Sarcoidosis

Abstract

Purpose of review: Research conducted in recent years has added to our current understanding of the epidemiologic, immune, and genetic factors involved in the pathogenesis of sarcoidosis.

Recent findings: Exposure to an environmental or occupational antigen in a genetically susceptible individual is thought to trigger an immunologic response. The cells and cytokines that lead to granuloma formation have been an area of active study. Certain human leukocyte antigen genes appear to play roles in susceptibility and disease phenotype, and two genome scans have identified candidate genes. A genetic susceptibility has been suggested for ocular involvement as well. High-resolution computed tomography has been invaluable in selected patients, and new radionucleotide techniques are currently being developed. The tumor necrosis factor alpha antagonist infliximab has been used successfully in cases of refractory sarcoidosis, whereas the use of etanercept in the treatment of sarcoidosis has been disappointing, and may actually cause the disease.

Summary: Recent advances in our understanding of the immunologic events in sarcoidosis may lead to developments in treatments that would further decrease systemic and ocular morbidity.