New antigens in sarcoidosis

In search of an effective treatment strategy for sarcoidosis, candidate antigens, Aspergillus Nidulans, and vimentin (a T-cell autoantigen), have been recently identified. Given the involvement of these antigens in the underlying mechanisms of sarcoidosis, functional analyses are currently ongoing to assess whether targeting these components could offer future therapeutic options.

“The incidence of sarcoidosis in Sweden is 12/100,000 a year with 1,200 new cases a year,” explained Prof. Johan Grünewald (Karolinska Institute, Sweden). “Men show an early peak between the age of 30 to 40 years, whereas in women the peak occurs between the age of 50 to 60 years (sex hormones may play a role).” Although the origin of the disease is still largely unknown, it seems to develop as a result of a genetic predisposition in combination with external triggers (viruses, bacteria, etc.). Treatment options are limited, imposing a considerable unmet need. According to Prof. Grünewald, current research is aiming to identify specific sarcoidosis-antigens: i.e. to characterise the function of previously identified antigens and identify new biomarkers (e.g. IGRA). There are many possible antigens in sarcoidosis such as bacteria which prompt research. Recently, vimentin – a cytoskeletal protein – has been suggested to act as a T-cell auto-antigen, as it was identified in human leukocyte antigen molecules of sarcoidosis patients. Another candidate is Aspergillus Nidulans which is found in immunosuppressed individuals and is capable of triggering T-cells in sarcoidosis patients [1,2].

1. Greaves SA, et al. J Exp Med. 2021 Oct 4;218(10).
2. Grünewald J. Latest discoveries in the mechanisms of sarcoidosis. Nordic Lung Congress 2022, 01–03 June, Copenhagen, Denmark.

 

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Posted on 17 August 202216 August 2022