Targeting the mycobiome in sarcoidosis.

INTRODUCTION

Sacoidosis is a multisystem granulomatous disorder characterized by the formation of non-caseating granulomas in affected organs, predominantly the lungs and lymph nodes. Despite extensive research, its etiology remains elusive. Recent evidence suggests fungi may play a role in disease pathogenesis through immune modulation and chronic inflammation.

METHODS

We conducted a comprehensive fungal profiling study using samples from thirteen patients with confirmed sarcoidosis and five controls with other pulmonary diseases. Multiple specimen types were analyzed, including bronchoalveolar lavage fluid, lung tissue biopsies, and blood (both cultured and non-cultured). Fungal communities were characterized using ITS (Internal Transcribed Spacer) targeted sequencing followed by bioinformatic analysis.

RESULTS

Distinctive taxonomic patterns emerged in sarcoidosis samples. Several genera previously implicated in the pathogenesis of sarcoidosis were detected, including Penicillium, Mucor, Saccharomyces, and Yarrowia, which are regarded as potential pathogens. Sample type and processing method significantly influenced community composition, with cultured samples showing reduced diversity dominated by fast-growing taxa.

CONCLUSIONS

This study provides evidence of diverse fungal communities in sarcoidosis patients' blood and respiratory specimens, with potential immunomodulatory implications. Our findings integrate with existing epidemiologic and immunologic evidence highlighting fungi as credible antigenic drivers in sarcoidosis and suggest directions for future functional studies exploring fungal-host interactions in disease pathogenesis.