Extrinsic Allergic Alveolitis (Hypersensitivity Pneumonitis)

A common interstitial lung disease caused by hypersensitivity reactions of PULMONARY ALVEOLI after inhalation of and sensitization to environmental antigens of microbial, animal, or chemical sources. The disease is characterized by lymphocytic alveolitis and granulomatous pneumonitis.

Also Known As:

Networked: 1339 relevant articles (35 outcomes, 90 trials/studies)

Relationship Network

Disease Context: Research Results

Related Diseases

1.	Sarcoidosis (Schaumann Disease)
2.	Idiopathic Pulmonary Fibrosis
3.	Connective Tissue Diseases (Connective Tissue Disease)
4.	Tuberculosis (Tuberculoses)
5.	Interstitial Lung Diseases (Interstitial Lung Disease)

Experts

1.	Miyazaki, Yasunari: 38 articles (06/2022 - 05/2003)
2.	Inase, Naohiko: 31 articles (07/2019 - 05/2003)
3.	Yoshizawa, Yasuyuki: 16 articles (05/2013 - 05/2003)
4.	Okamoto, Tsukasa: 14 articles (05/2022 - 03/2012)
5.	Tateishi, Tomoya: 13 articles (01/2022 - 03/2011)
6.	Muñoz, Xavier: 13 articles (09/2021 - 04/2003)
7.	Morell, Ferran: 13 articles (04/2020 - 04/2003)
8.	Pardo, Annie: 12 articles (01/2022 - 01/2006)
9.	Takemura, Tamiko: 12 articles (01/2022 - 09/2007)
10.	Costabel, Ulrich: 12 articles (01/2020 - 06/2003)

Drugs and Biologics

Drugs and Important Biological Agents (IBA) related to Extrinsic Allergic Alveolitis:

1.	AntigensIBA 03/01/2015 - "Detecting a causative antigen in fibrotic hypersensitivity pneumonitis is challenging but critically important both for accurate diagnosis and improved prognosis. " 12/01/2014 - "In hypersensitivity pneumonitis the mainstay of treatment is complete avoidance of exposure to the provoking antigen. " 11/01/1990 - "The measurement of rate of clearance of 99mTc-DTPA in pigeon fanciers can identify an alteration in pulmonary integrity more subtle than found with conventional pulmonary function tests and may therefore be a useful test for studying the pulmonary response to inhaled antigen and for detecting the earliest stages in the evolution of hypersensitivity pneumonitis." 01/15/1989 - "We report that electrostatic dust filters may be an effective treatment for patients with hypersensitivity pneumonitis when avoidance of the causative antigen cannot be easily and rapidly achieved." 10/01/2009 - "A provocation test, in which antigen exposure is limited using a closed space, such as a sickroom, was simple, safe and effective for determining the antigen causing hypersensitivity pneumonitis."
2.	Adrenal Cortex Hormones (Corticosteroids)IBA 07/19/2021 - "Efficacy of treatment with corticosteroids for fibrotic hypersensitivity pneumonitis: a propensity score-matched cohort analysis." 06/01/2020 - "After the results of a comprehensive workup for infectious etiology returned negative, she was diagnosed with hypersensitivity pneumonitis and started on systemic corticosteroids." 01/01/2020 - "Systemic corticosteroids are widely used in chronic hypersensitivity pneumonitis (CHP); however, there is not much evidence to support their use, besides being associated with significant side effects. " 12/01/2018 - " words: corticosteroids - extrinsic allergic alveolitis - environmental exposure." 01/01/2017 - "The treatment of chronic hypersensitivity pneumonitis (cHP) often includes systemic oral corticosteroids, but the optimal pharmacologic management remains unclear. "
3.	Immunoglobulin G (IgG)IBA 10/24/2023 - "We aimed to investigate the contribution of serum IgG testing to the history of exposure in the diagnosis of fibrotic hypersensitivity pneumonitis. " 07/01/2023 - "Utility of budgerigar/pigeon/parrot-specific IgG antibody with ImmunoCAP® in bird-related hypersensitivity pneumonitis caused by other bird species and duvet." 01/01/2023 - "Serum Immunoglobulin G Testing against Pigeon Egg in Stable Fibrotic Hypersensitivity Pneumonitis." 11/01/2022 - "The role of adjunctive tests, such as serum IgG testing, bronchoalveolar lavage lymphocyte analysis, and pulmonary function testing is discussed in the context of supporting diagnostic confidence for hypersensitivity pneumonitis diagnosis. " 01/01/2022 - "Validation of inhalation challenge test and serum immunoglobulin G test for bird-related fibrotic hypersensitivity pneumonitis."
4.	PrecipitinsIBA 01/15/1989 - "The results of a bronchial challenge to Aspergillus species, however, remained positive; these positive results suggest that long-term memory immune mechanisms may play an important role in the pathogenesis of hypersensitivity pneumonitis and lessen the importance of precipitins in establishing a diagnosis. " 01/01/1980 - "A study was made of the prevalence of serum precipitins to Micropolyspora faeni, Thermoactinomyces vulgaris, Aspergillus fumigatus, and pigeon serum in population groups suspected to be at high risk for the development of hypersensitivity pneumonitis. " 04/01/2007 - "Serum precipitins have a controversial diagnostic value in hypersensitivity pneumonitis (HP). " 02/01/2003 - "[Hypersensitivity pneumonitis: a technical note on precipitins]." 07/01/1998 - "Hypersensitivity pneumonitis affected seven workers, with six exhibiting serum precipitins to Acinetobacter Iwoffii. "
5.	AerosolsIBA 05/01/2006 - "Because hypersensitivity pneumonitis is not typically associated with exposure to metalworking fluid aerosols, this study examined whether Mycobacterium immunogenum (M. " 01/07/2016 - "M. immunogenum, a rapidly growing mycobacterium previously reported to be the cause of hypersensitivity pneumonitis from contaminated metalworking fluid aerosols, is becoming a public health concern. " 01/01/2016 - "This review summarises the clinical knowledge of hypersensitivity pneumonitis in workers exposed to aerosols of metalworking fluid, reviewing published outbreaks and clinical cases. " 01/01/2016 - "Hypersensitivity Pneumonitis Due to Metalworking Fluid Aerosols." 08/01/2004 - "Successful treatment of hypersensitivity pneumonitis caused by Grifola frondosa (Maitake) mushroom using a HFA-BDP extra-fine aerosol."
