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A comprehensive examination was made of 101 patients with sarcoidosis of the intrathoracic lymph nodes (ITLN) (n = 33), with that of ITLN and lung (n = 47) or sarcoidosis of the lung (n = 21). Special studies were conducted to examine the pulmonary scintigraphic and X-ray pneumopolygraphic findings reflecting impaired microcirculation and biomechanics of respiration, the levels of medium-weight molecules, their fractions, and small-weight molecules in the sera and urine, which reflects the severity of endoxemia, as well as the electrophoretic motility of red blood cells which are involved in metabolism and the degree of tissue hypoxia. The findings have confirmed that there are respiratory, circulatory, and tissue hypoxias, and endogenous intoxication just in earliest respiratory sarcoidosis, which is of definite importance in the pathogenesis of the disease, allowing the use of pathogenetic agents as antihypoxants to be justified.

The paper deals with a possible contribution of microorganisms to the development of interstitial pulmonary diseases (IPD). An examination was made of 57 patients who were in terms of nosological entities were divided into 3 groups: 1) patients with fibrotic alveolitis; 2) those with pulmonary sarcoidosis, and 3) those with histiocytosis X. All patients underwent general clinical examinations, microbiological studies of bronchial contents, mainly bronchial swabs. Based on the examinations and studies, it may be concluded that the infectious component is not the leading predictor of IPD development. However, it should be borne in mind that some patients, those with pulmonary sarcoidosis in particular, have a pneumococcal infectious process.

The study carried out with the use of microbiological diagnostic methods has revealed that in 67% of cases specimens obtained from sarcoidosis patients for analysis contain different forms of mycobacteria (typical Mycobacterium tuberculosis and granular forms of mycobacteria). The content of typical and granular forms of mycobacteria detected in diagnostic specimens has been shown to differ, depending on the clinical form of sarcoidosis: as a rule, in cases of the sluggish course of sarcoidosis granular forms of mycobacteria are detected, while during the exacerbation of the disease and in cases of the acute course of newly diagnosed sarcoidosis the proportion of typical M.tuberculosis increases. To verify M.tuberculosis with greater certainty, two highly sensitive and specific amplification test systems have been developed on the basis of polymerase chain reaction. In this article the goals of microbiological and molecular genetic investigations which may jointly give direct proofs of the etiological importance of mycobacteria in sarcoidosis are considered and discussed; sarcoidosis may probably be regarded as chronic persistence infection.