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Immunology of sarcoidosis: old companions, new relationships

Immunology of sarcoidosis: old companions, new relationships
Immunology of sarcoidosis: old companions, new relationships
Purpose of review: The immune determinants of granuloma formation and disease progression in sarcoidosis have not been completely disclosed, and the role of both innate and the adaptive immunity is still under investigation.

Recent findings: M2 macrophage polarization, previously thought to be a specific feature of a progressing and fibrosing disease, has been related to the initial steps of granuloma formation both in animal and in-vitro models. The dysregulation of specific metabolic pathways and autophagy has been associated with disease activity and progression. T cells have been reported to be strongly influenced by a macrophage-driven microenvironment and more dangerous when acquiring hybrid phenotypes (e.g. Th17.1) or even becoming anergic, leading to disease chronicization. Locally released serum amyloid A was suggested to induce a more pro-inflammatory Th17 transcription program. The possible role of in-situ humoral immunity and bone marrow-derived mesenchymal stromal cells has also been highlighted.

Summary: Evidence points at microenvironment and cell functional features rather than cell polarization or differentiation as determinants of pathogenesis. In terms of therapeutic implications, future advances will rely on molecular disease profiling, aiming at personalized and combined therapeutic approaches.
1078-1641
535-543
Cinetto, Francesco
27cc2f83-3263-4dbf-b47d-79854297161e
Scarpa, Riccardo
f325b095-dbe9-4a2f-b8e1-943ef123202e
Dell'Edera, Alessandro
11a028b7-2a92-4ebe-a8db-d6fded4ed122
Jones, Mark
a6fd492e-058e-4e84-a486-34c6035429c1
Cinetto, Francesco
27cc2f83-3263-4dbf-b47d-79854297161e
Scarpa, Riccardo
f325b095-dbe9-4a2f-b8e1-943ef123202e
Dell'Edera, Alessandro
11a028b7-2a92-4ebe-a8db-d6fded4ed122
Jones, Mark
a6fd492e-058e-4e84-a486-34c6035429c1

Cinetto, Francesco, Scarpa, Riccardo, Dell'Edera, Alessandro and Jones, Mark (2020) Immunology of sarcoidosis: old companions, new relationships. Current Opinion in Pulmonary Medicine, 26 (5), 535-543. (doi:10.1097/MCP.0000000000000711).

Record type: Review

Abstract

Purpose of review: The immune determinants of granuloma formation and disease progression in sarcoidosis have not been completely disclosed, and the role of both innate and the adaptive immunity is still under investigation.

Recent findings: M2 macrophage polarization, previously thought to be a specific feature of a progressing and fibrosing disease, has been related to the initial steps of granuloma formation both in animal and in-vitro models. The dysregulation of specific metabolic pathways and autophagy has been associated with disease activity and progression. T cells have been reported to be strongly influenced by a macrophage-driven microenvironment and more dangerous when acquiring hybrid phenotypes (e.g. Th17.1) or even becoming anergic, leading to disease chronicization. Locally released serum amyloid A was suggested to induce a more pro-inflammatory Th17 transcription program. The possible role of in-situ humoral immunity and bone marrow-derived mesenchymal stromal cells has also been highlighted.

Summary: Evidence points at microenvironment and cell functional features rather than cell polarization or differentiation as determinants of pathogenesis. In terms of therapeutic implications, future advances will rely on molecular disease profiling, aiming at personalized and combined therapeutic approaches.

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ImmunologyofSarcoid - Accepted Manuscript
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More information

Accepted/In Press date: 28 June 2020
e-pub ahead of print date: 20 July 2020
Published date: 1 September 2020

Identifiers

Local EPrints ID: 443813
URI: http://eprints.soton.ac.uk/id/eprint/443813
ISSN: 1078-1641
PURE UUID: df872d65-6efd-4bed-9bf9-b370231b122b
ORCID for Mark Jones: ORCID iD orcid.org/0000-0001-6308-6014

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Date deposited: 14 Sep 2020 16:31
Last modified: 30 Jun 2022 04:01

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Contributors

Author: Francesco Cinetto
Author: Riccardo Scarpa
Author: Alessandro Dell'Edera
Author: Mark Jones ORCID iD

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