PULMONARY SARCOIDOSIS - COULD MYCOPLASMA-LIKE ORGANISMS BE A CAUSE

The etiology of sarcoidosis is unknown but an unusual bacterial agent is possible. Mycoplasma-Like Organisms [MLO] are obligate intracellula r cell wall deficient bacteria with a distinctive ultrastructural appe arance. MLO are a common cause of various transmissible plant diseases . Despite over 25 years of effort MLO remain uncultivated. Molecular b iologic studies indicate MLO are only distantly related to extracellul ar cultivable mycoplasma. Diagnosis of MLO diseases is based chiefly o n detection of the organisms in Infected cells by electron microscopy. Recently MLO have been detected by electron microscopy within leucocy tes in sterile inflamed aqueous and vitreous humor from patients with idiopathic chronic uveitis including sarcoidosis uveitis. Preliminary molecular biologic studies suggest that human MLO are quite closely re lated phylogenetically to plant MLO. Inoculation of human uveitis MLO into mouse eyelids produced chronic uveitis and lethal systemic granul omatous disease with MLO within leucocytes and endothelial cells in th e disease sites. The MLO induced animal pulmonary disease resembled sa rcoidosis. This report describes abnormal intracellular bodies consist ent with MLO within leucocytes and endothelial cells adjacent to the g ranulomas in transbronchial biopsies from 9 corticosteroid untreated s arcoidosis patients versus none in 4 control lungs.