Hypersensitivity pneumonitis.
Journal
Nature reviews. Disease primers
ISSN: 2056-676X
Titre abrégé: Nat Rev Dis Primers
Pays: England
ID NLM: 101672103
Informations de publication
Date de publication:
06 08 2020
06 08 2020
Historique:
accepted:
11
06
2020
entrez:
9
8
2020
pubmed:
9
8
2020
medline:
16
6
2021
Statut:
epublish
Résumé
Hypersensitivity pneumonitis (HP) is a complex syndrome caused by the inhalation of a variety of antigens in susceptible and sensitized individuals. These antigens are found in the environment, mostly derived from bird proteins and fungi. The prevalence and incidence of HP vary widely depending on the intensity of exposure, the geographical area and the local climate. Immunopathologically, HP is characterized by an exaggerated humoral and cellular immune response affecting the small airways and lung parenchyma. A complex interplay of genetic, host and environmental factors underlies the development and progression of HP. HP can be classified into acute, chronic non-fibrotic and chronic fibrotic forms. Acute HP results from intermittent, high-level exposure to the inducing antigen, usually within a few hours of exposure, whereas chronic HP mostly originates from long-term, low-level exposure (usually to birds or moulds in the home), is not easy to define in terms of time, and may occur within weeks, months or even years of exposure. Some patients with fibrotic HP may evolve to a progressive phenotype, even with complete exposure avoidance. Diagnosis is based on an accurate exposure history, clinical presentation, characteristic high-resolution CT findings, specific IgG antibodies to the offending antigen, bronchoalveolar lavage and pathological features. Complete antigen avoidance is the mainstay of treatment. The pharmacotherapy of chronic HP consists of immunosuppressive drugs such as corticosteroids, with antifibrotic therapy being a potential therapy for patients with progressive disease.
Identifiants
pubmed: 32764620
doi: 10.1038/s41572-020-0191-z
pii: 10.1038/s41572-020-0191-z
doi:
Substances chimiques
Immunosuppressive Agents
0
Types de publication
Journal Article
Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
65Références
Selman, M., Pardo, A. & King, T. E. Jr. Hypersensitivity pneumonitis: insights in diagnosis and pathobiology. Am. J. Respir. Crit. Care Med. 186, 314–324 (2012).
pubmed: 22679012
Okamoto, T. et al. Nationwide epidemiological survey of chronic hypersensitivity pneumonitis in Japan. Respir. Investig. 51, 191–199 (2013).
pubmed: 23978646
Sema, M. et al. Environmental levels of avian antigen are relevant to the progression of chronic hypersensitivity pneumonitis during antigen avoidance. Immun. Inflamm. Dis. 6, 154–162 (2018).
pubmed: 29168324
Lacasse, Y. et al. Classification of hypersensitivity pneumonitis: a hypothesis. Int. Arch. Allergy Immunol. 149, 161–166 (2009).
pubmed: 19127074
Ohtani, Y. et al. Clinical features of recurrent and insidious chronic bird Fancier’s lung. Ann. Allergy Asthma Immunol. 90, 604–610 (2003).
pubmed: 12839317
Selman, M., Lacasse, Y., Pardo, A. & Cormier, Y. Hypersensitivity pneumonitis caused by fungi. Proc. Am. Thorac. Soc. 7, 229–236 (2010).
pubmed: 20463253
Raghu, G. et al. Diagnosis of hypersensitivity pneumonitis in adults: an official ATS/JRS/ALAT clinical practice guideline. Am. J. Respir. Crit. Care. Med. 202, e36–e69 (2020).
pubmed: 32706311
pmcid: 7397797
Morell, F. et al. Chronic hypersensitivity pneumonitis in patients diagnosed with idiopathic pulmonary fibrosis: a prospective case-cohort study. Lancet Respir. Med. 1, 685–694 (2013).
pubmed: 24429272
Salisbury, M. L. et al. Hypersensitivity pneumonitis: radiologic phenotypes are associated with distinct survival time and pulmonary function trajectory. Chest 155, 699–711 (2019). This study demonstrates that fibrotic features on HRCT are associated with worse outcomes in HP.
pubmed: 30243979
Depierre, A. et al. Epidemiological study of farmer’s lung in five districts of the French Doubs province. Thorax 43, 429–435 (1988).
pubmed: 3420554
pmcid: 461305
Fernandez Perez, E. R. et al. Identifying an inciting antigen is associated with improved survival in patients with chronic hypersensitivity pneumonitis. Chest 144, 1644–1651 (2013). This study highlights the crucial role of antigen identification to improve survival in chronic HP.
