Hypersensitivity pneumonitis: A new strategy for serodiagnosis and environmental surveys.

Abstract

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.

• Authors: Anne-Pauline Bellanger, Gabriel Reboux, Adeline Rouzet, Coralie Barrera, Steffi Rocchi, Emeline Scherer, Laurence Millon
• Journal: Respiratory medicine (Respir Med) Vol. 150 Pg. 101-106 (04 2019) ISSN: 1532-3064 [Electronic] England
• PMID: 30961934 (Publication Type: Journal Article, Review)
• Copyright: Copyright © 2019 Elsevier Ltd. All rights reserved.

Chemical References

• Antigens

Topics

• Alveolitis, Extrinsic Allergic (diagnosis, diagnostic imaging, etiology, immunology)
• Antigens (immunology)
• Bird Fancier's Lung (immunology)
• Bronchial Provocation Tests (methods, standards)
• Environmental Exposure (adverse effects)
• Humans
• Predictive Value of Tests
• Radiography (standards)
• Serologic Tests (methods)
• Surveys and Questionnaires (statistics & numerical data)