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What Causes Sarcoidosis?
 Moderated by: Prof Trevor Marshall Page:  First Page Previous Page  1  2  3   
 

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Prof Trevor Marshall
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 Posted: Sat Nov 5th, 2011 17:55

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:)

be-well
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 Posted: Fri Mar 30th, 2012 07:45

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Chen and Moller's most recent paper on Sarcoidosis seems to summarise its findings with a message that says, well yes there is great progressive strides in understanding pathogenesis, but actually its not worth writing home about so lets leave it at that until the answers we seek knock on our door and say 'boo'.

Their first paper can be interpreted as a solid watertight basis to recommend immunostimulation as the most logical next step, particularly for those who are not in the latter stages of progressive th1 disease and therefore in a position to make faster progress, thus validating the pathway to recovery for others to consider.  The second then kills that off with its clinical directive to continue prescribing steroids as the only safe, sensible intervention even though they add, their role "remains uncertain".

What is it they are just not 'getting' if they are familiar with a MP intervention structure. I assume they have articulated their reservation at some point.  Is it partly due to the long years of universal reliance on steroids which feed into a faster disease progression and conceal  inflammatory data,  that has encouraged a lack of 'fire in the belly' for doctors to say hey, this really looks promising, let's give it a whirl, let's discuss it with our patients ?

Last edited on Fri Mar 30th, 2012 08:04 by be-well



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Prof Trevor Marshall
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 Posted: Fri Mar 30th, 2012 08:00

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The 'fire in the belly' is an issue, as Dr Om Sharma, from USC, effectively controls publication of any paper with 'sarcoidosis' in the title. Dr Sharma is the universally recognized peer-reviewer for sarcoidosis papers, and is on the editorial board of just about every pulmonology journal. Anger him, and you lose your path to publishing, your path to success.

But the problem runs deeper than that. Most pulmonologists have tried everything (their words). For example, Moller and Chen were trialling a minocycline /doxycycline therapy at one point. It didn't work. Therefore, microbes can't possibly be the cause of the disease (do you understand their logic in drawing that conclusion?). Similarly, the MP can't possibly work, either (by the same logic).

There is a simplicity in 20th Century clinical medicine which many physicians seem to hold dear. They need to release this, if they are to be successful in the 21st Century, but most seem to think that maintaining the status-quo should be their career goal.

Neither Moller or Chen have ever bothered to email or phone me, or contact any of my colleagues :X

..trevor..
 

wrotek
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 Posted: Sat Mar 31st, 2012 04:13

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It is amazing how they define success.

I once got letter from pulmunologist, asking for informations, who does biopsies for sarc patients and was himself diagnosed with sarc.



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Freddie Ash
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 Posted: Sat Mar 31st, 2012 08:05

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HI ALL

This is Fred in  WV.  My family doctor once (since I have been on the MP) to tell him how to diagnose another doctor patient of his with sarcoidosis.

Remember, we are all in this together and I am pulling for us.

Your friend in Sarcoidosis
Freddie



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be-well
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 Posted: Mon Apr 2nd, 2012 10:46

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" there are no clinically useful biomarkers that can assist the clinician in diagnosis, prognosis or assessment of treatment effects" (chen/moller). 

To claim stagnation at such close quarters for a promising way forward in treatment defies logic, particularly because both doctors will no doubt be familiar with the sum total of universal mortality and suffering from the  standard palliation.

Sarcoidosis does not belong exclusively to men of medicine.  Everyone whose life has been touched by it, has a vested interest.

I am familiar with the godlike aura of some 'status quo' clinicians over the years.  But what I have noticed more recently here in UK is a definate confusion about the subject of 'vitamin' D and more care in the benefit to risk equation before prescribing steroids.   A caution has been nurtured which is here to stay and more docs are delving deeper.  Things are moving!

I think pure Olmesartan will bring a closer more careful scrutiny to a wider audience in the very near future.











Last edited on Mon Apr 2nd, 2012 10:53 by be-well



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Dmitry
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 Posted: Mon Oct 5th, 2020 19:12

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Molecular Analysis of Sarcoidosis Granulomas Reveals Antimicrobial Targets
https://www.atsjournals.org/doi/full/10.1165/rcmb.2015-0212OC

Sarcoidosis is a granulomatous disease of unknown cause. Prior molecular and immunologic studies have confirmed the presence of mycobacterial virulence factors, such as catalase peroxidase and superoxide dismutase A, within sarcoidosis granulomas. Molecular analysis of granulomas can identify targets of known antibiotics classes. Currently, major antibiotics are directed against DNA synthesis, protein synthesis, and cell wall formation. We conducted molecular analysis of 40 sarcoidosis diagnostic specimens and compared them with 33 disease control specimens for the presence of mycobacterial genes that encode antibiotic targets. We assessed for genes involved in DNA synthesis (DNA gyrase A [gyrA] and DNA gyrase B), protein synthesis (RNA polymerase subunit β), cell wall synthesis (embCAB operon and enoyl reductase), and catalase peroxidase. Immunohistochemical analysis was conducted to investigate the locale of mycobacterial genes such as gyrA within 12 sarcoidosis specimens and 12 disease controls. Mycobacterial DNA was detected in 33 of 39 sarcoidosis specimens by quantitative real-time polymerase chain reaction compared with 2 of 30 disease control specimens (P < 0.001, two-tailed Fisher’s test). Twenty of 39 were positive for three or more mycobacterial genes, compared with 1 of 30 control specimens (P < 0.001, two-tailed Fisher’s test). Immunohistochemistry analysis localized mycobacterial gyrA nucleic acids to sites of granuloma formation in 9 of 12 sarcoidosis specimens compared with 1 of 12 disease controls (P < 0.01). Microbial genes encoding enzymes that can be targeted by currently available antimycobacterial antibiotics are present in sarcoidosis specimens and localize to sites of granulomatous inflammation. Use of antimicrobials directed against target enzymes may be an innovative treatment alternative.



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seanlane
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 Posted: Thu Oct 15th, 2020 23:41

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Trevor...didn't your Sarcoidosis succumb to Olmesartan and pulsed doses antibiotics?


Sean



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be-well
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 Posted: Mon Oct 19th, 2020 00:19

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possible cause of Sarcoidosis, turning the immune system on and off over time with immunosuppressants or environmental radiation

or some of the above with frequent ct scans or xrays often rationalised as necessary part of an annual check up.
or maybe long term chronic stress often caused by poverty induced from retiring from work early in life on 'medical grounds'.
some evidence for shift work patterns is also recognised as a contender

the 'old guard' is without question, one of the causes of Sarcoidosis.



____________________
mcs,chronic fatigue,hiatus hernia,grains intolerance,tinnitus,photosensitivity.
25-D-3.3,-1,25D-70,Dec 2014.25-D-18, 1,25D,45.Sept 2019.
Dmitry
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 Posted: Fri Oct 30th, 2020 11:38

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Immune reconstitution inflammatory syndrome associated with pulmonary sarcoidosis in an HIV-infected patient: an immunohistochemical study
https://pubmed.ncbi.nlm.nih.gov/22218523/
Sarcoidosis has been rarely described in literature as a cause of interstitial pulmonary disease associated with AIDS. This study reports a case of immune reconstitution inflammatory syndrome associated with pulmonary sarcoidosis in a patient with a history of previous pulmonary tuberculosis concomitant with HIV infection. Results of the immunohistochemical study of samples from the resected right lower lobe are described. Pathological findings suggest a role of Th1, Th2 and Th17 response in IRIS associated sarcoidosis.



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