{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,9]],"date-time":"2026-01-09T20:22:33Z","timestamp":1767990153314,"version":"3.49.0"},"reference-count":121,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2022,8,15]],"date-time":"2022-08-15T00:00:00Z","timestamp":1660521600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"ZonMw","award":["10070012010004"],"award-info":[{"award-number":["10070012010004"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Microorganisms"],"abstract":"<jats:p>Cutibacterium acnes (C. acnes, formerly Propionibacterium acnes) is considered to be a non-pathogenic resident of the human skin, as well as mucosal surfaces. However, it also has been demonstrated that C. acnes plays a pathogenic role in diseases such as acne vulgaris or implant infections after orthopedic surgery. Besides a role in infectious disease, this bacterium also seems to harbor immunomodulatory effects demonstrated by studies using C. acnes to enhance anti-tumor activity in various cancers or vaccination response. Sarcoidosis is a systemic inflammatory disorder of unknown causes. Cultures of C. acnes in biopsy samples of sarcoidosis patients, its presence in BAL fluid, tissue samples as well as antibodies against this bacterium found in serum of patients with sarcoidosis suggest an etiological role in this disease. In this review we address the antigenic as well as immunomodulatory potential of C. acnes with a focus on sarcoidosis. Furthermore, a potential role for antibiotic treatment in patients with sarcoidosis will be explored.<\/jats:p>","DOI":"10.3390\/microorganisms10081649","type":"journal-article","created":{"date-parts":[[2022,8,15]],"date-time":"2022-08-15T20:58:08Z","timestamp":1660597088000},"page":"1649","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":17,"title":["The Role of Cutibacterium acnes in Sarcoidosis: From Antigen to Treatable Trait?"],"prefix":"10.3390","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5867-0750","authenticated-orcid":false,"given":"Raisa","family":"Kraaijvanger","sequence":"first","affiliation":[{"name":"Interstitial Lung Diseases Centre of Excellence, Department of Pulmonology, St. Antonius Hospital, 3435 CM Nieuwegein, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marcel","family":"Veltkamp","sequence":"additional","affiliation":[{"name":"Interstitial Lung Diseases Centre of Excellence, Department of Pulmonology, St. Antonius Hospital, 3435 CM Nieuwegein, The Netherlands"},{"name":"Division of Hearth and Lungs, University Medical Center Utrecht, 3584 CX Utrecht, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2022,8,15]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"244","DOI":"10.1038\/nrmicro2537","article-title":"The skin microbiome","volume":"9","author":"Grice","year":"2011","journal-title":"Nat. Rev. Microbiol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1149","DOI":"10.1586\/eri.11.137","article-title":"Propionibacterium acnes: Infection beyond the skin","volume":"9","author":"Perry","year":"2011","journal-title":"Expert Rev. Anti-Infect. Ther."},{"key":"ref_3","doi-asserted-by":"crossref","unstructured":"Portillo, M.E., Corvec, S., Borens, O., and Trampuz, A. (2013). Propionibacterium acnes: An underestimated pathogen in implant-associated infections. BioMed Res. Int., 2013.","DOI":"10.1155\/2013\/804391"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"326","DOI":"10.1128\/JCM.43.1.326-334.2005","article-title":"Propionibacterium acnes types I and II represent phylogenetically distinct groups","volume":"43","author":"McDowell","year":"2005","journal-title":"J. Clin. Microbiol."},{"key":"ref_5","doi-asserted-by":"crossref","unstructured":"McDowell, A., Nagy, I., Magyari, M., Barnard, E., and Patrick, S. (2013). The opportunistic pathogen Propionibacterium acnes: Insights into typing, human disease, clonal diversification and CAMP factor evolution. PLoS ONE, 8.","DOI":"10.1371\/journal.pone.0070897"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"218","DOI":"10.1099\/jmm.0.47489-0","article-title":"A new phylogenetic group of Propionibacterium acnes","volume":"57","author":"McDowell","year":"2008","journal-title":"J. Med. Microbiol."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"5","DOI":"10.1111\/jdv.15043","article-title":"Cutibacterium acnes (Propionibacterium acnes) and acne vulgaris: A brief look at the latest updates","volume":"32","author":"Corvec","year":"2018","journal-title":"J. Eur. Acad. Dermatol. Venereol."},{"key":"ref_8","doi-asserted-by":"crossref","unstructured":"Mayslich, C., Grange, P.A., and Dupin, N. (2021). Cutibacterium acnes as an opportunistic pathogen: An update of its virulence-associated factors. Microorganisms, 9.","DOI":"10.3390\/microorganisms9020303"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"773","DOI":"10.1111\/j.1468-3083.2006.01671.x","article-title":"A review of the European Directive for prescribing systemic isotretinoin for acne vulgaris","volume":"20","author":"Layton","year":"2006","journal-title":"J. Eur. Acad. Dermatol. Venereol."