Acute inflammatory and immunologic responses against antigen in chronic bird-related hypersensitivity pneumonitis |
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Authors: | Yukihisa Inoue Masahiro Ishizuka Haruhiko Furusawa Takayuki Honda Tatsuo Kawahara Tomoya Tateishi Yasunari Miyazaki |
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Affiliation: | Department of Respiratory Medicine, Tokyo Medical and Dental University, Tokyo, Japan |
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Abstract: | BackgroundHypersensitivity pneumonitis (HP) is an immune-mediated lung disease induced by the inhalation of a wide variety of antigens and a persistent antigen exposure induces inevitably pulmonary fibrosis in chronic HP. Although neutrophils, Th1 and Th17 cells contribute to lung inflammation in acute phase of HP, there is no clear explanation as to how the immunological reaction occurs just after the inhalation of causative antigens in the chronic phase of HP.MethodsWe examined the inflammatory and immunologic profiles before and after the inhalation provocation test (IPT) in serum and bronchoalveolar lavage fluid (BALF) from patients with chronic bird-related HP (BRHP) and other interstitial lung diseases (ILDs). We analyzed BALF samples from 39 patients (19 BRHP and 20 other ILDs) and serum samples from 25 consecutive patients (20 BRHP and 5 other ILDs) who underwent the IPT.ResultsA significant increase of neutrophils was observed in the BALF from the BRHP patients following the IPT. Neutrophil chemoattractants, namely, granulocyte colony-stimulating factor, IL-6, IL-8, IL-17, and CXCL2 significantly increased in both the serum and BALF of the BRHP patients after the IPT. Serum IFN-γ and CXCL10, cytokines/chemokines that contributed to Th1 inflammation, were also significantly increased in BRHP following the IPT.ConclusionsThis study demonstrated the exposure to the causative antigen provoked acute neutrophilic and Th1 immunologic responses similar to acute HP even in the chronic phase of HP. |
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Keywords: | Corresponding author. Department of Respiratory Medicine, Tokyo Medical and Dental University, 1-5-45, Yushima, Bunkyo-ku, Tokyo 113-8510, Japan. Bird-related hypersensitivity pneumonitis Chemokine Cytokine Inhalation provocation test Neutrophil BALF bronchoalveolar lavage fluid BRHP bird-related hypersensitivity pneumonitis CRP C reactive protein DLco diffusing capacity for carbon monoxide G-CSF granulocyte colony-stimulating factor HP hypersensitivity pneumonitis ILDs interstitial lung diseases IPF idiopathic pulmonary fibrosis IPT inhalation provocation test KL-6 Kreb von den Lungen-6 LDH lactate dehydrogenase LPT lymphocyte proliferation test PDE pigeon dropping extracts SI stimulation index SP-D surfactant protein D VC vital capacity WBC white blood cell |
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