An immunoproteomic approach revealed antigenic proteins enhancing serodiagnosis performance of bird fancier's lung

Rouzet, Adeline; Reboux, Gabriel; Dalphin, Jean‐Charles; Gondouin, Anne; Vuyst, Paul De; Balliau, Thierry; Millon, Laurence; Valot, Benoı̂t; Roussel, Sandrine

doi:10.1016/j.jim.2017.07.012

Cited by 22 publications

(22 citation statements)

References 32 publications

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“…7 from Fernández Pérez et al 10 ). 3,[41][42][43][44][45][46][47][48][49][50][51] We identified limitations of the diagnostic yield data from these studies including small samples, limited clinical context (eg, unclear exposure status, disease severity), inappropriate reference standards, test incorporation bias, and minimal reporting of testing information, and noted limitations to the use of serum antigen-specific tests including cross-reactivity among ubiquitous fungal species and avian antigens (increasing the risk of false-positive results), and poorly standardized techniques and antigen preparations (increasing the risk of false-negative results). 49,[52][53][54][55][56][57] We concluded there is insufficient evidence to support the use of serum antigen-specific antibody testing results to reliably confirm or rule out the diagnosis of HP in the absence of an identifiable IA or consistently identify the particular type of antigen (eg, mold) involved in the disease process.…”

Section: Fig 4 Fibrosismentioning

confidence: 99%

Executive Summary

Pérez

Travis

Lynch

et al. 2021

Chest

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BACKGROUND:The purpose of this analysis is to provide evidence-based and consensusderived guidance for clinicians to improve individual diagnostic decision-making for hypersensitivity pneumonitis (HP) and decrease diagnostic practice variability.STUDY DESIGN AND METHODS: Approved panelists developed key questions regarding the diagnosis of HP using the PICO (Population, Intervention, Comparator, and Outcome) format. MEDLINE (via PubMed) and the Cochrane Library were systematically searched for relevant literature, which was supplemented by manual searches. References were screened for inclusion and vetted evaluation tools were used to assess the quality of included studies, to extract data, and to grade the level of evidence supporting each recommendation or statement. The quality of the evidence was assessed using the GRADE (Grading of Recommendations, Assessment, Development, and Evaluation) approach. Graded recommendations and ungraded consensus-based statements were drafted and voted on using a modified Delphi technique to achieve consensus. RESULTS:The systematic review of the literature based on 14 PICO questions resulted in 14 key action statements: 12 evidence-based, graded recommendations, and 2 ungraded consensus-based statements. All evidence was of very low quality.INTERPRETATION: Diagnosis of HP should employ a patient-centered approach and include a multidisciplinary assessment that incorporates the environmental and occupational exposure history and CT pattern to establish diagnostic confidence prior to considering BAL and/or lung biopsy. Additional research is needed on the performance characteristics and generalizability of exposure assessment tools and traditional and new diagnostic tests in modifying clinical decision-making for HP, particularly among those with a provisional diagnosis.

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Section: Fig 4 Fibrosismentioning

confidence: 99%

Executive Summary

Pérez

Travis

Lynch

et al. 2021

Chest

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“…Recombinant antigens are the most recent ones [43][44][45][46]58]. They are obtained after cloning a specific gene coding for a unique antigenic protein.…”

Section: Using Elisa Level Of Recombinant Antigens For Fld Bfl and Mwf-hpmentioning

confidence: 99%

“…However, these antigens correspond to a single protein and will thus reflect a limited part of the complex immunologic signals of the disease [43][44][45][46]58]. Numerous RAg were created, but only some of them were selected for three HP serodiagnoses: MWF-HP (Acyl-CoA-dehydrogenase (Acyl-CoA) and dihydrolipoyl dehydrogenase (DHDH)), FLD (SR17 hydroperoxidase (SR17) & Dihydrolipoamide dehydrogenase (DLDH)) and BFL (Immunoglobulin lamda-likepolypeptide-1 (IGLL1) and proproteinase E (ProE)) [43][44][45][46]. They can be used for ELISA (Enzyme Linked ImmunoSorbent Assay) with sensitivity and specificity reaching 80% and 90%, respectively, for MWF-HP [45], 83% and 77% for FLD [44] and 76% and 100% for BFL [46].…”

