Introduction: Sarcoidosis is a complex multisystem inflammatory disease characterized by the formation of granulomas, primarily affecting the lungs and lymph nodes. This article aims to provide a comprehensive overview of sarcoidosis, including its epidemiology, etiology, clinical manifestations, diagnostic approaches, treatment modalities, and recent advancements in research.

Epidemiology: Sarcoidosis exhibits significant variability in its global distribution and incidence rates, with higher prevalence observed in certain ethnic groups, particularly individuals of African or Scandinavian descent. While sarcoidosis can occur at any age, it most commonly affects adults aged 20 to 40 years, with a slight predilection for females.

Etiology: The exact etiology of sarcoidosis remains elusive, although it is widely believed to result from an aberrant immune response triggered by exposure to environmental or infectious agents in genetically predisposed individuals. Genetic factors, environmental exposures, and immune dysregulation likely contribute to disease susceptibility and pathogenesis.

Clinical Manifestations: Clinical features of sarcoidosis can vary widely depending on the organs involved and the extent of disease. Common manifestations include:

• Pulmonary involvement, presenting as cough, dyspnea, chest pain, and/or radiographic findings of bilateral hilar lymphadenopathy and parenchymal infiltrates.
• Cutaneous manifestations such as erythema nodosum, lupus pernio, and non-caseating granulomas.
• Ocular involvement, including uveitis, conjunctival nodules, and lacrimal gland enlargement.
• Systemic symptoms such as fatigue, fever, weight loss, and malaise.

Diagnostic Approaches: Diagnosing sarcoidosis requires a comprehensive evaluation integrating clinical, radiological, laboratory, and histopathological findings. Key diagnostic modalities include:

• Chest radiography or computed tomography (CT) imaging to assess pulmonary involvement and detect characteristic hilar lymphadenopathy or pulmonary infiltrates.
• Pulmonary function tests (PFTs) to evaluate respiratory function and assess for restrictive or obstructive lung disease.
• Biopsy of involved tissues, such as skin, lymph nodes, or lungs, to confirm the presence of non-caseating granulomas and exclude other differential diagnoses.

Treatment Modalities: The management of sarcoidosis is highly individualized and depends on the severity of symptoms, organ involvement, and disease progression. Therapeutic options may include:

• Observation and symptomatic management for asymptomatic or mild cases.
• Systemic corticosteroids as first-line therapy for moderate to severe disease, aiming to suppress inflammation and prevent organ damage.
• Immunosuppressive agents such as methotrexate, azathioprine, or mycophenolate mofetil for steroid-refractory or intolerant cases.
• Biologic agents targeting specific inflammatory pathways, including tumor necrosis factor-alpha (TNF-α) inhibitors or interleukin-6 (IL-6) antagonists, for refractory disease.

Recent Advancements: Recent advancements in sarcoidosis research have focused on elucidating its pathogenesis, identifying novel therapeutic targets, and developing personalized treatment approaches. Promising areas of investigation include:

• Genome-wide association studies (GWAS) to identify genetic susceptibility loci and biomarkers associated with disease progression and treatment response.
• Targeted immunomodulatory therapies aiming to selectively modulate immune pathways implicated in sarcoidosis pathogenesis while minimizing off-target effects.
• Precision medicine approaches integrating genomic, transcriptomic, and proteomic data to tailor treatment strategies to individual patient profiles and optimize therapeutic outcomes.

Reference Sites:

1. Foundation for Sarcoidosis Research (FSR) – https://www.stopsarcoidosis.org/
2. American Thoracic Society (ATS) – https://www.thoracic.org/
3. European Respiratory Society (ERS) – https://www.ersnet.org/
4. National Eye Institute (NEI) – https://www.nei.nih.gov/

By raising awareness of sarcoidosis and highlighting recent advancements in diagnosis and treatment, this article aims to empower healthcare professionals in their efforts to effectively manage and treat this complex multisystem disorder. With continued research and collaborative efforts, the prognosis for individuals with sarcoidosis continues to improve, offering hope for improved outcomes and quality of life.