Pulmonary aspergillosis: Diagnostic and immunological significance of antigens and C‐substance in Aspergillus fumigatus

Furrier's lung

“…Similar asthma-like symptoms have been described in maple-bark disease, which is a granulomatoustype pneumonitis, very similar to furrier's lung and has been related to the inhalation of Coniosporum corticale (Towey, Sweany, and Huron, 1932;Emanuel et al, 1962). With pulmonary aspergillosis an asthma-like syndrome has also been described (Hinson, Moon, and Plummer, 1952;Pepys, Riddell, Citron, Clayton, and Short, 1959;Longbottom and Pepys, 1964;Pepys, 1969) along with an 'allergic alveolitis' (Riddle and Grant, 1967) related to the massive inhalation of fungus spores, characterized by a tuberculoid granuloma (Filip and Barborik, 1966) similar to the one we have described. Finally, contact with some species of birds can give rise not only to bird fancier's lung but also to hypersensitivity reactions of immediate type, characterized by rhinitis and asthma which may be related to antigens found in the feathers (Carrego, 1969).…”

“…The case was later reviewed and we believe the data obtained are sufficiently demonstrative of a disease intimately related to the inhalation of hair dust which is similar to other diseases produced by vegetable, animal, and chemical dusts, sometimes related to fungi, such as farmer's lung (Pepys et al, 1964;Seal et al, 1968), bagassosis (Jamison and Hopkins, 1940-41), maple-bark disease (Emanuel et al, 1962), sequoiosis (Cohen et al, 1967), bird fancier's lung (Nash et al, 1967), suberosis (Cancella, 1955(Cancella, , 1959Horta and Cancella, 1956-57;Avila and Villar, 1968), malt handler's 'extrinsic allergic-alveolitis' (Filip and Barborik, 1966;Riddle and Grant, 1967;Riddle, Channell, Blyth, Weir, Lloyd, Amos, and Grant, 1968), vineyard sprayer's lung (Pimentel and Marques, 1969), and coffee worker's lung (van Toorn, 1970). These findings suggest that inhalation of animal hair leads not only to sensitization which affects the nose and bronchial tree, often revealed as an asthma-like syndrome, but also to an interstitial granulomatous process which damages the interalveolar septa and culminates in diffuse irreversible pulmonary fibrosis.…”

Pulmonary Hypersensitivity Disease Due to Inhaled Organic Antigens

“…This type of reaction is mediated by non-precipitating, skin-sensitising antibody, known as reagin, demonstrable by the production of immediate wealing reactions on skin testing, and immediate bronchial reactions on inhalation testing. In a survey in which there was some selection of patients (Longbottom and Pepys, 1964), positive skin test reactions to prick test with A. fumigatus were reported in 38 per cent of patients with uncomplicated asthma. A lower proportion, about 10 to 20 per cent, of unselected patients with extrinsic asthma give positive reactions to A. fumigatus.…”

“…On X-ray, pulmonary infiltration of the collapse-consolidation type appear. (Longbottom and Pepys, 1964 Culture of the sputum for A. fumigatus is of limited value in the diagnosis, since the spores are inhaled by the population at large and can, therefore, be present in the sputum of unaffected subjects. Positive cultures are, however, obtained more frequently from patients with asthma (Pepys, Riddell, Citron, Clayton and Short, 1959 The causes of other cases of pulmonary eosinophilia in Britain are not known.…”

Binding of C-reactive protein to Aspergillus fumigatus fractions

“…Longbottom and Pepys (1964) described a precipitin reaction involving aspergillus C-reactive substance and CRP and pointed to this as a source of error in the serodiagnosis of aspergillosis. Pulmonary aspergillosis occurs in different clinical forms (Pennington, 1980); complement activation may be important in some of them.…”