Section: Using Elisa Level Of Recombinant Antigens For Fld Bfl and Mwf-hpmentioning

confidence: 99%

“…Improved species identification can be obtained thanks to molecular biology, progressively extending the list of new etiologic agents, since specific antibodies of the etiologic agent are present in HP patient serum [41,42]. Serodiagnosis techniques are being improved, especially with the development of more standardized recombinant antigens (RAg) [43][44][45][46]. Moreover, some RAg are shared by species involved in different HP, and one of the common peptide epitopes was shown to be able to differenciate patients from healthy exposed farmers [47].…”

Section: Introductionmentioning

confidence: 99%

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Hypersensitivity pneumonitis: A new strategy for serodiagnosis and environmental surveys

Bellanger

Reboux

Rouzet

et al. 2019

Respiratory Medicine

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We propose a strategy for serodiagnosis of hypersensitivity pneumonitis (HP): 1) question patients about their private or occupational activity, or visit him on site; 2) select panels of six somatic specific antigens appropriate for each type of exposure; 3) and use ELISA to test concomitantly two recombinant antigens highly specific to Farmer's lung, Metalworking-fluid HP, and for Bird fancier's lung. The serodiagnosis provides an immunological argument that may complete radiological, functional lung exploration and clinical features; 4) If the serodiagnosis is negative but the suspicion of HP is strong, a microbial analysis of the patient's specific exposure is conducted; 5) "A la carte" antigens are produced from the microorganisms isolated in the patient's environment sample and tested; 6) Finally, the patient may be asked to undergo a specific inhalation challenge with the offending antigens in a safety cabin, or to avoid his usual environment for a few days.

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“…Our experience shows that some patients claim more than one exposure. It was found that at least some orthologous immunogenic proteins of inhalation antigens possess common epitopes (Rouzet et al, 2017); however, these epitopes have been described only in several antigens thus far. Currently, if EAA patients claim more potential sources of exposure, we are not sure whether all of them are clinically relevant and therefore should be avoided.…”

Section: Introductionmentioning

confidence: 99%

Quantitative assessment of specific serum IgGs may verify source of environmental exposure in extrinsic allergic alveolitis (EAA)

et al. 2021

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Assessment of humoral response to inhalation antigens is currently the most frequently used method to confirm exposure. It may be useful in extrinsic allergic alveolitis (EAA) patients, especially in cases that are unaware of the source of exposure. However, commercially available test may not include relevant antigens, which may lead to false negativity of the test. We proposed that testing patient serological responses to antigens from respectively environments might be useful in showing the relevance of these exposures. Ten patients diagnosed with EAA were included in the case-control study. Samples from potentially harmful environments were collected, and antigenic extracts were prepared and used for enzyme-linked immunosorbent assays (ELISA) to investigate serological responses to suspected antigens. Plasma samples of unexposed volunteers were used as controls. The results were interpreted in the context of other clinical findings when known (e.g., radiologic patterns, bronchoalveolar lavage fluid findings, histology results) and patient history. We suggest that environmental sampling may provide more information than previous history assessment and commercially available specific IgGs tests and helps to either reveal hidden exposures or find relevant exposure in cases with multiple potential sources. The results of these tests must be interpreted carefully in the context of other clinical data.

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An immunoproteomic approach revealed antigenic proteins enhancing serodiagnosis performance of bird fancier's lung

Cited by 22 publications

References 32 publications

Executive Summary

Executive Summary

Hypersensitivity pneumonitis: A new strategy for serodiagnosis and environmental surveys

Quantitative assessment of specific serum IgGs may verify source of environmental exposure in extrinsic allergic alveolitis (EAA)

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