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"264","DOI":"10.4103\/ijabmr.IJABMR_469_16","article-title":"Retinoic acid embryopathy","volume":"7","author":"Mondal","year":"2017","journal-title":"Int. J. Appl. Basic Med. Res."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"2","DOI":"10.1016\/j.clindermatol.2009.03.012","article-title":"The role of Propionibacterium acnes in acne pathogenesis: Facts and controversies","volume":"28","author":"Dessinioti","year":"2010","journal-title":"Clin. Dermatol."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"2355","DOI":"10.1016\/j.jid.2018.05.032","article-title":"The anti-inflammatory activities of propionibacterium acnes CAMP factor-targeted acne vaccines","volume":"138","author":"Wang","year":"2018","journal-title":"J. Investig. Dermatol."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"419","DOI":"10.1128\/CMR.00092-13","article-title":"Propionibacterium acnes: From commensal to opportunistic biofilm-associated implant pathogen","volume":"27","author":"Achermann","year":"2014","journal-title":"Clin. Microbiol. Rev."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"S19","DOI":"10.1016\/j.otsr.2017.05.030","article-title":"Cutibacterium acnes prosthetic joint infection: Diagnosis and treatment","volume":"104","author":"Boisrenoult","year":"2018","journal-title":"Orthop. Traumatol. Surg. Res."},{"key":"ref_15","doi-asserted-by":"crossref","unstructured":"Br\u00fcggemann, H., Salar-Vidal, L., Gollnick, H.P.M., and Lood, R. (2021). A Janus-faced bacterium: Host-beneficial and -detrimental roles of cutibacterium acnes. Front. Microbiol., 12.","DOI":"10.3389\/fmicb.2021.673845"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"1333","DOI":"10.1128\/JCM.00096-09","article-title":"Pilot study of association of bacteria on breast implants with capsular contracture","volume":"47","author":"Tran","year":"2009","journal-title":"J. Clin. Microbiol."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"297","DOI":"10.1093\/asj\/sjv177","article-title":"The relationship of bacterial biofilms and capsular contracture in breast implants","volume":"36","author":"Ajdic","year":"2016","journal-title":"Aesthetic Surg. J."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"73","DOI":"10.1086\/588298","article-title":"Characteristics and treatment outcome of cerebrospinal fluid shunt\u2013associated infections in adults: A retrospective analysis over an 11-year period","volume":"47","author":"Conen","year":"2008","journal-title":"Clin. Infect. Dis."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"1878","DOI":"10.1128\/JCM.01686-08","article-title":"Microbiologic diagnosis of prosthetic shoulder infection by use of implant sonication","volume":"47","author":"Piper","year":"2009","journal-title":"J. Clin. Microbiol."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"1884","DOI":"10.1086\/588477","article-title":"Propionibacterium acnes postoperative shoulder arthritis: An emerging clinical entity","volume":"46","author":"Levy","year":"2008","journal-title":"Clin. Infect. Dis."},{"key":"ref_21","doi-asserted-by":"crossref","unstructured":"Davidsson, S., M\u00f6lling, P., Rider, J., Unemo, M., Karlsson, M.G., Carlsson, J., Andersson, S.-O., Elgh, F., S\u00f6derquist, B., and Andr\u00e9n, O. (2016). Frequency and typing of Propionibacterium acnes in prostate tissue obtained from men with and without prostate cancer. Infect. Agents Cancer, 11.","DOI":"10.1186\/s13027-016-0074-9"},{"key":"ref_22","doi-asserted-by":"crossref","unstructured":"Bidaud, A.-L., Karam, G., Kandel-Aznar, C., D\u2019Epenoux, L.R., Guillouzouic, A., B\u00e9mer, P., Leroy, A.-G., and Corvec, S. (2020). Low prevalence of Cutibacterium acnes in prostatic tissue biopsies in a French hospital. Anaerobe, 66.","DOI":"10.1016\/j.anaerobe.2020.102286"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"363","DOI":"10.1002\/pros.23742","article-title":"M2 macrophages and regulatory T cells in lethal prostate cancer","volume":"79","author":"Erlandsson","year":"2019","journal-title":"Prostate"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"40","DOI":"10.1002\/pros.23442","article-title":"FOXP3+ regulatory T cells in normal prostate tissue, postatrophic hyperplasia, prostatic intraepithelial neoplasia, and tumor histological lesions in men with and without prostate cancer","volume":"78","author":"Davidsson","year":"2018","journal-title":"Prostate"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"1177","DOI":"10.1007\/s00262-014-1591-2","article-title":"Correlation between frequencies of blood monocytic myeloid-derived suppressor cells, regulatory T cells and negative prognostic markers in patients with castration-resistant metastatic prostate cancer","volume":"63","author":"Idorn","year":"2014","journal-title":"Cancer Immunol. Immunother."