Precipitin (F.L.H.) Test in Farmer's Lung

Pepys, J.; Jenkins, P. A.

doi:10.1136/thx.20.1.21

Cited by 233 publications

(109 citation statements)

References 11 publications

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“…Antibodies specific to the offending agent are increased in both serum and BAL of patients with HP (86,87). Even if the quantity of antibodies in the alveoli correlates with the severity of HP, there is no proof that they are involved in the disease.…”

Section: Specific Antibodies In Balmentioning

confidence: 95%

Hypersensitivity pneumonitis

Girard

and

Cormier

2009

Allergy

116

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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: Specific Antibodies In Balmentioning

confidence: 95%

Hypersensitivity pneumonitis

Girard

and

Cormier

2009

Allergy

116

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“…Among these criteria, serology has long been considered to be either a minor criterion or a simple marker of exposure [23][24][25][26]. However, with typical FL patients, the use of antigens isolated from patients' environments has lead to convincing results [11,27]. In addition, a recent study by LACASSE et al [4] identified serum precipitins as a significant predictive factor of HP, regardless of exposure.…”

Section: Discussionmentioning

confidence: 99%

“…The most discriminative antigens within the tested panel were S. rectivirgula, A. corymbifera, E. amstelodami and W. sebi; the first is recognised as the major aetiological antigen of FL [27] and is responsible for other professional HP due to actinomycetes. The three others are likely to be aetiological factors of FL in Eastern France [11]; however, A. corymbifera and W. sebi have also been shown to be aetiological agents in FL in Scandinavia [28,29].…”

Section: Discussionmentioning

confidence: 99%

Diagnostic value of serum precipitins to mould antigens in active hypersensitivity pneumonitis

Fenoglio¹,

Reboux²,

Súdre³

et al. 2006

Eur Respir J

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Serum precipitins have a controversial diagnostic value in hypersensitivity pneumonitis (HP). The present authors' objective was to assess their diagnostic value by developing scores from a panel of specific antigens tested by two techniques (electrosyneresis and double diffusion) to discriminate active HP from other interstitial lung diseases.Consecutive patients presenting with a condition for which HP was considered in the differential diagnosis were included in the study. All patients underwent the same standardised diagnostic procedure, including precipitin tests performed in routine conditions. Clinical manifestations, bronchoalveolar lavage and high-resolution computed tomography defined the presence or absence of HP. Receiver-operating characteristic curves and logistic regression were used to develop the serological scores.A total of 122 patients (including 31 cases of HP) were included in the study. Five antigens from the panel were selected for the serological scores (Absidia corymbifera, Eurotium amstelodami, Wallemia sebi, Saccharopolyspora rectivirgula and mesophilic Streptomyces sp.). Electrosyneresis was more discriminative than the double-diffusion technique. Predictive negative values varied 81-88% and predictive positive values varied 71-75% for prevalence of HP 20-35%.In conclusion, serological scores using a panel of relevant antigens may guide both biological and clinical practice in areas of high prevalence of hypersensitivity pneumonitis.

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“…British studies have shown that a thermophilic actinomycete, Micropolyspora (M) faeni, is the main causative agent of farmer's lung (9,10). The microflora of Finnish moldy hay differs from that of British moldy hay (12,13); thus it can be assumed that also the microorganisms liberated in the ambient air causing farmer's lung might be different.…”

mentioning

confidence: 99%

Airborne molds and actinomycetes in the work environment of farmer's lung patients in Finland.

Kotimaa¹,

Husman²,

Terho³

et al. 1984

Scand J Work Environ Health

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KOTIMAA MH, HUSMAN KH, TERHO EO, MUSTONEN MH. Airborne molds and actinomycetes in the work environment of farmer's lung patients in Finland. Scand J Work Environ Health 10 (1984) 115-1 19. Occurrence of molds and actinomycetes in the breathing zone of farmers during the handling of hay, straw, or grain was studied with the use of an Andersen sampler on 35 farms in Finland. On 24 farms there was a person with recently diagnosed farmer's lung disease, and on 11 farms people were free of the disease. The total spore concentration and the concentrations of the spores of Thermoactinomyces (7) vulgaris, Micropolyspora ( M ) faeni, and Aspergillus ( A ) umbrosus were statistically significantly higher on the farms of patients with farmer's lung than on the disease-free farms. The mean proportions of the spores of thermotolerant and thermophilic microbes were greater on the farms of farmer's lung patients than on the reference farms. T vulgaris was the predominant actinomycete species. Both T vulgaris and A umbrosus were found on all farms of farmer's lung patients, but M faeni on only about half of such farms. The findings match the results of previous microbiological analyses of Finnish moldy hay and serological analyses of Finnish farmer's lung patients. It seems that T vulgaris, not Mfaeni, may be the main causative agent of farmer's lung in Finland. The possible etiologic role of A umbrosus requires further investigation. Because the farmers often failed to identify the moldiness of the plant material in contrast to researchers, it might be possible, through training, to improve farmers' ability to identify moldiness.

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Precipitin (F.L.H.) Test in Farmer's Lung

Cited by 233 publications

References 11 publications

Hypersensitivity pneumonitis

Hypersensitivity pneumonitis

Diagnostic value of serum precipitins to mould antigens in active hypersensitivity pneumonitis

Airborne molds and actinomycetes in the work environment of farmer's lung patients in Finland.

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