Sarcoidosis, asthma, and asthma-like symptoms among occupants of a historically water-damaged office building

Laney, A. Scott; Cragin, Lori A.; Blevins, Lynn Zanardi; Sumner, Austin; Cox‐Ganser, Jean M.; Kreiss, Kathleen; Moffatt, Sharon; Lohff, Cortland

doi:10.1111/j.1600-0668.2008.00564.x

Cited by 43 publications

(45 citation statements)

References 24 publications

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“…The latter is likely related to fungal contamination coexisting with damp buildings and supports the role of moulds and musty environments as precipitants of ‘sarcoidosis’ 30. Occupants of historically water-damaged premises have been shown to have a high prevalence of new-onset sarcoidosis 65. Metalworking-fluid associated ‘sarcoidosis’ might also be due to bacterial or fungal contamination of the liquids and generated aerosols.…”

Section: Environmental Factorsmentioning

confidence: 94%

Sarcoidosis: the links between epidemiology and aetiology

Dubrey

Shah

Hardman³

et al. 2014

Postgraduate Medical Journal

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Sarcoidosis is a multisystem inflammatory disease, the aetiology of which has still to be resolved. The proposed mechanism is that a susceptible genotype is exposed to one or more potential antigens. A sustained inflammatory response follows, which ultimately results in pathognomonic granuloma formation. Various clinical phenotypes exist with specific genetic associations influencing disease susceptibility, protection, and clinical progression. Occupational and environmental factors, including microbial elements, may then effect the development of this disease. Sarcoidosis is a heterogeneous disease, showing geographic and racial variation in clinical presentation. It demonstrates a familial tendency and clear genotype associations. Additionally, it appears to cluster within closely associated populations (eg, work colleagues) and appears to be related to selected occupations and environmental exposures. Frequently occult, but occasionally fatal, this disease has a very variable prognosis. It is also unusual in having no specific biomarker. The epidemiology and multiple factors that appear to influence the aetiology of sarcoidosis illustrate why this disease state is frequently described as a clinical enigma.

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Section: Environmental Factorsmentioning

confidence: 94%

Sarcoidosis: the links between epidemiology and aetiology

Dubrey

Shah

Hardman³

et al. 2014

Postgraduate Medical Journal

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“…They work in an environment with high levels of aerosolized organic humidity laden materials. New cases of sarcoidosis were found among persons in an office building with mould problems [Laney et al 2009]. …”

Section: Introductionmentioning

confidence: 99%

Antifungal medication is efficient in the treatment of sarcoidosis

Terčelj

Salobir

Zupančič

et al. 2011

Ther Adv Respir Dis

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Abstract:Objectives: Fungi have been suspected of contributing to the pathogenesis of sarcoidosis. A previous intervention study demonstrated an improvement in the clinical condition in 15 out of 18 patients with a long-term history of sarcoidosis when antifungal medication was added to corticosteroids. The present study was performed to compare the effects of antifungal treatment with corticosteroid treatment in sarcoidosis. Methods: Patients with newly diagnosed sarcoidosis were recruited. Corticosteroids were given to 39 subjects, corticosteroid þ antifungal to 31, and antifungal only to 22 subjects. The effects of the treatments were evaluated at 6 months. X-ray scores were measured before and after treatment together with pulmonary diffusion capacity and two markers of sarcoidosis activity, that is, angiotensin-converting enzyme in serum (sACE) and chitotriosidase (CTO). Results: X-ray scores as well as sACE and CTO decreased significantly in all groups. The X-ray score decreased slightly more among subjects in the groups that received antifungal medication compared with corticosteroids only (p < 0.001). Conclusion:The results suggest that antifungal treatment is as efficient as corticosteroid treatment against the granulomatous and inflammatory manifestations of sarcoidosis. This is probably because this treatment is directed towards the causative agent. Additional studies are required to define the phenotype, where the antifungal treatment was not efficient (4/22) and to perform long-term follow up to determine the risk of recurrence.

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“…A link between sarcoidosis and fungi was established through epidemiological studies with fungi exposure correlating to increased risk of sarcoidosis [124][125][126]. Analyzing BAL fluid of sarcoidosis patients, Tercelj, et al were able to detect increased levels of the fungal cell wall component β-glucan, which has previously shown immunomodulatory effects and granuloma inducing potential [127].…”

Section: Antimicrobialmentioning

confidence: 99%

Sarcoidosis: Unknown Etiology and Genetic Predisposition Provides Therapeutic Challenges

Rotsinger

Drake²

2014

J Pulm Respir Med

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Sarcoidosis is an idiopathic multisystem disorder characterized by noncaseating epithelioid granulomas predominately affecting lungs and lymph nodes, but with potential to affect any organ system. Sarcoidosis shares similarities in development to other infectious granulomatous diseases, such as berylliosis and tuberculosis; however, its elusive etiology and non-distinctive histology have provided many diagnostic challenges. Evidence of a transferrable antigen combined with a high incidence rate in the lungs has focused efforts primarily on antigens with airborne transmissibility. While Mycobacterium tuberculosis and Propionibacterium acnes have provided strong associations to implicate each as a contributor to sarcoidosis pathogenesis, detection challenges remain and consensus of a definitive antigen is lacking.

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Sarcoidosis, asthma, and asthma-like symptoms among occupants of a historically water-damaged office building

Cited by 43 publications

References 24 publications

Sarcoidosis: the links between epidemiology and aetiology

Sarcoidosis: the links between epidemiology and aetiology

Antifungal medication is efficient in the treatment of sarcoidosis

Sarcoidosis: Unknown Etiology and Genetic Predisposition Provides Therapeutic Challenges

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