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"289","DOI":"10.1016\/S0934-8840(11)80686-9","article-title":"Immunomodulation by propionibacteria","volume":"274","author":"Roszkowski","year":"1990","journal-title":"Zent. Bakteriol."},{"key":"ref_27","first-page":"535","article-title":"The effect of Propionibacterium acnes on maturation of dendritic cells derived from acne patients\u2019 peripherial blood mononuclear cells","volume":"46","author":"Tabarkiewicz","year":"2008","journal-title":"Folia Histochem. Cytobiol."},{"key":"ref_28","doi-asserted-by":"crossref","unstructured":"Talib, W.H., and Saleh, S. (2015). Propionibacterium acnes augments antitumor, anti-angiogenesis and immunomodulatory effects of melatonin on breast cancer implanted in mice. PLoS ONE, 10.","DOI":"10.1371\/journal.pone.0124384"},{"key":"ref_29","doi-asserted-by":"crossref","unstructured":"Tsuda, K., Yamanaka, K., Linan, W., Miyahara, Y., Akeda, T., Nakanishi, T., Kitagawa, H., Kakeda, M., Kurokawa, I., and Shiku, H. (2011). Intratumoral injection of Propionibacterium acnes suppresses malignant melanoma by enhancing Th1 immune responses. PLoS ONE, 6.","DOI":"10.1371\/journal.pone.0029020"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"15155","DOI":"10.1073\/pnas.251543698","article-title":"Combination bacteriolytic therapy for the treatment of experimental tumors","volume":"98","author":"Dang","year":"2001","journal-title":"Proc. Natl. Acad. Sci. USA"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"417","DOI":"10.4103\/0973-1482.103523","article-title":"Combination of Ononis hirta and Bifidobacterium longum decreases syngeneic mouse mammary tumor burden and enhances immune response","volume":"8","author":"Talib","year":"2012","journal-title":"J. Cancer Res. Ther."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"1905","DOI":"10.1158\/1078-0432.CCR-07-2050","article-title":"Toll-like receptor 4 mediates an antitumor host response induced by Salmonella choleraesuis","volume":"14","author":"Lee","year":"2008","journal-title":"Clin. Cancer Res."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"620","DOI":"10.1128\/iai.27.2.620-627.1980","article-title":"Investigation of the component of Propionibacterium acnes (Corynebacterium parvum) responsible for macrophage activation","volume":"27","author":"Buck","year":"1980","journal-title":"Infect. Immun."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"290","DOI":"10.1016\/0008-8749(73)90251-7","article-title":"Biological effects of Corynebacterium parvum: IV. Adjuvant and inhibitory activities on B lymphocytes","volume":"7","author":"Howard","year":"1972","journal-title":"Cell. Immunol."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"137","DOI":"10.1016\/0192-0561(83)90005-X","article-title":"Augmentation of NK activity by Corynebacterium parvum fractions in vivo and in vitro","volume":"5","author":"Lichtenstein","year":"1983","journal-title":"Int. J. Immunopharmacol."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"4531","DOI":"10.1200\/JCO.2009.27.2146","article-title":"Immune regulation of cancer","volume":"28","author":"Disis","year":"2010","journal-title":"J. Clin. Oncol."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"845","DOI":"10.1016\/j.intimp.2007.02.005","article-title":"Intravenous administration of MIP-1\u03b1 with intra-tumor injection of P. acnes shows potent anti-tumor effect","volume":"7","author":"Nakano","year":"2007","journal-title":"Int. Immunopharmacol."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"1945","DOI":"10.4049\/jimmunol.123.5.1945","article-title":"Immunotherapy of a murine ovarian carcinoma with Corynebacterium parvum and specific heteroantiserum. I. Activation of peritoneal cells to mediate antibody-dependent cytotoxicity","volume":"123","author":"Bast","year":"1979","journal-title":"J. Immunol."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"782","DOI":"10.1016\/0002-9378(77)90721-9","article-title":"Corynebacterium parvum as an immunotherapeutic agent in an ovarian cancer model","volume":"128","author":"Knapp","year":"1977","journal-title":"Am. J. Obstet. Gynecol."},{"key":"ref_40","first-page":"1871","article-title":"Immunotherapy with biochemically dissociated fractions of Propionibacterium acnes in a murine ovarian cancer model","volume":"44","author":"Berek","year":"1984","journal-title":"Cancer Res."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1007\/BF02123706","article-title":"The correlation of susceptibility of different Propionibacterium strains to macrophage killing and antitumor activity","volume":"169","author":"Roszkowski","year":"1980","journal-title":"Med. Microbiol. Immunol."},{"key":"ref_42","first-page":"692","article-title":"Preventive effect of Propionibacterium acnes on metastasis in mice rendered tolerant to tumor-associated transplantation antigens","volume":"71","author":"Fujiwara","year":"1980","journal-title":"GANN Jpn. J. Cancer Res."