Extrinsic allergic alveolitis

Ismail, Tengku Saifudin Tengku; McSharry, Charles; Boyd, G.

doi:10.1111/j.1440-1843.2006.00839.x

Cited by 50 publications

(34 citation statements)

References 53 publications

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“…Production and release of IL-1, IL-8, TNF, IL-12, IL-6, MCP-1 and MIP-1a from macrophages are important for the later influx of cells like lymphocytes and the generation of the inflammatory environment (3,68). These cytokines seems to be responsible for the upregulation of ICAM-1 in macrophages of patients.…”

Section: Soluble Factorsmentioning

confidence: 99%

“…This is now challenged as the CD4/CD8 ratio can be increased in HP to levels as high as those seen in sarcoidosis (64)(65)(66). Recent studies suggest that this low CD4 + /CD8 + ratio is associated to the chronic form of HP and to asymptomatic individuals whereas a predominance of CD4 + T cells is related to the acute phase of the disease (67,68). In addition to the stage of the disease, the CD4 + /CD8 + ratio also depends on the type and dose of inhaled antigen as well as the duration of this antigenic exposure (3,68,69).…”

Section: Bronchoalveolar Lavagementioning

confidence: 99%

“…In HP, the nature of the cells present in the lung reflects the stage of the disease. Contact with the offending agent initially leads to a recruitment of neutrophils into the alveoli and the small airways (68). In mice exposed to S. rectivirgula, neutrophils amplify the immune response by the release of soluble factors required for the formation of granulomas (91).…”

Section: Important Actors In Hp: Inflammatory Cellsmentioning

confidence: 99%

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Hypersensitivity pneumonitis

Girard

and

Cormier

2009

Allergy

114

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The first few cases of hypersensitivity pneumonitis (HP) were described in the early 20th century in farmers exposed to moldy hay or straw. As then, HP has been ascribed to multiple inhaled antigens found in a large variety of environmental settings. Hypersensitivity pneumonitis results from an exaggerated immune response, which gives rise to acute infection‐like symptoms or to progressive, sometimes irreversible lung damage. The diagnosis is based on a combination of clinical characteristics of the disease. Clinical diagnostic criteria have recently been published. The immune mechanisms leading to HP are still incompletely understood. Initially, believed to be a classes III and IV immune response, we now have a clearer understanding of the complex inflammatory events involved. These include the release of pro inflammatory cytokines and a decrease in the immune control mechanisms via surfactant, dendritic and T‐regulatory cells. Despite the improved understanding, the treatment and outcome of HP have not changed. Oral corticosteroids remain the only effective drugs and contact withdrawal constitutes the ideal solution. If unchecked, HP can lead to irreversible lung damage in the form of fibrosis or emphysema, respiratory insufficiency and even death.

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Section: Soluble Factorsmentioning

confidence: 99%

Section: Bronchoalveolar Lavagementioning

confidence: 99%

Section: Important Actors In Hp: Inflammatory Cellsmentioning

confidence: 99%

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Hypersensitivity pneumonitis

Girard

and

Cormier

2009

Allergy

114

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“…71 Currently, courses of corticosteroids are frequently prescribed for HSP patients, when there are symptoms and physiologic abnormalities, but randomized controlled trials of prednisone and immunossupressants in fibrotic HSP patients have not been performed. 72,73 The best available evidence comes from a randomized placebo-controlled trial in farmer's lung that showed a faster improvement in lung function with corticosteroids, in comparison to avoidance only, but there were no differences in the long-term outcomes between the two groups. 74 A subset of patients develop progressive fibrosis, even after removing the causative antigen.…”

Section: Treatmentmentioning

confidence: 99%

Chronic Hypersensitivity Pneumonitis

2010

High-Yield Imaging: Chest

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“…Case subjects were diagnosed with MWF-associated HP in our department (Dept of Pneumonology, University of Lille, Lille, France) according to clinical, biological and radiological criteria [1,5,6] (medical investigations are given in the Results section).…”

Section: Subjectsmentioning

confidence: 99%

Hypersensitivity pneumonitis and metalworking fluids contaminated by mycobacteria

Tillie‐Leblond¹,

Grenouillet²,

Reboux³

et al. 2010

European Respiratory Journal

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Metalworking fluids (MWF) are responsible for hypersensitivity pneumonitis (HP). The aim of the present study was to identify the antigen (Ag) responsible for MWF-associated HP, and to optimise serological diagnosis by definition of a threshold allowing discrimination between HP patients and asymptomatic exposed workers.13 patients, who were workers at a car engine manufacturing plant, were suspected of MWF-associated HP. Microbial analysis of 83 used MWFs was carried out. Sera from 13 MWFassociated HP patients, 12 asymptomatic exposed workers and 18 healthy unexposed controls were tested to determine their immunological responses to three Ags, including Mycobacterium immunogenum.M. immunogenum was identified in 40% of used fluids by culture and confirmed by DNA sequencing. The threshold for differentiating MWF-associated HP patients from asymptomatic exposed workers was five arcs of precipitation (sensitivity 77% and specificity 92%), as determined by electrosyneresis (ES). Using ELISA methods with protein extract from M. immunogenum, a threshold leading to 92% sensitivity and 100% specificity was established.The detection of specific antibodies against M. immunogenum Ag at high levels in case sera suggests that M. immunogenum-contaminated MWF is responsible for MWF-associated HP. To discriminate MWF-associated HP patients from asymptomatic exposed workers, we suggest a five-arc threshold for ES and a 1.6-AU threshold for ELISA methods.

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Extrinsic allergic alveolitis

Cited by 50 publications

References 53 publications

Hypersensitivity pneumonitis

Hypersensitivity pneumonitis

Chronic Hypersensitivity Pneumonitis

Hypersensitivity pneumonitis and metalworking fluids contaminated by mycobacteria

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