Sarcoidosis

Lancet. 2003 Mar 29;361(9363):1111-8. doi: 10.1016/S0140-6736(03)12888-7.

Abstract

There have been several new insights into the cause and treatment of sarcoidosis. Studies of genetic variation have shown that specific genetic polymorphisms are associated with increased risk of disease or affect disease presentation. These polymorphisms include variation of MHC and cytokines such as tumour necrosis factor (TNF). Not all investigators have come to the same conclusion, suggesting an interaction of various factors, including the patient's ethnic origin. Treatment of sarcoidosis varies considerably. Patients with symptomatic disease for more than 2-5 years have been of particular interest. Corticosteroids remain the standard of care in such cases, but immunosuppressive drugs have proved steroid-sparing in many patients. New agents, including pentoxifylline, thalidomide, and infliximab have proved useful in selected cases. The effectiveness of these agents seems to lie in their ability to block TNF, especially in the treatment of chronic disease.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.
  • Review

MeSH terms

  • Adrenal Cortex Hormones / administration & dosage
  • Adrenal Cortex Hormones / therapeutic use*
  • African Continental Ancestry Group
  • European Continental Ancestry Group
  • Genes, MHC Class II / genetics
  • Humans
  • Immunosuppressive Agents / adverse effects
  • Immunosuppressive Agents / therapeutic use*
  • Macrophage Activation / drug effects
  • Macrophage Activation / genetics
  • Peptidyl-Dipeptidase A / genetics
  • Polymorphism, Genetic
  • Sarcoidosis / drug therapy*
  • Sarcoidosis / genetics
  • Tumor Necrosis Factor-alpha / genetics

Substances

  • Adrenal Cortex Hormones
  • Immunosuppressive Agents
  • Tumor Necrosis Factor-alpha
  • Peptidyl-Dipeptidase A