Study will classify ocular sarcoidosis based on causes of inflammation

The effort could lead to more targeted treatments, researchers say

Marisa Wexler, MS avatar

by Marisa Wexler, MS |

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Scientists at the University of Colorado are planning a study to better classify sarcoidosis as it affects the eyes, called ocular sarcoidosis. Having a grasp on the specific biological mechanisms that drive sarcoidosis in different patients could lead to more targeted treatments, researchers say.

“Improving our ability to define subtypes of disease and then applying molecular techniques like the ones we are using in my lab will help us understand what’s driving the inflammation and what is targetable with drugs,” Lynn Hassman, MD, PhD, assistant professor of ophthalmology and one of the scientists leading the study, said in a university news story. “Patients want to know why this is happening to them,” Hassman said. “The better we are able to define the disease, the closer we are in helping them understand why this might have happened and what can be done to help.”

Those interested in learning more about the study can reach out to researchers at Colorado University’s Center for Ocular Inflammation via phone at 720-848-2020 or by email at [email protected].

Sarcoidosis is an inflammatory condition defined by clumps of immune cells called granulomas. The disease can affect various body parts and manifest differently from one person to the next.

A diagnosis of sarcoidosis is made based on identifying granulomas and ruling out other conditions, without much consideration given for what’s actually causing the immune clumps to appear.

“There’s a typical configuration of inflammatory cells present in a granuloma. You must prove that there is not an active infection or cancer. Once you’ve excluded those diseases, you’re left with sarcoidosis,” Hassman said. “But the one disease we call sarcoidosis can affect patients in very different ways.”

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Classifying sarcoidosis so broadly and without regard to the specific causes means a diagnosis doesn’t necessarily offer any ideas about the best way to treat it, Hassman said.

Granulomas can appear in the eyes of people diagnosed with sarcoidosis. According to Hassman, this typically leads to a type of eye inflammation called uveitis, which can cause “redness, blurry vision, floaters, light sensitivity, pain around the eyes, and potentially permanent loss of vision.”

Hassman and her colleagues will collect samples of eye cells from people with uveitis and analyze the molecular activity in individual cells to better understand how runaway inflammation develops and persists.

“Through this study, we hope to place uveitis patients into groups that aren’t based on descriptive terms like ‘sarcoidosis,’ but instead are based on treatable molecular features, like ‘IL-6-driven inflammation’ or ‘TNF-driven inflammation,’” Hassman said. IL-6 and TNF are both inflammatory signaling molecules.

Similar work has already started to uncover subtypes of sarcoidosis in other parts of the body.

“There’s some great work showing that specific organ systems often manifest together in individual patients with sarcoidosis. Researchers have learned that there is a skin and lymph node phenotype, for example,” Hassman said. “That’s where we need to go with uveitis. First, we need to learn which clinical signs correlate into disease subtypes, then which molecules are characteristic of each disease subtype. From there, we can target those specific molecules and more effectively treat patients.”