},{"key":"ref_43","doi-asserted-by":"crossref","unstructured":"Teixeira, D., Ishimura, M.E., Apostolico, J., Viel, J.M., Passarelli, V.C., Cunha-Neto, E., Rosa, D., and Longo-Maug\u00e9ri, I.M. (2018). Propionibacterium acnes enhances the immunogenicity of HIVBr18 human immunodeficiency virus-1 vaccine. Front. Immunol., 9.","DOI":"10.3389\/fimmu.2018.00177"},{"key":"ref_44","doi-asserted-by":"crossref","unstructured":"Squaiella-Baptist\u00e3o, C.C., Teixeira, D., Mussalem, J.S., Ishimura, M.E., and Longo-Maug\u00e9ri, I.M. (2015). Modulation of Th1\/Th2 immune responses by killed Propionibacterium acnes and its soluble polysaccharide fraction in a type I hypersensitivity murine model: Induction of different activation status of antigen-presenting cells. J. Immunol. Res., 2015.","DOI":"10.1155\/2015\/132083"},{"key":"ref_45","doi-asserted-by":"crossref","unstructured":"Mussalem, J.S., Squaiella-Baptist\u00e3o, C.C., Teixeira, D., Yendo, T.M., Thies, F.G., Popi, A.F., Mariano, M., and Longo-Maug\u00e9ri, I.M. (2012). Adjuvant effect of killed Propionibacterium acnes on mouse peritoneal B-1 lymphocytes and their early phagocyte differentiation. PLoS ONE, 7.","DOI":"10.1371\/journal.pone.0033955"},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.vetimm.2013.01.010","article-title":"A systematic review of the immune-modulators Parapoxvirus ovis and Propionibacterium acnes for the prevention of respiratory disease and other infections in the horse","volume":"153","author":"Paillot","year":"2013","journal-title":"Vet. Immunol. Immunopathol."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"399","DOI":"10.1016\/S0737-0806(06)80132-2","article-title":"Adjunct treatment of equine respiratory disease complex (ERDC) with the Propionibacterium acnes, immunostimulant, EqStim\u00ae","volume":"10","author":"Vail","year":"1990","journal-title":"J. Equine Vet. Sci."},{"key":"ref_48","first-page":"17","article-title":"Inactivated Propionibacterium acnes (immunoregulin) as adjunct to conventional therapy in the treatment of equine respiratory diseases","volume":"10","author":"Evans","year":"1998","journal-title":"Equine Pract."},{"key":"ref_49","doi-asserted-by":"crossref","unstructured":"Tchaptchet, S., Gumenscheimer, M., Kalis, C., Freudenberg, N., H\u00f6lscher, C., Kirschning, C.J., Lamers, M., Galanos, C., and Freudenberg, M.A. (2012). TLR9-dependent and independent pathways drive activation of the immune system by Propionibacterium acnes. PLoS ONE, 7.","DOI":"10.1371\/journal.pone.0039155"},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"4295","DOI":"10.4049\/jimmunol.174.7.4295","article-title":"Requirement for TLR9 in the immunomodulatory activity of Propionibacterium acnes","volume":"174","author":"Kalis","year":"2005","journal-title":"J. Immunol."},{"key":"ref_51","doi-asserted-by":"crossref","unstructured":"Holland, C., Mak, T.N., Zimny-Arndt, U., Schmid, M., Meyer, T.F., Jungblut, P.R., and Br\u00fcggemann, H. (2010). Proteomic identification of secreted proteins of Propionibacterium acnes. BMC Microbiol., 10.","DOI":"10.1186\/1471-2180-10-230"},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"97","DOI":"10.1016\/S0923-1811(02)00013-0","article-title":"Propionibacterium acnes-induced IL-8 production may be mediated by NF-\u03baB activation in human monocytes","volume":"29","author":"Chen","year":"2002","journal-title":"J. Dermatol. Sci."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"931","DOI":"10.1111\/j.0022-202X.2005.23705.x","article-title":"Distinct strains of Propionibacterium acnes induce selective human \u03b2-defensin-2 and interleukin-8 expression in human keratinocytes through toll-like receptors","volume":"124","author":"Nagy","year":"2005","journal-title":"J. Investig. Dermatol."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"2221","DOI":"10.1016\/j.jid.2016.06.615","article-title":"Different Propionibacterium acnes phylotypes induce distinct immune responses and express unique surface and secreted proteomes","volume":"136","author":"Yu","year":"2016","journal-title":"J. Investig. Dermatol."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"1535","DOI":"10.4049\/jimmunol.169.3.1535","article-title":"Activation of toll-like receptor 2 in acne triggers inflammatory cytokine responses","volume":"169","author":"Kim","year":"2002","journal-title":"J. Immunol."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"794","DOI":"10.1016\/j.bbadis.2006.07.006","article-title":"Sarcoidosis and NOD1 variation with impaired recognition of intracellular Propionibacterium acnes","volume":"1762","author":"Tanabe","year":"2006","journal-title":"Biochim. Biophys. Acta"},{"key":"ref_57","doi-asserted-by":"crossref","unstructured":"Fischer, N., Mak, T.N., Shinohara, D.B., Sfanos, K.S., Meyer, T.F., and Br\u00fcggemann, H. (2013). Deciphering the intracellular fate of Propionibacterium acnes in macrophages. BioMed Res. Int., 2013.","DOI":"10.1155\/2013\/603046"},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"182","DOI":"10.1007\/s12026-019-09077-9","article-title":"Catalase expression of Propionibacterium acnes may contribute to intracellular persistence of the bacterium in sinus macrophages of lymph nodes affected by sarcoidosis","volume":"67","author":"Yamamoto","year":"2019","journal-title":"Immunol. Res."