6.	Biomarkers (Surrogate Marker)IBA 01/01/2022 - "The aim of this study was to investigate the values of KL-6 and YKL-40 as biomarkers in the diagnosis and prognosis of patients with hypersensitivity pneumonitis (HP). " 01/01/2021 - "This study aims to identify the biomarkers for chronic hypersensitivity pneumonitis (CHP) and facilitate the precise gene therapy of CHP. " 10/06/2023 - "To identify diagnostic feature biomarkers based on metabolism-related genes (MRGs) and determine the correlation between MRGs and M2 macrophages in patients with hypersensitivity pneumonitis (HP). " 02/17/2023 - "This is not the case, however, with hypersensitivity pneumonitis, where there is still great room for research in the path to find consensual diagnostic biomarkers. " 02/17/2023 - "Diagnosis of Fibrotic Hypersensitivity Pneumonitis: Is There a Role for Biomarkers?"
7.	Proteins (Proteins, Gene)FDA Link 05/01/2007 - "Further studies in a greater number of patients are needed to understand the contribution of oxidatively modified proteins to the pathogenesis of DLD and, in particular, to the development of extrinsic allergic alveolitis where the highest levels of carbonylated proteins were found." 11/01/2019 - "Short peripheral blood leukocyte (PBL) telomere length predicts poor outcomes in chronic hypersensitivity pneumonitis (CHP).Objectives: Determine the prevalence and clinical relevance of rare protein-altering variants in telomere-related genes in patients with CHP.Methods" 11/01/2019 - "Rare Protein-Altering Telomere-related Gene Variants in Patients with Chronic Hypersensitivity Pneumonitis." 01/01/2019 - "Bronchoalveolar lavage cell profiles and proteins concentrations can be used to phenotype extrinsic allergic alveolitis patients." 04/01/2017 - "Protein cross-linking potential has also been found to be a consistent feature of chemicals that have caused human cases of hypersensitivity pneumonitis. "
8.	Immunoglobulins (Immunoglobulin)IBA 08/01/1993 - "The aim of this study was to investigate whether there is a relationship between the presence of plasma cells and other cells, and immunoglobulin levels in BAL fluid of patients with extrinsic allergic alveolitis. " 01/01/2023 - "The accuracy of serum immunoglobulin (Ig) G testing for diagnosis of stable bird-related fibrotic hypersensitivity pneumonitis (HP) is controversial. " 08/01/1993 - "Patients suffering from extrinsic allergic alveolitis with plasma cells in the BAL fluid (n = 18) had increased absolute numbers of lymphocytes, eosinophils and mast cells, a decreased percentage of alveolar macrophages and lower CD4/CD8 ratio, as well as higher immunoglobulin levels, when compared with patients with extrinsic allergic alveolitis having no plasma cells in the BAL fluid (n = 12). " 01/01/1978 - "Experimental hypersensitivity pneumonitis: serum immunoglobulins G1, G2, M, A and E in Micropolysopra faeni sensitized and desensitized calves." 01/01/2011 - "Immunoglobulin free light chains are increased in hypersensitivity pneumonitis and idiopathic pulmonary fibrosis."
9.	nintedanibIBA 01/01/2021 - "Hypersensitivity pneumonitis has historically been treated with immunosuppression, but recently nintedanib was approved for the treatment of progressive fibrotic HP. " 03/08/2022 - "Recent advances in fibrotic hypersensitivity pneumonitis include improved diagnostic guidance, systematic assessments of immunosuppressive therapy, and the recent availability of antifibrotic therapy (nintedanib) for those with progressive disease. " 11/15/2023 - "To get insight on the cellular and molecular mechanisms that drive the clinical efficiency of nintedanib in patients with non-IPF PF-ILD, we investigated its effects on the fibrosing functions of HLFs derived from patients with PF-hypersensitivity pneumonitis (PF-HP, n = 7), PF-sarcoidosis (n = 5) and pleuroparenchymal fibroelastosis (PPFE, n = 4). " 01/01/2021 - "In this randomized, double-blind, placebo-controlled, phase III trial, patients with chronic hypersensitivity pneumonitis, idiopathic non-specific interstitial pneumonia, unclassifiable ILD, autoimmune ILD, sarcoidosis, and others were included, and nintedanib slowed the annual decline of pulmonary function by 57 % in these patients. " 01/01/2019 - "Studies in animal models with features of fibrosing ILDs such as IPF, SSc-ILD, rheumatoid arthritis-ILD, hypersensitivity pneumonitis and silicosis demonstrate that nintedanib has anti-fibrotic activity irrespective of the trigger for the lung pathology. "
10.	pirfenidoneIBA 01/01/2018 - "Objectives: The aim of this study was to evaluate the efficacy of pirfenidone in patients with chronic hypersensitivity pneumonitis (HP). " 04/01/2021 - "Design and rationale of a randomised, double-blind trial of the efficacy and safety of pirfenidone in patients with fibrotic hypersensitivity pneumonitis." 03/01/2020 - "An Open-label Study With Pirfenidone on Chronic Hypersensitivity Pneumonitis." 11/01/2023 - "Pirfenidone in fibrotic hypersensitivity pneumonitis: is it ready for prime time?" 11/01/2023 - "Pirfenidone in fibrotic hypersensitivity pneumonitis: a double-blind, randomised clinical trial of efficacy and safety."

