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Many<jats:italic>P. acnes<\/jats:italic>have been detected in sarcoid lymph nodes using quantitative PCR and in sarcoid granulomas by<jats:italic>in situ<\/jats:italic>hybridization.<jats:italic>P. acnes<\/jats:italic>trigger factor protein causes a cellular immune response only in sarcoid patients and induces pulmonary granulomas in mice sensitized with the protein and adjuvant, but only those with latent<jats:italic>P. acnes<\/jats:italic>infection in their lungs. Eradication of<jats:italic>P. acnes<\/jats:italic>by antibiotics prevents the development of granulomas in this experimental model. Although<jats:italic>P. acnes<\/jats:italic>is the most common commensal bacterium in the lungs and lymph nodes,<jats:italic>P. acnes<\/jats:italic>-specific antibody detected the bacterium within sarcoid granulomas of these organs.<jats:italic>P. acnes<\/jats:italic>can cause latent infection in the lung and lymph node and persist in a cell-wall-deficient form. The dormant form is activated endogenously under certain conditions and proliferates at the site of latent infection. In patients with<jats:italic>P. acnes<\/jats:italic>hypersensitivity, granulomatous inflammation is triggered by intracellular proliferation of the bacterium. Proliferating bacteria may escape granulomatous isolation, spreading to other organs. Latent<jats:italic>P. acnes<\/jats:italic>infection in systemic organs can be reactivated by another triggering event, leading to systemic sarcoidosis.<\/jats:p>","DOI":"10.1155\/2013\/935289","type":"journal-article","created":{"date-parts":[[2013,6,16]],"date-time":"2013-06-16T21:00:41Z","timestamp":1371416441000},"page":"1-18","source":"Crossref","is-referenced-by-count":83,"title":["Etiologic Aspect of Sarcoidosis as an Allergic Endogenous Infection Caused by<i>Propionibacterium acnes<\/i>"],"prefix":"10.1155","volume":"2013","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0521-1670","authenticated-orcid":true,"given":"Yoshinobu","family":"Eishi","sequence":"first","affiliation":[{"name":"Department of Human Pathology, Tokyo Medical and Dental University Graduate School, 1-5-45, Yushima, Bunkyo-ku, Tokyo 113-8510, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","reference":[{"key":"1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199704243361706"},{"issue":"2","key":"2","first-page":"149","volume":"16","year":"1999","journal-title":"Sarcoidosis Vasculitis and Diffuse Lung Disease"},{"key":"3","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(03)12888-7"},{"key":"4","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.200402-249OC"},{"issue":"2","key":"5","first-page":"149","volume":"18","year":"2001","journal-title":"Sarcoidosis Vasculitis and Diffuse Lung Diseases"},{"key":"6","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2796.2003.01073.x"},{"key":"7","doi-asserted-by":"publisher","DOI":"10.1097\/01.mcp.0000239554.01068.94"},{"key":"8","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.40.1.198-204.2002"},{"key":"9","doi-asserted-by":"publisher","DOI":"10.1165\/rcmb.2010-0433TR"},{"key":"10","doi-asserted-by":"publisher","DOI":"10.1128\/IAI.00732-06"},{"issue":"3","key":"11","first-page":"256","volume":"17","year":"2000","journal-title":"Sarcoidosis Vasculitis and Diffuse Lung Diseases"},{"key":"12","doi-asserted-by":"publisher","DOI":"10.1007\/s10875-012-9700-5"},{"issue":"1","key":"13","doi-asserted-by":"crossref","first-page":"146","DOI":"10.1093\/clinids\/23.1.146","volume":"23","year":"1996","journal-title":"Clinical Infectious Diseases"},{"issue":"3","key":"14","first-page":"251","volume":"48","year":"1978","journal-title":"Japanese Journal of Experimental Medicine"},{"issue":"4","key":"15","first-page":"541","volume":"256","year":"1984","journal-title":"Zentralblatt f\u00fcr Bakteriologie Mikrobiologie und Hygiene. 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