On the Etiology of Sarcoidosis.

Bacteriophages lytic for tubercle bacilli were isolated from tuberculous patients and patients with sarcoidosis. While tuberculous patients were found to raise phage-neutralizing antibodies, those with sarcoidosis appeared unable to do so. In vitro experiments showed that in the absence of neutralizing antibodies, phagolysis and lysogenic conversion of tubercle bacilli proceed. Lysogenic conversion results in the emergence of bacilli so modified in their morphological and antigenic properties that, on the basis of the classical bacteriological criteria, they can no longer be recognized as tubercle bacilli. From six lymph node biopsies collected from patients with sarcoidosis and cultured on a variety of media, including media containing anti-phage sera, five variant strains of tubercle bacilli were isolated. These observations support the view that certain cases of sarcoidosis are due to "modified" tubercle bacilli.