Therapies and Procedures

1.	Therapeutics 02/01/2008 - "After admission the patient's symptoms improved without therapy and examination of the bronchoalveolar lavage fluid (BALF) and transbronchial lung biopsy (TBLB) revealed findings compatible with acute hypersensitivity pneumonitis. " 11/01/2002 - "Discontinuation of hot tub use, without antimycobacterial therapy, led to prompt improvement in symptoms, pulmonary function, and radiographic abnormalities, strongly supporting a diagnosis of hypersensitivity pneumonitis. " 01/01/2022 - "There is accumulating evidence that antifibrotic medications can be useful as a second-line therapy in some patients with fibrotic hypersensitivity pneumonitis who have progression despite immunosuppression. " 01/01/2021 - "Addition of antifibrotic therapy to immunosuppression in hypersensitivity pneumonitis: A case series." 01/01/2021 - "Leukocyte telomere length and mycophenolate therapy in chronic hypersensitivity pneumonitis."
2.	Injections 09/01/1991 - "To establish a model of experimental hypersensitivity pneumonitis (EHP) in mice and to examine the influence of genetic background on the pulmonary inflammatory response to Micropolyspora faeni, we determined the responses of C57BL/6, SJL/J, and C3H/HeJ mice to intratracheal (i.t.) injections of M. " 10/01/1985 - "Pulmonary histologic abnormalities resolve despite continuing intratracheal injections of Micropolyspora faeni in a rabbit model of hypersensitivity pneumonitis. " 01/01/1977 - "Experimental hypersensitivity pneumonitis: reduced severity of clinical response following repeated injections of Micropolyspora faeni antigen." 01/01/1977 - "To study the effects of steroids on the pulmonary lesions in experimental hypersensitivity pneumonitis, rabbits were sensitized to ovalbumin (OA) by injections of OA into footpads and 3 weeks later they were subjected to two successive aerosol challenges with OA at an interval of 48 hr. Injections of hydrocortisone sodium succinate 10 mg twice daily (but not at the reduced dosage of 5 mg twice daily) or methyprenisolone acetate 5 mg twice daily beginning 30 min before the first challenge and continued to the time of killing reduced the extent and intensity of vasculitis in both the treated groups and showed less alveolar septal thickening in the hydrocortisone treated group and less alveolar consolidation in the methylprednisolone treated group compared to the pulmonary lesions in the rabbits which were sensitized and then subjected to OA aerosol challenges, but received no treatment. "
3.	Mechanical Ventilators (Ventilator) 12/01/1981 - "We conclude that respirators of this type can offer substantial, and in most cases complete, protection against single exposures to environmental dusts that may provoke extrinsic allergic alveolitis." 12/01/1981 - "Protective value of dust respirators in extrinsic allergic alveolitis: clinical assessment using inhalation provocation tests." 11/01/2022 - "Case reports (n = 3) possibly due to the inhalation of particles from ultrasonic humidifier include hypersensitivity pneumonitis in adults and a 6-month infant; the young infant exhibited nonreversible mild obstructive ventilator defect. "
4.	Nebulizers and Vaporizers (Inhaler) 07/01/1989 - "Hypersensitivity pneumonitis by a cool-mist vaporizer: a detailed microbiologic and immunologic study." 07/01/1989 - "A patient with hypersensitivity pneumonitis caused by a contaminated cool-mist vaporizer was evaluated. " 04/01/1974 - "Hypersensitivity pneumonitis caused by a contaminated cool-mist vaporizer."
5.	Humidifiers 09/26/2023 - "Recurrent episodes of febrile dyspnoea: hypersensitivity pneumonitis caused by a household ultrasonic humidifier." 01/01/2023 - "Based on the clinical history, imaging features, and amount of humidifier usage, hypersensitivity pneumonitis caused by a humidifier was suspected. " 10/01/2022 - "Humidifier lung (HL) is a hypersensitivity pneumonitis resulting from exposure to humidifiers, with fungi from the humidifier as one of the etiologic agents. " 11/01/2020 - "Ultrasonic humidifier lung is a rare form of hypersensitivity pneumonitis (HP), and its clinical and radiological features are unclear. " 01/01/2020 - "Thus, humidifier lung seems to have different characteristics compared to other hypersensitivity pneumonitis phenotypes. "