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Nutrition and corticosteroids in the treatment of sarcoidosis

Bast, Aalta,b; Semen, Khrystyna O.b; Drent, Marjoleina,c

Current Opinion in Pulmonary Medicine: September 2018 - Volume 24 - Issue 5 - p 479–486
doi: 10.1097/MCP.0000000000000501
SARCOIDOSIS: Edited by Peter Korsten and Marjolein Drent

Purpose of review Sarcoidosis is a chronic disease, which is routinely treated with corticosteroids. Steroid resistance or steroid-induced adverse effects require alternatives. Other immune-modulating pharmacological treatments have been developed, and therefore expanded tremendously. Until now, the role of nutrition in the overall management of sarcoidosis has been neglected although anti-inflammatory properties of nutritional components have been known for many years now. New nutritional possibilities emerge from already existing data and offer new therapeutic avenues in the treatment of sarcoidosis.

Recent findings Various dietary components have been shown to reduce pulmonary inflammatory processes. It is increasingly recognized, however, that the specificity and magnitude of the effect of nutrition differs from pharmacological interventions. Conventional randomized clinical trials are less suitable to test the effect of nutrition in comparison with testing drugs. Mechanistic knowledge on the action of dietary components in conjunction with an increasing understanding of the molecular processes underlying steroid resistance (as investigated in asthma and COPD and unfortunately hardly in sarcoidosis) lead to exciting suggestions on combinations of nutrition/nutritional bioactive compounds and corticosteroids that may benefit sarcoidosis patients.

Summary In order to understand the effects of nutrition in chronic disease, it is important to elucidate mechanisms and pathways of effects. Several complementing lines of evidence should be integrated in order to be able to advise sarcoidosis patients on a healthy diet as such or in combination with prescribed anti-inflammatory therapy.

aDepartment of Pharmacology and Toxicology, Faculty of Health, Medicine and Life Science, Maastricht University, Maastricht

bVenlo Campus, Maastricht University, Venlo

cILD Center of Excellence, Department of Respiratory Medicine, St. Antonius Hospital, Nieuwegein, The Netherlands

Correspondence to Aalt Bast, Venlo Campus Maastricht University, P.O. Box 8, 5900 AA Venlo, The Netherlands. Tel: +31 43 3883195; e-mail: a.bast@maastrichtuniversity.nl

Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.
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