Clinical Course of Sarcoidosis in World Trade Center-Exposed Firefighters

Hena, K.M.; Yip, Jennifer; Jaber, Nadia; Goldfarb, David G.; Fullam, Kelly; Cleven, Krystal L.; Moir, William; Webber, Mayris P.; Spevack, Daniel M.; Judson, Marc A.; Maier, Lisa A.; Krumerman, Andrew; Aizer, Anthony; Spivack, Simon D.; Berman, Jessica; Aldrich, Thomas K.; Prezant, David J.; Christodoulou, Vasilios; Hena, Zachary; Plotycia, Steven M.; Soghier, Israa; Gritz, David C.; Acuna, Dianne S.; Weiden, Michael D.; Nolan, Anna; Diaz, Keith M.; Ortiz, Viola; Kelly, Kerry J.

doi:10.1016/j.chest.2017.10.014

Cited by 47 publications

(50 citation statements)

References 27 publications

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“…An association between the HLA-DQB1*0601 allele and cardiac sarcoidosis was also identified in the Japanese cohort [35]. Interestingly, it is well-known that exposure to mineral and nanoparticles (NNPs) during the NYC World Trade Center disaster in September 2001 has been a predisposing factor to "sarcoidosis-like" granulomatous pulmonary disease among New York Fire Department rescue workers [36]. Even in this highly environmental inducing context, it was recently shown that more that seventeen novel HLA alleles were associated with an increased risk of sarcoidosis in exposed individuals, with OR values varying from 1.66 (HLA-DPA1/HLA-DPB1) to 5.21 (HLA-DRB1) [37].…”

Section: Contribution Of Gwas To Understanding Immunogenetics Of Sarcmentioning

confidence: 90%

Current Insights in Genetics of Sarcoidosis: Functional and Clinical Impacts

Calender

Weichhart

Valeyre

et al. 2020

JCM

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Sarcoidosis is a complex disease that belongs to the vast group of autoinflammatory disorders, but the etiological mechanisms of which are not known. At the crosstalk of environmental, infectious, and genetic factors, sarcoidosis is a multifactorial disease that requires a multidisciplinary approach for which genetic research, in particular, next generation sequencing (NGS) tools, has made it possible to identify new pathways and propose mechanistic hypotheses. Codified treatments for the disease cannot always respond to the most progressive forms and the identification of new genetic and metabolic tracks is a challenge for the future management of the most severe patients. Here, we review the current knowledge regarding the genes identified by both genome wide association studies (GWAS) and whole exome sequencing (WES), as well the connection of these pathways with the current research on sarcoidosis immune-related disorders.

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Section: Contribution Of Gwas To Understanding Immunogenetics Of Sarcmentioning

confidence: 90%

Current Insights in Genetics of Sarcoidosis: Functional and Clinical Impacts

Calender

Weichhart

Valeyre

et al. 2020

JCM

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“…Asymptomatic sarcoidosis may be identified in respiratory surveillance programmes and its early radiological stages can be very difficult to distinguish from CWP or silicosis. There is mounting evidence suggesting a relationship between sarcoidosis and occupational and environmental exposures [27,28], supported by epidemiological studies [29]. Sarcoidosis likely arises from several triggers, with underlying predisposing factors.…”

