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Granuloma formation – Th1/Th17 hypothesis. Initiation: alveolar macrophages and dendritic cells are activated by a putative antigen. Dendritic cells migrate to lymph nodes and initiate Th1/Th17-cell amplification. Chemokines, produced by alveolar macrophages, attract Th1/17, Treg, B-cells as well as CD8+ cells and fibroblast and initiate granuloma formation (effector phase). Both dendritic cells and macrophages produce cytokines favoring Th1 and Th17 cells in sarcoidosis [54].
