Monocytes and macrophages in chronic sarcoidosis pathology

Extract

Kaiser et al. [1] make a compelling case for T-lymphocytes in the pathogenesis of sarcoidosis, particularly when considering the initiation of granulomatous inflammation and patients with acute, self-resolving sarcoidosis (Lofgren's syndrome). However, in some situations it seems that T-cells are less important. For example, SCID (severe combined immunodeficient) mice, which have no lymphocytes, develop macrophage-rich granulomas when infected with mycobacteria [2]. In clinical practice, powerful suppression of T-lymphocytes with anti-rejection medication cannot prevent recurrence of granulomas in one third of patients who have undergone lung transplantation for pulmonary sarcoidosis [3].