Pulmonary Hypersensitivity Disease Due to Inhaled Organic Antigens

The risk of asthma among Finnish patients with farmer's lung

“…Erkinjuntti-Pekkanen found asthma diagnosed by physician in 16% of farmer's-lung patients during a mean follow-up of 14 years [5]. In the two former studies the definition of asthma is more restrictive, yet despite the differences in duration of follow-up and definition of asthma, all these Finnish studies are quite consistent with the conclusion of Pepys, who stated that asthma may develop in approximately 10% of subjects some time after the onset of farmer's lung [15]. Our results indicate clearly that this is more than the incidence of asthma in farming occupations in general and factors explaining the overall excess of asthma in farming (e.g., exposure to endotoxins or animal-derived allergens) may thus not explain the finding.…”

“…Follow-up studies have indicated that the prevalence of asthma [4,9,10,15], airway obstruction or bronchial hyperresponsiveness [1,3,6,11,13] may be increased among patients with farmer's lung. Very few of the studies have included a comparison group that would have allowed for adjustment for the overall risk of asthma among farmers.…”

Newer Concepts of Managing Asthmatic Patients

“…British workers postulate that the delayed pulmonary reactions that appear within five or six hours after challenge and resolve within 24 hours may represent an Arthus phenomenon in the lung. 4 If the relationship to the causal agent is not recognized, the associated systemic symptoms of fever, chills and malaise may suggest infection.…”

“…4 This disease is not always associated with wheezing, but patients seek medical help for dyspnea and often fever and malaise, which are directly associated with inhalation of specific dust . .…”

Long-term occupational inhalation of organic dust ? Effect on pulmonary function

“…Inhalation of organic dust has been established as the cause of allergic alveolitis (Hargraeve et al , 1966, Pepys, 1966 Such dusts act as antigens and the pathological pattern of extrinsic allergic alveolitis is characterised primarily by Type III allergic reaction (Arthus reaction) on the alveolar walls and in the terminal bronchioli Organic changes are preceded by sensitisation of the organism with formation of local and humoral specific antibody which in combination with the inhaled antigen tends to generate immune complexes.…”