Focus on Sarcoidosis
- Cutoffs for most of the phenotypic measures used to assess sarcoidosis distinguished groups of sarcoidosis patients with differing OIPs over the subsequent 6 months. The patients’ global assessment of their disease was the most accurate of these measures.
- To study how demographic differences impact disease manifestation of sarcoidosis using the WASOG tool in a large multicentric study.
- The most common causes of disability and death from sarcoidosis are directly or indirectly related to complications of fibrotic lung disease . Fibrosis develops in up to 20% of pulmonary sarcoidosis patients [2,3] and may result in end-stage parenchymal lung disease . Fibrotic pulmonary sarcoidosis is associated with distortion of airways leading to airflow obstruction, bronchiectasis, and increased episodes of clinical worsening that are often related to pulmonary infections [4–7]. Sarcoidosis associated pulmonary hypertension is caused by a variety of mechanisms, but the most common of these is distortion of the pulmonary vasculature from fibrosis [8,9].
- Although it is the general consensus that sarcoidosis patients who present with sarcoidosis-related symptoms have a worse outcome than patients whose disease is detected incidentally without symptoms, this premise has not been rigorously examined.
- Several drugs have been associated with druginduced sarcoidosis-like reactions (DISRs) that are clinically indistinguishable from sarcoidosis. Daclizumab is a humanized monoclonal IgG1 antibody that binds to CD25 that has been studied for the treatment of multiple sclerosis (MS). During MS clinical trials of daclizumab, 12 subjects developed clinical conditions potentially consistent with sarcoidosis. Therefore, an independent adjudication committee of individuals with expertise in sarcoidosis was organized to determine the likelihood of these cases representing sarcoidosis.
- Cardiac sarcoidosis is a potentially life-threatening form of the disease. Although most sarcoidosis-related deaths result from lung involvement, most of these deaths occur after years of the slow development of lung fibrosis from granulomatous inflammation [1,2]. Contrary to pulmonary sarcoidosis, cardiac sarcoidosis may cause life-threatening events and severe organ dysfunction relatively quickly because of myocardial granulomas deposited in unfortunate locations. Furthermore, myocardial sarcoid granulomas tend to progress relatively quickly to scar  that does not respond to anti-granulomatous therapy and is permanent.
- Sarcoidosis remains an enigmatic disease. Its cause is unknown, the indications for treatment are often unclear, and its natural history is variable. An additional important enigmatic issue that has hampered clinical sarcoidosis research is the failure to develop reliable and universally accepted clinical endpoints.
- With this editorial, my Editorial Board Members and I launch the maiden voyage of Respiratory Medicine: Focus on Sarcoidosis, a companion journal of Respiratory Medicine. The journal's scope will encompass the etiology, immunopathogenesis, diagnosis, clinical manifestations, natural history, treatment, and outcomes of sarcoidosis. The journal will devote a significant amount of space to extrapulmonary sarcoidosis, in addition to pulmonary sarcoidosis.