SARCOIDOSIS. NEW COVID-19 INFECTION AND VACCINATION ISSUES

Aim.The aim of the study was to analyze the available publications devoted to the problem of the combination of the new infection COVID­19 and sarcoidosis, and the issues of vaccination in sarcoidosis. The urgency of the problem is dictated by the need to prevent infections in such granulomatosis as well as by the growing worldwide experience of vaccination against COVID­19. Material and methods. An analytical review of 50 publications in the scientific medical literature was performed. Results and discussion. A review of publications has shown that there is already an accumulation of data on the vaccination of sarcoidosis patients against other manageable infections. We did not come across any papers indicating that vaccinating sarcoidosis patients is dangerous. It remains intriguing to consider any antigenic factors as triggers of sarcoidosis in genetically predisposed individuals. But even from this point of view, an antigenically complete pathogen can play both the role of a trigger and the development of infection in a sarcoidosis patient with drug immunosuppression than a vaccine strain. Regarding vaccination in general and against COVID­19 in particular in advanced sarcoidosis is the statement that the patient should be vaccinated before the start of immunomodulating therapy. Conclusion. From the point of evidence­based medicine, the question of the safety and efficacy of vaccinating patients with sarcoidosis remains open. The current transnational position is based on the extrapolation of the experience with other vaccines for sarcoidosis and the use of COVID­19 vaccines for other diseases. Understanding COVID­19 as a severe life­threatening disease makes vaccination justified, the key position being to assess potential risks, to correct immunosuppressive therapy and, if possible, to vaccinate before the use of hormones and immunosuppressants.

Models Contribution to the Understanding of Sarcoidosis Pathogenesis: “Are There Good Models of Sarcoidosis?”

Sarcoidosis is a systemic, granulomatous, and noninfectious disease of unknown etiology. The clinical heterogeneity of the disease (targeted tissue(s), course of the disease, and therapy response) supports the idea that a multiplicity of trigger antigens may be involved. The pathogenesis of sarcoidosis is not yet completely understood, although in recent years, considerable efforts were put to develop novel experimental research models of sarcoidosis. In particular, sarcoidosis patient cells were used within in vitro 3D models to study their characteristics compared to control patients. Likewise, a series of transgenic mouse models were developed to highlight the role of particular signaling pathways in granuloma formation and persistence. The purpose of this review is to put in perspective the contributions of the most recent models in the understanding of sarcoidosis.