Prognostic factors in chronic hypersensitivity pneumonitis

Creamer, Andrew; Barratt, Shaney

doi:10.1183/16000617.0167-2019

Cited by 27 publications

(17 citation statements)

References 75 publications

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“…Frequently used prognostic factors in fibrotic ILD include older age, male sex and lower baseline FVC and diffusing capacity of the lung for carbon monoxide (DLCO), which have all been associated with progressive disease in various ILD subtypes. [24][25][26] However, the imperfect predictive ability of these clinical features raises the question of whether additional factors may provide further prognostic information. RF and ACPA presence have previously been associated with increased mortality in RA and RA-ILD, 27,28 but their prognostic impact in other ILD subtypes is unknown.…”

Section: Discussionmentioning

confidence: 99%

Clinical relevance of rheumatoid factor and anti‐citrullinated peptides in fibrotic interstitial lung disease

et al. 2022

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Background and objective Rheumatoid arthritis (RA) is a frequent cause of interstitial lung disease (ILD); however, the impact of rheumatoid factor and anti‐citrullinated peptide antibody seropositivity in ILD without connective tissue disease (CTD) is unclear. We examined the association of seropositivity with ILD progression, mortality and response to immunosuppression in non‐CTD ILD. Methods A total of 1570 non‐CTD patients (with idiopathic pulmonary fibrosis, hypersensitivity pneumonitis, interstitial pneumonia with autoimmune features or unclassifiable ILD) and 181 RA‐ILD patients were included from a prospective registry. Longitudinal forced vital capacity (FVC), transplant‐free survival and incidence of progressive fibrosing‐ILD (PF‐ILD) were compared between seronegative non‐CTD ILD (reference group), seropositive non‐CTD ILD and RA‐ILD using linear mixed‐effect and Cox proportional hazards models adjusted for age, sex, smoking pack‐years and baseline FVC. Interaction between seropositivity and immunosuppression on FVC decline was assessed in patients with ≥6 months of follow‐up before and after the treatment. Results Two hundred and seventeen (13.8%) patients with seropositive non‐CTD ILD had similar rates of FVC decline and transplant‐free survival compared to seronegative non‐CTD ILD, but more frequently met the criteria for PF‐ILD (hazard ratio [HR] = 1.35, p = 0.004). RA‐ILD had slower FVC decline (p = 0.03), less PF‐ILD (HR = 0.75, p = 0.03) and lower likelihood of lung transplant or death (HR = 0.66, p = 0.01) compared to seronegative non‐CTD ILD. No interaction was found between seropositivity and treatment on FVC decline in non‐CTD ILD. Conclusion Seropositivity in non‐CTD ILD was not associated with improved outcomes or treatment response, highlighting the importance of other disease features in determining prognosis and predicting response to immunosuppression.

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Section: Discussionmentioning

confidence: 99%

Clinical relevance of rheumatoid factor and anti‐citrullinated peptides in fibrotic interstitial lung disease

et al. 2022

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“…Antigen avoidance is a key aspect of management, however about half of patients with chronic HP do not have identifiable inciting antigen, which is associated with worse prognosis ( 50 ). Other clinical factors associated with worse prognosis include older age, male sex, smoking history, lower baseline FVC or DLCO, and absent lymphocytosis on bronchoalveolar lavage ( 47 , 51 ). In addition to antigen avoidance, corticosteroids and steroid-sparing agents are often used, with limited evidence ( 52 ).…”

Section: Ilds At Risk For a Progressive Fibrosing Phenotypementioning

confidence: 99%

Clinical Overview of Progressive Fibrotic Interstitial Lung Disease

Case

2022

Front. Med.

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Interstitial lung diseases (ILD) on the whole have variable prognoses, but there are those which manifest with fibrosis and are characterized by disease progression. Chief among these is idiopathic pulmonary fibrosis, but other ILDs, including autoimmune ILD and chronic hypersensitivity pneumonitis, may have a progressive fibrotic phenotype also. A usual interstitial pneumonia pattern of lung involvement is a prominent risk factor for such a course, suggesting shared fibrotic pathways that may be targeted by antifibrotic therapies. This brief review describes ILDs that are most commonly fibrotic, shared risk factors for development of PF-ILD, and evidence for antifibrotic use in their management.

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“…It remains unknown why, among such a considerable number of people exposed, only a slight percentage of them become ill, and why the disease may take a chronic form with an unfavourable prognosis [11]. Creamer and Barratt [37] presented a review of the current data concerning prognostic factors of the progression and survival with chronic HP. The researchers reported that older age is associated with increased mortality due to hypersensitivity pneumonitis, similar to COVID-19.…”

Section: Clinical Course Of Hypersensitivity Pneumonitis (Hp)mentioning

confidence: 99%

COVID 19 – Possible interrelations with respiratory comorbidities caused by occupational exposure to various hazardous bioaerosols. Part II. Clinical course, diagnostics, treatment and prevention

Maćkiewicz¹,

Lemieszek²,

Dutkiewicz³

2021

Ann Agric Environ Med.

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Introduction and objective. The course of COVID-19 caused by the SARS-CoV-2 may be aggravated by bioaerosols containing other viruses, bacteria, and fungi, occurring mainly in the occupational environment. Hence, the diagnostics and treatment of COVID-19 should address such a possibility in the anamnesis, treatment and final recommendations for avoiding of adverse exposure. Abbreviated description of the state of knowledge. As SARS-CoV-2 attacks primarily the respiratory system and the severe manifestation of COVID-19 is interstitial pneumonia, diagnostics should include the following clinical and laboratory examinations: chest X-ray; high resolution computed tomography (HRCT); pulmonary function tests; arterial-blood gas test; genetic tests for the presence of SARS-CoV-2, in the future with the use of highly specific and sensitive nano-based biosensors; tests for the presence of specific immunity against the antigens of microorganisms causing other infectious or allergic pulmonary diseases (in the case of anamnestic indications). Because an universally accepted treatment for COVID-19 does not exist, the hitherto prescribed antiviral and immune-modulating drugs should be used be with caution. In many cases, a better alternative could be a safe supportive therapy, such as supplementation of the diet with probiotics, prebiotics, vitamins and microelements. Conclusions. The most important preventive measures against COVID-19 should include: vaccination; the use of filter or surgical masks; disinfection and sterilization; maintaining of well-functioning ventilation and air conditioning systems; reduction of the community air pollution which has been identified as an important factor increasing the COVID-19 severity. In the choice of preventive measures, the above should be considered for their potential efficacy against other bioaerosols as potential disease-aggravating agents.

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Prognostic factors in chronic hypersensitivity pneumonitis

Cited by 27 publications

References 75 publications

Clinical relevance of rheumatoid factor and anti‐citrullinated peptides in fibrotic interstitial lung disease

Clinical relevance of rheumatoid factor and anti‐citrullinated peptides in fibrotic interstitial lung disease

Clinical Overview of Progressive Fibrotic Interstitial Lung Disease

COVID 19 – Possible interrelations with respiratory comorbidities caused by occupational exposure to various hazardous bioaerosols. Part II. Clinical course, diagnostics, treatment and prevention

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