Short Communication: Possible association between sarcoidosis and fungal infection

Abstract

Sarcoidosis is a multisystem inflammatory disease of unidentified aetiology, which manifests as noncaseating granulomas. It is hypothesised that sarcoidosis has an antigenic or inflammatory trigger that initiates the immune reaction in a susceptible host. Research is focusing on the correlation between sarcoidosis and exposure to airborne antigens, such as tree pollen, insecticides, mouldy environments, and inorganic particles. There are indications, that microbial cell wall agents, particularly agents from fungi, even in the absence of clinical infections can cause a late hypersensitivity reaction leading to granulomas. The occurrence of bacterial or fungal infections in sarcoidosis was repeatedly described and DNA or proteins of microbial organisms have been found. Cladosporium species were significantly enriched in specimen of patients with sarcoidosis. It is presumed that different inhaled microbial exposures, including moisture damage, can increase the risk of sarcoidosis, a causal link between mould exposure and sarcoidosis could not yet be proven, but the analysis of tissue samples of patients with sarcoidosis by application of metagenomic sequencing and other techniques identified traces of several fungi.