},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"253","DOI":"10.1111\/j.1348-0421.2006.tb03791.x","article-title":"Adjuvant effect of the Propionibacterium acnes and its purified soluble polysaccharide on the immunization with plasmidial DNA containing a Trypanosoma cruzi gene","volume":"50","author":"Mussalem","year":"2006","journal-title":"Microbiol. Immunol."},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"1226","DOI":"10.1046\/j.1523-1747.2003.12550_6.x","article-title":"Propionibacterium acnes-reactive T helper-1 cells in the skin of patients with acne vulgaris","volume":"121","author":"Mouser","year":"2003","journal-title":"J. Investig. Dermatol."},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"110","DOI":"10.1038\/jid.2014.290","article-title":"Propionibacterium acnes promotes Th17 and Th17\/Th1 responses in acne patients","volume":"135","author":"Kistowska","year":"2015","journal-title":"J. Investig. Dermatol."},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"445","DOI":"10.1146\/annurev-immunol-030409-101212","article-title":"Differentiation of effector CD4 T cell populations","volume":"28","author":"Zhu","year":"2010","journal-title":"Annu. Rev. Immunol."},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"366","DOI":"10.1038\/jid.2013.334","article-title":"Propionibacterium acnes induces an IL-17 response in Acne vulgaris that is regulated by vitamin A and vitamin D","volume":"134","author":"Agak","year":"2014","journal-title":"J. Investig. Dermatol."},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"316","DOI":"10.1016\/j.jid.2017.07.842","article-title":"Phenotype and antimicrobial activity of Th17 cells induced by Propionibacterium acnes strains associated with healthy and acne skin","volume":"138","author":"Agak","year":"2018","journal-title":"J. Investig. Dermatol."},{"key":"ref_65","doi-asserted-by":"crossref","unstructured":"Kelh\u00e4l\u00e4, H.-L., Palatsi, R., Fyhrquist, N., Lehtim\u00e4ki, S., V\u00e4yrynen, J., Kallioinen, M., Kubin, M.E., Greco, D., Tasanen, K., and Alenius, H. (2014). IL-17\/Th17 pathway is activated in acne lesions. PLoS ONE, 9.","DOI":"10.1371\/journal.pone.0105238"},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"56","DOI":"10.1016\/j.resinv.2013.01.001","article-title":"Etiologic link between sarcoidosis and Propionibacterium acnes","volume":"51","author":"Eishi","year":"2013","journal-title":"Respir. Investig."},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"198","DOI":"10.1128\/JCM.40.1.198-204.2002","article-title":"Quantitative analysis of mycobacterial and propionibacterial DNA in lymph nodes of Japanese and European patients with sarcoidosis","volume":"40","author":"Eishi","year":"2002","journal-title":"J. Clin. Microbiol."},{"key":"ref_68","doi-asserted-by":"crossref","first-page":"735","DOI":"10.1034\/j.1399-3003.1999.14d02.x","article-title":"ATS\/ERS\/WASOG statement on sarcoidosis","volume":"14","author":"Costabel","year":"1999","journal-title":"Eur. Respir. J."},{"key":"ref_69","doi-asserted-by":"crossref","first-page":"639","DOI":"10.1146\/annurev-immunol-032712-100022","article-title":"The formation and function of granulomas","volume":"36","author":"Ramakrishnan","year":"2018","journal-title":"Annu. Rev. Immunol."},{"key":"ref_70","doi-asserted-by":"crossref","first-page":"631","DOI":"10.1016\/S0002-9440(10)63327-5","article-title":"Indigenous pulmonary Propionibacterium acnes primes the host in the development of sarcoid-like pulmonary granulomatosis in mice","volume":"165","author":"Nishiwaki","year":"2004","journal-title":"Am. J. Pathol."},{"key":"ref_71","doi-asserted-by":"crossref","unstructured":"Yamaguchi, T., Costabel, U., McDowell, A., Guzman, J., Uchida, K., Ohashi, K., and Eishi, Y. (2021). Immunohistochemical detection of potential microbial antigens in granulomas in the diagnosis of sarcoidosis. J. Clin. Med., 10.","DOI":"10.3390\/jcm10050983"},{"key":"ref_72","doi-asserted-by":"crossref","unstructured":"Hawkins, C., Shaginurova, G., Shelton, D.A., Herazo-Maya, J.D., Oswald-Richter, K.A., Rotsinger, J.E., Young, A., Celada, L.J., Kaminski, N., and Sevin, C. (2017). Local and systemic CD4+ T cell exhaustion reverses with clinical resolution of pulmonary sarcoidosis. J. Immunol. Res., 2017.","DOI":"10.1155\/2017\/3642832"},{"key":"ref_73","doi-asserted-by":"crossref","first-page":"128","DOI":"10.1165\/rcmb.2015-0212OC","article-title":"Molecular analysis of sarcoidosis granulomas reveals antimicrobial targets","volume":"55","author":"Rotsinger","year":"2016","journal-title":"Am. J. Respir. Cell Mol. Biol."},{"key":"ref_74","doi-asserted-by":"crossref","first-page":"8784","DOI":"10.4049\/jimmunol.181.12.8784","article-title":"T cell responses to mycobacterial catalase-peroxidase profile a pathogenic antigen in systemic sarcoidosis","volume":"181","author":"Chen","year":"2014","journal-title":"J. Immunol."