Sarcoidosis

Clinical Centers


Mission Statement:

Dr. Jeffery Berman The Sarcoidosis Clinic at Boston Medical Center (Boston University School of Medicine) provides diagnostic and therapeutic services for patients with sarcoidosis and is the clinical repository for ongoing basic science, translational, and clinical studies on sarcoidosis. Our Mission is to improve the lives of persons with sarcoidosis by providing state-of-the-art patient care coupled with innovative research aimed at understanding the pathogenesis and natural history of sarcoidosis.

Background:

The staff of the Sarcoidosis Clinic at Boston Medical Center is comprised of two physicians with expertise in sarcoidosis and a dedicated clinic staff, including two nurse clinicians experienced in sarcoidosis. The clinic is directed by Jeffrey S. Berman, Professor of Medicine at Boston University School of Medicine and an acknowledged expert in the diagnosis, treatment, and investigation of sarcoidosis. Dr. Praveen Govender is newly arrived at the Sarcoidosis Clinic, after training in Pulmonary Medicine and Allergy and Immunology, and has worked extensively with Dr Berman in the care of patients with sarcoidosis. Drs. Berman and Govender are active members of the World Association of Sarcoidosis and Other Granulomatous Disorders (WASOG).

Patients with sarcoidosis are referred to the Sarcoidosis Clinic from both within Boston Medical Center as well as from throughout New England and the United States and from numerous foreign countries. Some patients come only for an initial evaluation or second opinion, while others may be followed for years. Approximately 100-150 new referrals per year are seen at the Sarcoidosis Clinic.

The Sarcoidosis Clinic provides patient care based on state-of-the-art clinical practice and translational/clinical research. The Sarcoidosis Clinic is part of the Boston University Pulmonary Center, which has extensive Research and Clinical programs in Molecular and Cell Biology, Immunology, Biochemistry, and Epidemiology. All clinical care is provided at Boston Medical Center, where a full range of Medical, Surgical and Radiologic subspecialists are available. Research is supported by grants from the NIH and private donations from patients, families, or organizations committed to advancement of sarcoidosis care. This support allows The Sarcoidosis Clinic to provide a broad range of services to patients and their families.

Clinical Activities:

  • Diagnosis and Initial Assessment of patients with Sarcoidosis
  • Secondary and Tertiary Referrals for management of complex cases of sarcoidosis throughout New England.
  • Ongoing treatment for multi-system Sarcoidosis, including lung, skin, cardiac and neurologic involvement
  • Use of immunosuppressive agents when indicated (e.g. methotrexate, anti-TNF agents)
  • Participation in clinical trials and on-going Investigator-initiated and Industry-sponsored research with the goal of advancing knowledge about the pathogenesis and treatment of Sarcoidosis

Research Activities:

Basic Science Research:

Our basic science research has focused on the regulation of granulomatous inflammation and development into a pro-fibrotic phenotype. Our most recent studies have involved the multi-functional Th1-type and pro-fibrotic cytokine osteopontin. Utilizing in vivo murine models and in vitro cell culture systems, our lab has established the importance of osteopontin in regulating granuloma development and lung remodeling.

Translational-Clinical Research:

Our Translational-Clinical research activities, centered in our Sarcoidosis Clinic, focus on gaining understanding of the pathogenesis and clinical phenotypes of sarcoidosis in order to develop more disease- and patient-specific treatments.

  • “The Immuno-phenotype of the Nasal Mucosa in Sarcoidosis”: Our ongoing NIH-sponsored research study utilizes modern bioinformatic tools and gene expression microarrays to develop predictors of lung disease based on the protein and gene expression from the upper respiratory tract. This study brings together collaborators from the Boston University School of Public Health, Genomics and Bioinformatics Departments, and the General Clinical Research Center.
  • A collaboration with the Slone Epidemiology Unit at Boston University will utilize a cohort of over 1000 African American women with Sarcoidosis. As part of their Black Women’s Health Study, we will evaluate the clinical characteristics and potential genetic determinants in this large and severely affected population with sarcoidosis.

