[A clinical-immunological concept of sarcoidosis]

A survey on immunologic phenomens up to now known in sarcoidosis is given and completed by own investigations in sarcoidosis patients concerning passive transfer of tuberculin reactivity, sensitivation with chemical contact allergens, lymphocyte transfer reaction, lymphocyte cultures, macrophage reaction in skin window, immune globulins, Kveim's reaction and reaction of basophilic granulocytes. As result of the investigations an immunologic conception of sarcoidosis is put up for discussion. The diminishment of the delayed type reactivity is the consequence of a strengthened immediate reaction on the begin of the disease. Therefore the impairment of T-lymphocytes would be not the cause but the consequence of the disease. Hypothetically a blockade of the surface of T-lymphocytes by products of the immediate reaction, for example immune complexes, is suggested. In this way it would be easier for the clinician to image, why sarcoidosis occurs in persons showing otherwise signs of hyperreactivity. The clinic of sarcoidosis is impressed by this hyperreactivity, especially by overwhelming formation of granulomatous tissue.