# Targeting the mycobiome in sarcoidosis

## TL;DR

This study explores the role of fungi in sarcoidosis by analyzing fungal communities in patient samples and finds distinct patterns that suggest fungi may contribute to the disease.

## Contribution

The study provides empirical evidence linking specific fungal genera to sarcoidosis and highlights their potential role in disease pathogenesis.

## Key findings

- Fungal genera like Penicillium, Mucor, Saccharomyces, and Yarrowia were detected in sarcoidosis samples.
- Cultured samples showed reduced fungal diversity dominated by fast-growing taxa.
- Fungal communities in sarcoidosis patients differ from controls, suggesting a potential role in disease.

## Abstract

Sacoidosis is a multisystem granulomatous disorder characterized by the formation of non-caseating granulomas in affected organs, predominantly the lungs and lymph nodes. Despite extensive research, its etiology remains elusive. Recent evidence suggests fungi may play a role in disease pathogenesis through immune modulation and chronic inflammation.

We conducted a comprehensive fungal profiling study using samples from thirteen patients with confirmed sarcoidosis and five controls with other pulmonary diseases. Multiple specimen types were analyzed, including bronchoalveolar lavage fluid, lung tissue biopsies, and blood (both cultured and non-cultured). Fungal communities were characterized using ITS (Internal Transcribed Spacer) targeted sequencing followed by bioinformatic analysis.

Distinctive taxonomic patterns emerged in sarcoidosis samples. Several genera previously implicated in the pathogenesis of sarcoidosis were detected, including Penicillium, Mucor, Saccharomyces, and Yarrowia, which are regarded as potential pathogens. Sample type and processing method significantly influenced community composition, with cultured samples showing reduced diversity dominated by fast-growing taxa.

This study provides evidence of diverse fungal communities in sarcoidosis patients' blood and respiratory specimens, with potential immunomodulatory implications. Our findings integrate with existing epidemiologic and immunologic evidence highlighting fungi as credible antigenic drivers in sarcoidosis and suggest directions for future functional studies exploring fungal-host interactions in disease pathogenesis.