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Immunohistochemical Detection of Potential Microbial Antigens in Granulomas in the Diagnosis of Sarcoidosis

1
Department of Human Pathology, Graduate School and Faculty of Medicine, Tokyo Medical and Dental University, Tokyo 113-8519, Japan
2
Department of Pulmonology, Shinjuku Tsurukame Clinic, Tokyo 151-0053, Japan
3
Department of Pneumology, Ruhrlandklinik, Medical Faculty, University of Duisburg-Essen, 45239 Essen, Germany
4
Nutrition Innovation Centre for Food and Health (NICHE), School of Biomedical Sciences, Ulster University, Coleraine BT52 1SA, UK
5
Department of General and Experimental Pathology, Ruhr University, 44801 Bochum, Germany
*
Author to whom correspondence should be addressed.
Academic Editor: Moritz Wildgruber
J. Clin. Med. 2021, 10(5), 983; https://doi.org/10.3390/jcm10050983
Received: 11 January 2021 / Revised: 17 February 2021 / Accepted: 23 February 2021 / Published: 2 March 2021
(This article belongs to the Special Issue New Frontiers in the Diagnosis of Sarcoidosis)
Sarcoidosis may have more than a single causative agent, including infectious and non-infectious agents. Among the potential infectious causes of sarcoidosis, Mycobacterium tuberculosis and Propionibacterium acnes are the most likely microorganisms. Potential latent infection by both microorganisms complicates the findings of molecular and immunologic studies. Immune responses to potential infectious agents of sarcoidosis should be considered together with the microorganisms detected in sarcoid granulomas, because immunologic reactivities to infectious agents reflect current and past infection, including latent infection unrelated to the cause of the granuloma formation. Histopathologic data more readily support P. acnes as a cause of sarcoidosis compared with M. tuberculosis, suggesting that normally symbiotic P. acnes leads to granuloma formation in some predisposed individuals with Th1 hypersensitivity against intracellular proliferation of latent P. acnes, which may be triggered by certain host or drug-induced conditions. Detection of bacterial nucleic acids in granulomas does not necessarily indicate co-localization of the bacterial proteins in the granulomas. In the histopathologic diagnosis of sarcoidosis, M. tuberculosis-associated and P. acnes-associated sarcoidosis will possibly be differentiated in some patients by immunohistochemistry with appropriate antibodies that specifically react with mycobacterial and propionibacterial antigens, respectively, for each etiology-based diagnosis and potential antimicrobial intervention against sarcoidosis. View Full-Text
Keywords: pathogenesis; quantitative PCR; hypersensitivity; immunohistochemistry; symbiosis; endogenous infection; Propionibacterium acnes; Corynebacterium parvum; Cutibacterium acnes; Mycobacterium tuberculosis pathogenesis; quantitative PCR; hypersensitivity; immunohistochemistry; symbiosis; endogenous infection; Propionibacterium acnes; Corynebacterium parvum; Cutibacterium acnes; Mycobacterium tuberculosis
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MDPI and ACS Style

Yamaguchi, T.; Costabel, U.; McDowell, A.; Guzman, J.; Uchida, K.; Ohashi, K.; Eishi, Y. Immunohistochemical Detection of Potential Microbial Antigens in Granulomas in the Diagnosis of Sarcoidosis. J. Clin. Med. 2021, 10, 983. https://doi.org/10.3390/jcm10050983

AMA Style

Yamaguchi T, Costabel U, McDowell A, Guzman J, Uchida K, Ohashi K, Eishi Y. Immunohistochemical Detection of Potential Microbial Antigens in Granulomas in the Diagnosis of Sarcoidosis. Journal of Clinical Medicine. 2021; 10(5):983. https://doi.org/10.3390/jcm10050983

Chicago/Turabian Style

Yamaguchi, Tetsuo, Ulrich Costabel, Andrew McDowell, Josune Guzman, Keisuke Uchida, Kenichi Ohashi, and Yoshinobu Eishi. 2021. "Immunohistochemical Detection of Potential Microbial Antigens in Granulomas in the Diagnosis of Sarcoidosis" Journal of Clinical Medicine 10, no. 5: 983. https://doi.org/10.3390/jcm10050983

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