In sarcoidosis, any organ may be affected, and the majority of cases have pulmonary involvement. The disease course in pulmonary sarcoidosis varies considerably, from complete resolution to chronic disease and/or pulmonary fibrosis. The heterogeneity of sarcoidosis is a major challenge in treatment decision-making, and the hope is that subgrouping patients into phenotypes may help to provide the right care for the right patient. In this issue of Thorax , Sharp et al 1 provide evidence that sarcoidosis phenotypes, based on pulmonary function tests (PFTs), predict lung function decline over time. They found that individuals with a restrictive pulmonary phenotype had a greater 3-year loss in pulmonary function compared with those without impairment. Furthermore, black individuals had a less favourable course compared with white individuals who improved in pulmonary function over time. The study by Sharp et al included longitudinal data with several years of follow-up, which is an improvement over previous studies which were based on cross-sectional data. Prognosis prediction in sarcoidosis is challenging due to the wide variation across patients, and many studies have not been replicated. Previous studies have examined different blood-based biomarkers, but it is still unclear whether these are reliable and useful to predict progression to fibrosis. Some more recent …

中文翻译：

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预测结节病肺恶化的风险


在结节病中，任何器官都可能受到影响，大多数病例有肺部受累。肺结节病的病程差异很大，从完全消退到慢性疾病和/或肺纤维化。结节病的异质性是治疗决策中的一个主要挑战，希望将患者亚组为表型可能有助于为正确的患者提供正确的护理。在本期 Thorax 中，Sharp 等人 1 提供了证据表明，基于肺功能测试 （PFT） 的结节病表型可预测肺功能随时间下降。他们发现，与没有损伤的个体相比，具有限制性肺表型的个体 3 年肺功能损失更大。此外，与肺功能随着时间的推移而改善的白人相比，黑人的病程较差。Sharp 等人的研究包括纵向数据和数年随访，这比以前基于横断面数据的研究有所改进。由于患者之间的差异很大，结节病的预后预测具有挑战性，并且许多研究尚未被复制。以前的研究已经检查了不同的基于血液的生物标志物，但目前尚不清楚这些生物标志物是否可靠和有用，可以预测进展为纤维化。一些最近的......