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: 891 relevant articles (23 outcomes, 70 trials/studies)

Relationship Network

Disease Context: Research Results

Related Diseases

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

Experts

1.	Inase, Naohiko: 22 articles (12/2015 - 05/2003)
2.	Miyazaki, Yasunari: 18 articles (12/2015 - 05/2003)
3.	Yoshizawa, Yasuyuki: 17 articles (10/2011 - 04/2003)
4.	Morell, Ferran: 12 articles (12/2014 - 04/2003)
5.	Ohtani, Yoshio: 12 articles (03/2011 - 05/2003)
6.	Muñoz, Xavier: 10 articles (12/2014 - 04/2003)
7.	Costabel, Ulrich: 10 articles (09/2013 - 06/2003)
8.	Guzman, Josune: 8 articles (09/2013 - 02/2004)
9.	Cormier, Yvon: 7 articles (03/2012 - 04/2004)
10.	Colby, Thomas V: 6 articles (12/2015 - 07/2005)

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.	Immunoglobulin G (IgG)IBA 11/01/2013 - "20 of the 46 (43%, 95% CI 29-58) patients with IPF according to 2011 guidelines had a subsequent diagnosis of chronic hypersensitivity pneumonitis: nine patients had positive bronchial challenge testing (eight of whom were also IgG positive and six of these patients also had surgical lung biopsy showing a pattern consistent with chronic hypersensitivity pneumonitis); seven were IgG positive plus had histopathology on surgical lung biopsy that was consistent with hypersensitivity pneumonitis; one was IgG positive plus had greater than 20% lymphocytes in bronchoalveolar lavage fluid; and three had findings on surgical lung biopsy that were consistent with subacute hypersensitivity pneumonitis (and IgG positive). " 03/15/2006 - "In addition, the adoptive transfer of DTA-1-pretreated NKT cells into CD1d(-/-) mice attenuated hypersensitivity pneumonitis more than control IgG pretreated NKT cells in these mice. " 01/01/2005 - "Determination of risk factors in the working environment that could explain the sensitisation process, and assessment of the differences in specific IgG levels to Aspergillus fumigatus, Saccharopolyspora rectivirgula and Thermoactynomices vulgaris in patients with hypersensitivity pneumonitis induced by esparto, exposed healthy plasterers and control population. " 01/01/2005 - "Specific IgG to Thermoactynomices vulgaris, Micropolyspora faeni and Aspergillus fumigatus in building workers exposed to esparto grass (plasterers) and in patients with esparto-induced hypersensitivity pneumonitis." 05/01/2004 - "Detection of IgG to specific fungi has been used as a marker of exposure to agents that may cause illnesses such as hypersensitivity pneumonitis. "
3.	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. "
4.	AerosolsIBA 05/01/2006 - "Because hypersensitivity pneumonitis is not typically associated with exposure to metalworking fluid aerosols, this study examined whether Mycobacterium immunogenum (M. " 11/01/2003 - "Mycobacteria and pseudomonads occurring in modern metalworking fluids (MWF) have been implicated in occupational health hazards as causal agents for hypersensitivity pneumonitis (HP) and other respiratory illnesses in machine workers exposed to these fluids and their aerosols. " 11/01/2003 - "Recent outbreaks of hypersensitivity pneumonitis (HP) have been associated with exposures to metalworking (MWF) fluid aerosols. " 03/01/1997 - "Hypersensitivity pneumonitis to inhaled aerosols has been described; these aerosols are from several sources of water. " 09/01/1995 - "A hypersensitivity pneumonitis disorder associated with exposure to metalworking fluid aerosols."
5.	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. " 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." 10/01/2012 - "The NSIP pattern is the histological background of a subacute/chronic interstitial pneumonitis that may be observed in many conditions, including CTD, drug-induced lung disease, hypersensitivity pneumonitis, slowly healing diffuse alveolar damage (DAD), relapsing organizing pneumonia, occupational exposure, immunodeficiency (mainly HIV infection), graft versus host disease (GVHD), familial pulmonary fibrosis, immunoglobulin G4 (IgG4)-related sclerosing disease, with or without overlap features with Rosai-Dorfman disease, multicentric Castleman disease, and myelodysplastic syndrome. "
6.	Pulmonary Surfactant-Associated Protein D (Surfactant Protein D)IBA 12/01/2015 - "The usefulness of KL-6 and SP-D for the diagnosis and management of chronic hypersensitivity pneumonitis." 11/01/2000 - "This is a report on two patients with occupational hypersensitivity pneumonitis (HP) caused by spores of Hypsizigus marmoreus (Bunashimeji) and serial follow-up measurements of serum surfactant protein D (SP-D) levels. " 12/01/2005 - "Involvement of eicosanoids and surfactant protein D in extrinsic allergic alveolitis." 12/01/2015 - "It is believed that Krebs von den Lungen-6 (KL-6) and surfactant protein D (SP-D) are useful biomarkers for the diagnosis of various types of interstitial lung diseases, including hypersensitivity pneumonitis (HP). " 09/01/2007 - "The immunohistochemical distribution of SP-D was compared with that of SP-A and KL-6 using a monoclonal antibody in lung tissues of 15 cases of collagen vascular disease-associated interstitial pneumonia (CVD-IP), 4 cases of hypersensitivity pneumonitis (CHP), and 6 cases of other diseases to determine their differences in distribution. "
7.	SteroidsIBA 01/01/1977 - "In view of the observation that even in a steroid sensitive species like the rabbit, extensive pulmonary changes like alveolar consolidation, septal thickening and vasculitis persisted in spite of treatment with relatively large doses of these steroids, it was felt that in human hypersensitivity pneumonitis steroids might only suppress the warning symptoms without substantially affecting the progress of the pulmonary lesions." 02/01/2009 - "We diagnosed summer type hypersensitivity pneumonitis and this condition improved in response to antigen isolation and steroids. " 01/01/2014 - "He was treated for pneumonia with antibiotics and then with steroids for hypersensitivity pneumonitis but continued to deteriorate. " 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. "
8.	Ribosomal DNA (rDNA)IBA 07/01/2001 - "Random amplified ribosomal DNA restriction analysis for rapid identification of thermophilic Actinomycete-like bacteria involved in hypersensitivity pneumonitis." 01/01/1997 - "We determined the partial sequences of large subunit rDNA of a new yeast species, Trichosporon domesticum, which was isolated from the house of a summer-type hypersensitivity pneumonitis patient. " 12/01/2002 - "Mushroom worker's lung (MWL) is a hypersensitivity pneumonitis or allergic alveolitis caused by a type III IgG-mediated immunopathogenic inflammatory reaction in the host due to the inhalation of several thermophilic organisms, including Thermoactinomyces spp. It is difficult to distinguish phenotypically the eight species of this genus; therefore, this study sought to develop an improved molecular means of identifying Thermoactinomyces spp. associated with MWL by partial 16S rDNA PCR amplification and direct sequencing. "
9.	GlucocorticoidsIBA 01/01/1977 - "A study of the effects of systemic administration of adrenal glucocorticoids in an experimental model of hypersensitivity pneumonitis." 01/26/1984 - "Main indications of glucocorticoids are those conditions in which immunologic and/or inflammatory reactions have a deleterious effect: in asthma, combined with bronchodilators, glucocorticoids are the mainspring of management of severe attacks and protracted, severe asthma; corticosteroid aerosols have the advantage that systemic corticosteroid therapy can be avoided or shortened, thereby lessening the risk/benefit ratio; extrinsic allergic alveolitis, sarcoidosis with multiple localizations, and/or respiratory impairment, and protracted pulmonary eosinophilia, are choice indications for systemic corticosteroid therapy; glucocorticoids may be insufficiently effective in idiopathic pulmonary fibrosis or respiratory localizations of vasculitis, which may justify association of immunosuppressants; indications of glucocorticoids in certain forms of tuberculosis or cancer of the respiratory tract are less clearly systematized.(ABSTRACT TRUNCATED AT 250 WORDS)"
10.	Pentetic Acid (DTPA)FDA LinkGeneric 07/01/1990 - "Transfer of 99mTc DTPA and bronchoalveolar lavage findings in patients with asymptomatic extrinsic allergic alveolitis." 07/01/1990 - "Pulmonary clearance of inhaled technetium-99m labelled diethylene triamine penta-acetic acid (DTPA) was measured in seven patients with a history of extrinsic allergic alveolitis but with no symptoms at the time of the study and in 12 control subjects. " 12/01/2003 - "Chronic hypersensitivity pneumonitis with heart involvement observed during in-111 DTPA octreotide (OctreoScan) imaging."

