C, Reale M, Confalonieri M, et al. Cardiopulmonary exercise testing complements both spirometry and nuclear imaging for assessing sarcoidosis stage and for monitoring disease activity. Sarcoidosis, Vasculitis and Diffuse Lung Diseases. 2024;41(1):e2024017. doi:10.36141/svdld.v41i1.15125
63. Vorselaars ADM, Wuyts WA, Vorselaars VMM, et al. Methotrexate vs Azathioprine in Second-line Therapy of Sarcoidosis. Chest. 2013;144(3):805-812. doi:10.1378/chest.12-1728
64. Santiago T, Santiago M, Ruaro B, Salvador MJ, Cutolo M, da Silva JAP. Ultrasonography for the Assessment of Skin in Systemic Sclerosis: A Systematic Review. Arthritis Care Res (Hoboken). 2019;71(4):563-574. doi:10.1002/acr.23597
65. Jamilloux Y, El Jammal T, Bert A, Sève P. L’hydroxychloroquine pour la sarcoïdose extra-pulmonaire non-sévère. La Revue de Médecine Interne. 2022;43(7):406-411. doi:10.1016/j.revmed.2022.04.030
Article Sidebar
Published
Dec 10, 2024
Article Details
How to Cite
1.
Pozzan R, Salton F, Confalonieri P, Trotta L, Barbieri M, Reccardini N, et al. Autoantibodies in sarcoidosis: Innocent bystander or promising biomarker for organ involvement?. Sarcoidosis Vasc Diffuse Lung Dis [Internet]. 2024 Dec. 10 [cited 2025 Jan. 22];41(4):e2024056. Available from: https://mattioli1885journals.com/index.php/sarcoidosis/article/view/16043
Issue
Section
Original Articles: Clinical Research
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Transfer of Copyright and Permission to Reproduce Parts of Published Papers.
Authors retain the copyright for their published work. No formal permission will be required to reproduce parts (tables or illustrations) of published papers, provided the source is quoted appropriately and reproduction has no commercial intent. Reproductions with commercial intent will require written permission and payment of royalties.
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
How to Cite
1.
Pozzan R, Salton F, Confalonieri P, Trotta L, Barbieri M, Reccardini N, et al. Autoantibodies in sarcoidosis: Innocent bystander or promising biomarker for organ involvement?. Sarcoidosis Vasc Diffuse Lung Dis [Internet]. 2024 Dec. 10 [cited 2025 Jan. 22];41(4):e2024056. Available from: https://mattioli1885journals.com/index.php/sarcoidosis/article/view/16043