Personnel and Collaborators:

  • Jeffrey S. Berman, MD, Professor of Medicine and Director of the Sarcoidosis Clinic at Boston University School of Medicine
  • Praveen Govender, MD, Assistant Professor of Medicine, Associate Director of the Sarcoidosis Clinic
  • Harrison Farber, MD, Professor of Medicine and Director of the Pulmonary Hypertension Center, specializing in treatment of Sarcoidosis patients with pulmonary hypertension
  • Yvette Cozier, D.Sc., Assistant Professor of Epidemiology, Boston University School of Public Health

Selected Publications:

  1. Serlin DM, Kuang PP, Subramanian M, O’Regan AW, Li XF, Berman JS, Goldstein RH. Interleukin-1 Beta Induces Osteopontin Expression in Pulmonary Fibroblasts. 2005. Journal of Cellular Biochemistry. (Published Online: 6 Oct 2005 in advance of print)
  2. Fisher KA, Serlin DM, Wilson KC, Walter RE, Berman JS and Farber HW. Sarcoidosis Associated Pulmonary Hypertension: Outcome with Long-Term Epoprostenol Treatment. 2005 (Submitted, Under Review)
  3. Berman JS, Serlin D, Li X, Whitley G, Hayes J, Rishikof DC et al. Altered bleomycin-induced lung fibrosis in osteopontin-deficient mice. Am J Physiol Lung Cell Mol Physiol 2004; 286(6):L1311-L1318.
  4. O’Regan AW, Berman JS. The gene for acute sarcoidosis? Am J Respir Crit Care Med 2003; 168(10):1142-1143.
  5. O’Regan AW, Hayden JM, Body S, Liaw L, Mulligan N, Goetschkes M, Berman JS. Abnormal pulmonary granuloma formation in osteopontin-deficient mice. Am J Respir Crit Care Med 2001; 164(12):2243-2247.
  6. O’Regan AW, Chupp GL, Lowry JA, Goetschkes M, Mulligan N, Berman JS. Osteopontin is associated with T cells in sarcoid granulomas and has T cell adhesive and cytokine-like properties in vitro. Journal of Immunology 1999; 162(2):1024-1031.
  7. Nau GJ, Guilfoile P, Chupp GL, Berman JS, Kim SJ, Kornfeld H et al. A chemoattractant cytokine associated with granulomas in tuberculosis and silicosis. Proceedings of the National Academy of Sciences of the United States of America 1997; 94(12):6414-6419.
  8. Denhardt DT, Noda M, O’Regan AW, Pavlin D, Berman JS. Osteopontin as a means to cope with environmental insults: regulation of inflammation, tissue remodeling, and cell survival. J Clin Invest 2001; 107(9):1055-1061.
  9. Fisher KA, Serlin DM, Wilson KC, Walter RE, Berman JS, Farber HW.  Sarcoidosis-associated pulmonary hypertension: Outcome with long-term epoprostenol treatment.  Chest; 2006:1481-1488.
  10. Y Cozier, JS Berman, et al. Sarcoidosis in U.S. black women:  Data from the Black Women’s Health Study; 2010; Chest; 138:1-7.
  11. Donagh C, Bruzzi J, MacNeill B, DaCosta M, Berman JS, O’Regan AW.  Clinical Problem Solving.  Looking at the Whole Picture.  2011; N Engl J Med,362:52.
  12. O’Regan AW, Berman JS.  In the clinic; sarcoidosis. Ann Int Med. 2012.

Links:

For patients:

To schedule a clinic visit, refer a pations, or speak with one of our physicians, please contact us at:

Sarcoidosis Clinic
725 Albany Street Suite 9B
Boston, MA 02118

617-638-7480
FAX 617-638-7486

 
Drs Govender (Left) and Berman in the clinic.
Research