Therapies and Procedures

1.	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. "
2.	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."
3.	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."
4.	Lung Transplantation 06/01/2015 - "Lung transplantation for hypersensitivity pneumonitis." 01/01/2013 - "This case report describes a patient with possible initial hypersensitivity pneumonitis and subsequent diagnosis of IPF with late development of pulmonary hypertension, and who was a candidate for lung transplantation. " 06/01/2013 - "We report the case of a 61-year-old man after bilateral lung transplantation for chronic hypersensitivity pneumonitis who presented with leg weakness, cognitive decline, and expressive aphasia at 5 months post transplantation. " 06/01/1999 - "Biochemical surfactant abnormalities of varying degrees have been described in obstructive lung diseases (asthma, bronchiolitis, chronic obstructive pulmonary disease, and following lung transplantation), infectious and suppurative lung diseases (cystic fibrosis, pneumonia, and human immunodeficiency virus), adult respiratory distress syndrome, pulmonary oedema, other diseases specific to infants (chronic lung disease of prematurity, and surfactant protein-B deficiency), interstitial lung diseases (sarcoidosis, idiopathic pulmonary fibrosis, and hypersensitivity pneumonitis), pulmonary alveolar proteinosis, following cardiopulmonary bypass, and in smokers. "
5.	Transplants (Transplant) 12/01/2012 - "It is the possible cause of summer-type hypersensitivity pneumonitis in Japan and systemic infections in transplant patients, patients on corticosteroid therapy, patients with solid tumors and burn patients. " 11/01/2009 - "Imaging-pathologic correlations will be presented for inflammatory bronchiolitis (infectious bronchiolitis, hypersensitivity pneumonitis, respiratory bronchiolitis, follicular bronchiolitis, diffuse panbronchiolitis) and fibrosing bronchiolitis (constrictive bronchiolitis, post-infectious bronchiolitis, toxic fume exposure, transplant-related bronchiolitis)." 01/01/2013 - "According to the possibility of either idiopathic pulmonary fibrosis or chronic hypersensitivity pneumonitis, treatment included prednisolone, azathioprine, acetylcysteine and avoidance of contact with the parakeet, but there was an unfavorable response and the patient was subsequently referred for lung transplant. "