},{"key":"ref_75","doi-asserted-by":"crossref","first-page":"157","DOI":"10.1007\/s10875-009-9311-y","article-title":"Mycobacterial ESAT-6 and katG are recognized by sarcoidosis CD4+ T cells when presented by the American sarcoidosis susceptibility allele, DRB1*1101","volume":"30","author":"Sato","year":"2010","journal-title":"J. Clin. Immunol."},{"key":"ref_76","doi-asserted-by":"crossref","unstructured":"Suzuki, Y., Uchida, K., Takemura, T., Sekine, M., Tamura, T., Furukawa, A., Hebisawa, A., Sakakibara, Y., Awano, N., and Amano, T. (2018). Propionibacterium acnes-derived insoluble immune complexes in sinus macrophages of lymph nodes affected by sarcoidosis. PLoS ONE, 13.","DOI":"10.1371\/journal.pone.0192408"},{"key":"ref_77","doi-asserted-by":"crossref","first-page":"1284","DOI":"10.1038\/modpathol.2012.80","article-title":"Localization of Propionibacterium acnes in granulomas supports a possible etiologic link between sarcoidosis and the bacterium","volume":"25","author":"Negi","year":"2012","journal-title":"Mod. Pathol."},{"key":"ref_78","doi-asserted-by":"crossref","first-page":"280","DOI":"10.1007\/s004170050078","article-title":"Seroprevalence of anti-Borrelia antibodies among patients with confirmed sarcoidosis in a region of Japan where Lyme borreliosis is endemic","volume":"236","author":"Ishihara","year":"1998","journal-title":"Graefe\u2019s Arch. Clin. Exp. Ophthalmol."},{"key":"ref_79","doi-asserted-by":"crossref","first-page":"225","DOI":"10.1164\/rccm.201705-0891OC","article-title":"Microbial lineages in sarcoidosis. A metagenomic analysis tailored for low\u2013microbial content samples","volume":"197","author":"Clarke","year":"2018","journal-title":"Am. J. Respir. Crit. Care Med."},{"key":"ref_80","doi-asserted-by":"crossref","first-page":"87","DOI":"10.1111\/j.1365-2249.2011.04456.x","article-title":"In vitro and in vivo reactivity to fungal cell wall agents in sarcoidosis","volume":"166","author":"Ihan","year":"2011","journal-title":"Clin. Exp. Immunol."},{"key":"ref_81","doi-asserted-by":"crossref","first-page":"259","DOI":"10.1111\/sji.12273","article-title":"Increased antifungal antibodies in bronchoalveolar lavage fluid and serum in pulmonary sarcoidosis","volume":"81","author":"Suchankova","year":"2015","journal-title":"Scand. J. Immunol."},{"key":"ref_82","doi-asserted-by":"crossref","unstructured":"Greaves, S.A., Ravindran, A., Santos, R.G., Chen, L., Falta, M.T., Wang, Y., Mitchell, A.M., Atif, S.M., Mack, D.G., and Tinega, A.N. (2021). CD4+ T cells in the lungs of acute sarcoidosis patients recognize an Aspergillus nidulans epitope. J. Exp. Med., 218.","DOI":"10.1084\/jem.20210785"},{"key":"ref_83","doi-asserted-by":"crossref","unstructured":"Lim, C.X., and Weichhart, T. (2021). A fungal antigenic driver for L\u00f6fgren\u2019s syndrome sarcoidosis. J. Exp. Med., 218.","DOI":"10.1084\/jem.20211572"},{"key":"ref_84","doi-asserted-by":"crossref","unstructured":"Beijer, E., Meek, B., Bossuyt, X., Peters, S., Vermeulen, R.C.H., Kromhout, H., and Veltkamp, M. (2020). Immunoreactivity to metal and silica associates with sarcoidosis in Dutch patients. Respir. Res., 21.","DOI":"10.1186\/s12931-020-01409-w"},{"key":"ref_85","doi-asserted-by":"crossref","unstructured":"Fireman, E., Bar Shai, A., Alcalay, Y., Ophir, N., Kivity, S., and Stejskal, V. (2016). Identification of metal sensitization in sarcoid-like metal-exposed patients by the MELISA\u00ae lymphocyte proliferation test\u2014A pilot study. J. Occup. Med. Toxicol., 11.","DOI":"10.1186\/s12995-016-0101-1"},{"key":"ref_86","doi-asserted-by":"crossref","first-page":"1797","DOI":"10.1183\/13993003.01469-2015","article-title":"Beryllium-induced lung disease exhibits expression profiles similar to sarcoidosis","volume":"47","author":"Li","year":"2016","journal-title":"Eur. Respir. J."},{"key":"ref_87","first-page":"104","article-title":"Is chronic beryllium disease sarcoidosis of known etiology?","volume":"20","author":"Rossman","year":"2003","journal-title":"Sarcoidosis Vasc. Diffus. Lung Dis."},{"key":"ref_88","doi-asserted-by":"crossref","first-page":"115","DOI":"10.1111\/cei.13519","article-title":"Simultaneous testing of immunological sensitization to multiple antigens in sarcoidosis reveals an association with inorganic antigens specifically related to a fibrotic phenotype","volume":"203","author":"Beijer","year":"2020","journal-title":"Clin. Exp. Immunol."},{"key":"ref_89","doi-asserted-by":"crossref","first-page":"815","DOI":"10.1053\/rmed.2000.0827","article-title":"Association of man-made mineral fibre exposure and sarcoidlike granulomas","volume":"94","author":"Drent","year":"2000","journal-title":"Respir. Med."},{"key":"ref_90","first-page":"365","article-title":"Sarcoidosis in iron-steel industry: Mini case series","volume":"34","author":"Sari","year":"2017","journal-title":"Sarcoidosis Vasc. Diffus. Lung Dis"},{"key":"ref_91","first-page":"212","article-title":"Metals that cause sarcoidosis","volume":"13","author":"Newman","year":"1998","journal-title":"Semin. Respir. Infect."