Preprint Review Version 1 Preserved in Portico This version is not peer-reviewed

Sarcoidosis, Mycobacterium paratuberculosis and Noncaseating Granulomas: Who Moved My Cheese

Version 1 : Received: 2 March 2023 / Approved: 7 March 2023 / Online: 7 March 2023 (03:46:55 CET)

A peer-reviewed article of this Preprint also exists.

Dow, C.T.; Lin, N.W.; Chan, E.D. Sarcoidosis, Mycobacterium paratuberculosis and Noncaseating Granulomas: Who Moved My Cheese. Microorganisms 2023, 11, 829. Dow, C.T.; Lin, N.W.; Chan, E.D. Sarcoidosis, Mycobacterium paratuberculosis and Noncaseating Granulomas: Who Moved My Cheese. Microorganisms 2023, 11, 829.

Abstract

Clinical and histological similarities between sarcoidosis and tuberculosis have driven repeated investigations looking for a mycobacterial cause of sarcoidosis. Over 50 years ago “anonymous mycobacteria” were suggested to have a role in the etiology of sarcoidosis. Both tuberculosis and sarcoidosis have a predilection for lung involvement though each can be found in any area of the body. A key histopathologic feature of both sarcoidosis and tuberculosis is the granuloma – while the tuberculous caseating granuloma has an area of caseous necrosis with a cheesy consistency; the non-caseating granuloma of sarcoidosis does not have this feature. This article reviews and reiterates the complicity of the infectious agent, Mycobacterium avium ss. paratuberculosis (MAP) as a cause of sarcoidosis. MAP is involved in a parallel story as the putative cause of Crohn’s disease, another disease featuring noncaseating granulomas. MAP is a zoonotic agent infecting ruminant animals and is found in dairy products and in environmental contamination of water and air. Despite increasing evidence tying MAP to several human diseases, there is a continued resistance to embracing its pleiotropic roles. "Who Moved My Cheese" is a simple yet powerful book that explores the ways in which individuals react to change. Extending the metaphor, the “non-cheesy” granuloma of sarcoidosis actually contains the difficult-to-detect “cheese”, MAP; MAP did not move, it was there all along.

Keywords

sarcoidosis; Mycobacterium avium ss. paratuberculosis; MAP; non-caseating granuloma; caseating granuloma; Blau syndrome; early onset sarcoidosis; Crohn’s disease; cell wall deficient (CWD); L-form; Mycobacterium tuberculosis; acid-fast bacilli; SLC11a1 (NRAMP1); NOD2 (CARD15)

Subject

Medicine and Pharmacology, Pathology and Pathobiology

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