Involvement of Bird-related IgG Antibodies in Interstitial Pneumonia

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概要

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• Background and Objective:Chronic interstitial pneumonia (IP) might include chronic hypersensitivity pneumonitis (HP) and chronic bird-related hypersensitivity pneumonitis (BRHP). A specific antigen is difficult to identify in these diseases, and such evidence would provide important clues suggesting a diagnosis of HP. In this study, we used an ImmunoCAP analysis system to measure specific IgG antibodies against pigeons and budgerigars in the sera of patients with IP and investigated the involvement of bird-related IgG antibodies in IP.Methods:The study group comprised 22 patients with idiopathic pulmonary fibrosis (IPF), 8 with chronic IP, 7 with subacute HP, 7 with chronic HP, and 10 with control diseases. All cases were diagnosed from 2000 through 2011 at the Institute of Pulmonary Medicine and Clinical Immunology, Dokkyo Medical University. Clinical features, results of laboratory examinations, and levels of serum IgG antibodies against pigeons and budgerigars were compared.Results:There were no significant differences among the disease groups in C-reactive protein, leukocyte count, lactate dehydrogenase, and the results of blood gas analysis. KL-6 and surfactant protein D were significantly higher in subacute HP and chronic HP. The levels of anti-pigeon IgG antibodies and anti-budgerigar IgG antibodies in each disease group were respectively as follows:IPF, 11.02±5.97 mg/l, 5.03±3.97 mg/l;chronic IP, 10.04±8.55 mg/l, 3.30±1.47 mg/l;subacute HP, 14.39±9.13 mg/l, 7.96±6.47 mg/l;chronic HP, 24.97±16.19 mg/l, 11.50±13.80 mg/l;and control diseases, 8.66±3.15 mg/l, 3.77±1.05 mg/l. The mean levels of anti-pigeon IgG antibodies and anti-budgerigar IgG antibodies were significantly higher in chronic HP. There was a positive correlation between anti-pigeon IgG antibodies and anti-budgerigar IgG antibodies (R2 = 0.715, p<0.001). Conclusions:In patients with clinically diagnosed chronic HP, high levels of anti-pigeon IgG antibodies or anti-budgerigar IgG antibodies were confirmed using an ImmunoCAP analysis system. In general, HP (especially chronic HP) is difficult to diagnose definitively, and this analysis system is expected to facilitate diagnosis.

• 2013-03-25

著者

• Sugiyama Kumiya

  Department Of Pulmonary Medicine And Clinical Immunology Dokkyo University School Of Medicine

• Hirata Hirokuni

  Department Of Pulmonary Medical And Clinical Immunology Dokkyo University School Of Medicine

• Fukushima Yasutsugu

  Department Of Pulmonary Medicine And Clinical Immunology Dokkyo Medical University

• Fukuda Takeshi

  Department Of Applied Chemistry And Biotechnology Graduate School Of Engineering University Of Fukui

• Ikeda Naoya

  Department Of Applied Molecular Chemistry College Of Industrial Technology Nihon University

• Yoshida Naruo

  Department of Pulmonary Medicine and Clinical Immunology, Dokkyo Medical University

• Mashio Kazuki

  Department of Pulmonary Medicine and Clinical Immunology, Dokkyo Medical University

• Oomi Fumito

  Department of Pulmonary Medicine and Clinical Immunology, Dokkyo Medical University

• Umetsu Takafumi

  Department of Pulmonary Medicine and Clinical Immunology, Dokkyo Medical University

• Ikeda Naoya

  Department of Pulmonary Medicine and Clinical Immunology, Dokkyo Medical University

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