},{"key":"ref_92","first-page":"66","article-title":"Elemental analysis of occupational granulomatous lung disease by electron probe microanalyzer with wavelength dispersive spectrometer: Two case reports","volume":"18","author":"Tomioka","year":"2016","journal-title":"Respir. Med. Case Rep."},{"key":"ref_93","doi-asserted-by":"crossref","first-page":"1183","DOI":"10.1378\/chest.116.5.1183","article-title":"The incidence, prevalence, and severity of sarcoidosis in New York City firefighters","volume":"116","author":"Prezant","year":"1999","journal-title":"Chest"},{"key":"ref_94","doi-asserted-by":"crossref","first-page":"974","DOI":"10.1164\/ajrccm\/148.4_Pt_1.974","article-title":"Investigation of a unique time-space cluster of sarcoidosis in firefighters","volume":"148","author":"Kern","year":"1993","journal-title":"Am. Rev. Respir. Dis."},{"key":"ref_95","doi-asserted-by":"crossref","first-page":"111","DOI":"10.1016\/S1047-2797(00)00179-4","article-title":"A current assessment of rurally linked exposures as potential risk factors for sarcoidosis","volume":"11","author":"Kajdasz","year":"2001","journal-title":"Ann. Epidemiol."},{"key":"ref_96","doi-asserted-by":"crossref","first-page":"898","DOI":"10.1183\/13993003.01209-2015","article-title":"T-cell receptor\u2013HLA-DRB1 associations suggest specific antigens in pulmonary sarcoidosis","volume":"47","author":"Grunewald","year":"2016","journal-title":"Eur. Respir. J."},{"key":"ref_97","doi-asserted-by":"crossref","first-page":"353","DOI":"10.1016\/j.clim.2009.08.008","article-title":"Autoimmune T cell responses to antigenic peptides presented by bronchoalveolar lavage cell HLA-DR molecules in sarcoidosis","volume":"133","author":"Dengjel","year":"2009","journal-title":"Clin. Immunol."},{"key":"ref_98","doi-asserted-by":"crossref","first-page":"3576","DOI":"10.1172\/JCI32401","article-title":"Identification of HLA-DR\u2013bound peptides presented by human bronchoalveolar lavage cells in sarcoidosis","volume":"117","author":"Dengjel","year":"2007","journal-title":"J. Clin. Investig."},{"key":"ref_99","first-page":"271","article-title":"Propionibacterium acnes isolated from lymph nodes of patients with sarcoidosis","volume":"32","author":"Veltkamp","year":"2015","journal-title":"Sarcoidosis Vasc. Diffus. Lung Dis"},{"key":"ref_100","first-page":"33","article-title":"Propionibacterium acnes is the most common bacterium commensal in peripheral lung tissue and mediastinal lymph nodes from subjects without sarcoidosis","volume":"22","author":"Ishige","year":"2005","journal-title":"Sarcoidosis Vasc. Diffus. Lung Dis. Off. J. WASOG"},{"key":"ref_101","doi-asserted-by":"crossref","first-page":"00486","DOI":"10.1183\/23120541.00486-2020","article-title":"Presence of Propionibacterium acnes in granulomas associates with a chronic disease course in Dutch sarcoidosis patients","volume":"7","author":"Beijer","year":"2021","journal-title":"ERJ Open Res."},{"key":"ref_102","doi-asserted-by":"crossref","first-page":"1473","DOI":"10.2169\/internalmedicine.2086-18","article-title":"Development of Propionibacterium acnes-associated sarcoidosis during etanercept therapy","volume":"58","author":"Isshiki","year":"2019","journal-title":"Intern. Med."},{"key":"ref_103","doi-asserted-by":"crossref","first-page":"2","DOI":"10.4172\/2161-105X.1000335","article-title":"Implication of immunohistochemistry for propionibacterium acnes in differential diagnosis of necrotizing granuloma","volume":"6","author":"Suzuki","year":"2016","journal-title":"J. Pulm. Respir. Med."},{"key":"ref_104","doi-asserted-by":"crossref","first-page":"421","DOI":"10.1016\/j.resinv.2020.04.003","article-title":"Histological differences between sarcoidosis and lung cancer-related sarcoid reaction","volume":"58","author":"Kinoshita","year":"2020","journal-title":"Respir. Investig."},{"key":"ref_105","doi-asserted-by":"crossref","unstructured":"Asakawa, N., Uchida, K., Sakakibara, M., Omote, K., Noguchi, K., Tokuda, Y., Kamiya, K., Hatanaka, K.C., Matsuno, Y., and Yamada, S. (2017). Immunohistochemical identification of Propionibacterium acnes in granuloma and inflammatory cells of myocardial tissues obtained from cardiac sarcoidosis patients. PLoS ONE, 12.","DOI":"10.1371\/journal.pone.0179980"},{"key":"ref_106","doi-asserted-by":"crossref","first-page":"198","DOI":"10.1016\/S0140-6736(98)12310-3","article-title":"Quantitative PCR of mycobacterial and propionibacterial DNA in lymph nodes of Japanese patients with sarcoidosis","volume":"354","author":"Ishige","year":"1999","journal-title":"Lancet"},{"key":"ref_107","first-page":"262","article-title":"Role of Propionibacterium acnes in sarcoidosis: A meta-analysis","volume":"30","author":"Zhou","year":"2013","journal-title":"Sarcoidosis Vasc. Diffus. Lung Dis. Off. J. WASOG"},{"key":"ref_108","doi-asserted-by":"crossref","unstructured":"Schupp, J.C., Tchaptchet, S., L\u00fctzen, N., Engelhard, P., M\u00fcller-Quernheim, J., Freudenberg, M.A., and Prasse, A. (2015). Immune response to Propionibacterium acnes in patients with sarcoidosis\u2014In vivo and in vitro. BMC Pulm. Med., 15.","DOI":"10.1186\/s12890-015-0070-7"},{"key":"ref_109","doi-asserted-by":"crossref","first-page":"1856","DOI":"10.1183\/09031936.94.07101856","article-title":"Bronchoalveolar lavage immunoglobulin A and G and antiproteases correlate with changes in diffusion indices during the natural course of pulmonary sarcoidosis","volume":"7","author":"Vandenplas","year":"1994","journal-title":"Eur. Respir. J."