Section: Other Interstitial Lung Diseasesmentioning

confidence: 99%

Respiratory surveillance in mineral dust-exposed workers

Yates¹

2020

Breathe

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Recently, there has been a worldwide resurgence in pneumoconiosis, or pulmonary fibrosis due to occupational mineral dust exposure. In Queensland, Australia, there has been a re-emergence of coal workers' pneumoconiosis and silicosis. Some coal mining communities have experienced a resurgence of progressive massive fibrosis in the USA and a worldwide epidemic is occurring of accelerated silicosis due to exposure to artificial stone.These diseases are all preventable and should not be occurring in the 21st century. Best practice prevention includes reduction of exposure to mineral dusts or, ideally, prevention of exposure altogether. However, where dust exposure has occurred, respiratory surveillance can provide a strategy for early disease detection. It is important to identify early signs of occupational lung disease at a stage where intervention may be beneficial, though it must be acknowledged that progression may occur even after cessation of exposure to dusts. Respiratory surveillance should be distinguished from population screening and case finding, which are different methods used for disease investigation and control. Designing an ideal respiratory surveillance programme is challenging, as there is no single test that accurately identifies early disease. Several different respiratory disorders may occur related to the same exposure(s). Physicians organising and interpreting tests used in respiratory surveillance must be aware of the broad range of potential work-related respiratory conditions, complexities in diagnosis, and appropriate interpretation of the exposure history, as well as current management options. A working knowledge of the compensation and medicolegal avenues available to workers in individual jurisdictions is also useful.Key pointsMineral dust exposure causes a number of conditions, including those specific to dust exposures, such as the pneumoconioses (or pulmonary fibroses due to mineral dust exposure), and others that may additionally be related to other causes, such as COPD.Identification of multiple conditions using respiratory investigations requires expert interpretation and understanding of the range of potential conditions.The frequency and content of a respiratory surveillance programme will vary according to the relevant occupational exposures, and be affected by both medical and nonmedical factors, including the background prevalence of local diseases. A programme will also need to consider other factors such as local legislation, availability of resources, worker convenience and cost.Educational aimsTo identify the large range of respiratory diseases caused by exposure to mineral dusts and identify the range of tests that may be used in a surveillance programme for occupational respiratory disorders.To highlight difficulties that might be experienced by medical practitioners in designing and operating an effective surveillance programme, while incorporating rapidly advancing medical technology and practice.

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“…Because of the extremely high sensitivity and specificity of cardiac MRI for the diagnosis of cardiac sarcoidosis, some have advocated incorporating this "diagnostic test" into the screening algorithm for cardiac sarcoidosis. 57,67 Although the cardiac MRI may be an unattractive screening test for cardiac sarcoidosis on the basis of its exorbitant cost, diagnostic tests such as the cardiac MRI as well as the cardiac PET may be useful not only to diagnose cardiac sarcoidosis but also to provide prognostic information concerning the likelihood of future adverse events. 68,69 Another analysis of a Polish sarcoidosis cohort developed a point system to predict the likelihood of cardiac sarcoidosis.…”

Section: Heartmentioning

confidence: 99%

Screening Sarcoidosis Patients for Occult Disease

Judson

2020

Semin Respir Crit Care Med

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As sarcoidosis may involve any organ, sarcoidosis patients should be evaluated for occult disease. Screening for some organ involvement may not be warranted if it is unlikely to cause symptoms, organ dysfunction, or affect clinical outcome. Even organ involvement that affects clinical outcome does not necessarily require screening if early detection fails to change the patient's quality of life or prognosis. On the other hand, early detection of some forms of sarcoidosis may improve outcomes and survival. This manuscript describes the approach to screening sarcoidosis patients for previously undetected disease. Screening for sarcoidosis should commence with a meticulous medical history and physical examination. Many sarcoidosis patients present with physical signs or symptoms of sarcoidosis that have not been recognized as manifestations of the disease. Detection of sarcoidosis in these instances depends on the clinician's familiarity with the varied clinical presentations of sarcoidosis. In addition, sarcoidosis patients may present with symptoms or signs that are not related to specific organ involvement that have been described as parasarcoidosis syndromes. It is conjectured that parasarcoidosis syndromes result from systemic release of inflammatory mediators from the sarcoidosis granuloma. Certain forms of sarcoidosis may cause permanent and serious problems that can be prevented if they are detected early in the course of their disease. These include (1) ocular involvement that may lead to permanent vision impairment; (2) vitamin D dysregulation that may lead to hypercalcemia, nephrolithiasis, and permanent kidney injury; and (3) cardiac sarcoidosis that may lead to a cardiomyopathy, ventricular arrhythmias, heart block, and sudden death. Screening for these forms of organ involvement requires detailed screening approaches.

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Clinical Course of Sarcoidosis in World Trade Center-Exposed Firefighters

Cited by 47 publications

References 27 publications

Current Insights in Genetics of Sarcoidosis: Functional and Clinical Impacts

Current Insights in Genetics of Sarcoidosis: Functional and Clinical Impacts

Respiratory surveillance in mineral dust-exposed workers

Screening Sarcoidosis Patients for Occult Disease

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