},{"key":"ref_110","doi-asserted-by":"crossref","first-page":"104","DOI":"10.1016\/j.resinv.2012.07.001","article-title":"Th1 and Th17 immune responses to viable Propionibacterium acnes in patients with sarcoidosis","volume":"50","author":"Furusawa","year":"2012","journal-title":"Respir. Investig."},{"key":"ref_111","doi-asserted-by":"crossref","first-page":"161","DOI":"10.1016\/j.resinv.2015.02.005","article-title":"Propionibacterium acnes catalase induces increased Th1 immune response in sarcoidosis patients","volume":"53","author":"Yorozu","year":"2015","journal-title":"Respir. Investig."},{"key":"ref_112","first-page":"256","article-title":"Proliferative response of peripheral blood mononuclear cells and levels of antibody to recombinant protein from Propionibacterium acnes DNA expression library in Japanese patients with sarcoidosis","volume":"17","author":"Ebe","year":"2000","journal-title":"Sarcoidosis Vasc. Diffus. Lung Dis. Off. J. WASOG"},{"key":"ref_113","doi-asserted-by":"crossref","first-page":"486","DOI":"10.1002\/path.1793","article-title":"Propionibacterium acnes-induced hepatic granuloma formation is impaired in mice lacking tetraspanin CD9","volume":"206","author":"Yamane","year":"2005","journal-title":"J. Pathol."},{"key":"ref_114","doi-asserted-by":"crossref","unstructured":"Beijer, E., Seldenrijk, K., Meek, B., Damen, J., Quanjel, M.J.R., Grutters, J.C., and Veltkamp, M. (2021). Detection of Cutibacterium acnes in granulomas of patients with either hypersensitivity pneumonitis or vasculitis reveals that its presence is not unique for sarcoidosis. ERJ Open Res., 7.","DOI":"10.1183\/23120541.00930-2020"},{"key":"ref_115","doi-asserted-by":"crossref","first-page":"9","DOI":"10.1016\/j.rmed.2017.09.003","article-title":"Toxicity risk from glucocorticoids in sarcoidosis patients","volume":"132","author":"Khan","year":"2017","journal-title":"Respir. Med."},{"key":"ref_116","doi-asserted-by":"crossref","first-page":"526","DOI":"10.1016\/j.rmed.2015.01.019","article-title":"The effect of corticosteroids on quality of life in a sarcoidosis clinic: The results of a propensity analysis","volume":"109","author":"Judson","year":"2015","journal-title":"Respir. Med."},{"key":"ref_117","doi-asserted-by":"crossref","first-page":"623","DOI":"10.1378\/chest.111.3.623","article-title":"Outcome in sarcoidosis","volume":"111","author":"Gottlieb","year":"1997","journal-title":"Chest"},{"key":"ref_118","first-page":"265","article-title":"Pulmonary granulomas caused experimentally in mice by a recombinant trigger-factor protein of Propionibacterium acnes","volume":"50","author":"Minami","year":"2003","journal-title":"J. Med. Dent. Sci."},{"key":"ref_119","doi-asserted-by":"crossref","first-page":"1195","DOI":"10.1007\/s10067-008-0903-3","article-title":"Minocycline for the treatment of sarcoidosis: Is the mechanism of action immunomodulating or antimicrobial effect?","volume":"27","author":"Miyazaki","year":"2008","journal-title":"Clin. Rheumatol."},{"key":"ref_120","doi-asserted-by":"crossref","unstructured":"Takemori, N., Nakamura, M., Kojima, M., and Eishi, Y. (2014). Successful treatment in a case of Propionibacterium acnes-associated sarcoidosis with clarithromycin administration: A case report. J. Med. Case Rep., 8.","DOI":"10.1186\/1752-1947-8-15"},{"key":"ref_121","doi-asserted-by":"crossref","first-page":"520","DOI":"10.1002\/joa3.12084","article-title":"Japanese antibacterial drug management for cardiac sarcoidosis (J-ACNES): A multicenter, open-label, randomized, controlled study","volume":"34","author":"Ishibashi","year":"2018","journal-title":"J. Arrhythmia"}],"container-title":["Microorganisms"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2076-2607\/10\/8\/1649\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T00:09:01Z","timestamp":1760141341000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2076-2607\/10\/8\/1649"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,8,15]]},"references-count":121,"journal-issue":{"issue":"8","published-online":{"date-parts":[[2022,8]]}},"alternative-id":["microorganisms10081649"],"URL":"https:\/\/doi.org\/10.3390\/microorganisms10081649","relation":{},"ISSN":["2076-2607"],"issn-type":[{"value":"2076-2607","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,8,15]]}}}