pubmed: 23828161
pmcid: 4694094
Morisset, J. et al. Use of mycophenolate mofetil or azathioprine for the management of chronic hypersensitivity pneumonitis. Chest 151, 619–625 (2017). This study suggests that the use of immunosuppressants can stabilize lung function and reduce prednisone dose in patients treated for chronic HP.
pubmed: 27816444
Fernandez Perez, E. R. et al. Epidemiology of hypersensitivity pneumonitis among an insured population in the United States: a claims-based cohort analysis. Ann. Am. Thorac. Soc. 15, 460–469 (2018).
pubmed: 29236517
Rittig, A. H., Hilberg, O., Ibsen, R. & Lokke, A. Incidence, comorbidity and survival rate of hypersensitivity pneumonitis: a national population-based study. ERJ Open Res. 5, 00259-2018 (2019).
Xaubet, A. et al. Report on the incidence of interstitial lung diseases in Spain. Sarcoidosis Vasc. Diffuse Lung Dis. 21, 64–70 (2004).
pubmed: 15127977
Singh, S. et al. Interstitial lung disease in India. Results of a prospective registry. Am. J. Respir. Crit. Care Med. 195, 801–813 (2017).
pubmed: 27684041
Solaymani-Dodaran, M., West, J., Smith, C. & Hubbard, R. Extrinsic allergic alveolitis: incidence and mortality in the general population. QJM 100, 233–237 (2007).
pubmed: 17307752
Coultas, D. B., Zumwalt, R. E., Black, W. C. & Sobonya, R. E. The epidemiology of interstitial lung diseases. Am. J. Respir. Crit. Care Med. 150, 967–972 (1994).
pubmed: 7921471
Christensen, L. T., Schmidt, C. D. & Robbins, L. Pigeon breeders’ disease — a prevalence study and review. Clin. Allergy 5, 417–430 (1975).
pubmed: 1053441
Lacasse, Y. et al. Clinical diagnosis of hypersensitivity pneumonitis. Am. J. Respir. Crit. Care Med. 168, 952–958 (2003).
pubmed: 12842854
Cimrin, A. H., Goksel, O. & Demirel, Y. S. General aspects of hypersensitivity pneumonitis in Turkey. Tuberk. Toraks 58, 242–251 (2010).
pubmed: 21038134
Costabel, U., Bonella, F. & Guzman, J. Chronic hypersensitivity pneumonitis. Clin. Chest Med. 33, 151–163 (2012).
pubmed: 22365252
Gbaguidi-Haore, H., Roussel, S., Reboux, G., Dalphin, J. C. & Piarroux, R. Multilevel analysis of the impact of environmental factors and agricultural practices on the concentration in hay of microorganisms responsible for farmer’s lung disease. Ann. Agric. Env. Med. 16, 219–225 (2009).
Terho, E. O. Work-related respiratory disorders among Finnish farmers. Am. J. Ind. Med. 18, 269–272 (1990).
pubmed: 2220830
Madsen, D., Klock, L. E., Wenzel, F. J., Robbins, J. L. & Schmidt, C. D. The prevalence of farmer’s lung in an agricultural population. Am. Rev. Respir. Dis. 113, 171–174 (1976).
pubmed: 1247230
Ando, M., Arima, K., Yoneda, R. & Tamura, M. Japanese summer-type hypersensitivity pneumonitis. Geographic distribution, home environment, and clinical characteristics of 621 cases. Am. Rev. Respir. Dis. 144, 765–769 (1991).
pubmed: 1928946
Wang, P. et al. Pathologic findings and prognosis in a large prospective cohort of chronic hypersensitivity pneumonitis. Chest 152, 502–509 (2017). This histopathological study confirms the association of fibrotic patterns with poor prognosis in chronic HP.
pubmed: 28223152
Tsutsui, T. et al. The amount of avian antigen in household dust predicts the prognosis of chronic bird-related hypersensitivity pneumonitis. Ann. Am. Thorac. Soc. 12, 1013–1021 (2015).
pubmed: 26010749
Gimenez, A. et al. Change in FVC and survival in chronic fibrotic hypersensitivity pneumonitis. Thorax 73, 391–392 (2018).
pubmed: 28883091
Bang, K. M. et al. Twenty-three years of hypersensitivity pneumonitis mortality surveillance in the United States. Am. J. Ind. Med. 49, 997–1004 (2006).
pubmed: 17096370
Fernandez Perez, E. R. et al. Increasing hypersensitivity pneumonitis-related mortality in the United States from 1988 to 2016. Am. J. Respir. Crit. Care Med. 199, 1284–1287 (2019).
pubmed: 30768910
Kokkarinen, J., Tukiainen, H. & Terho, E. O. Mortality due to farmer’s lung in Finland. Chest 106, 509–512 (1994).
pubmed: 7774328
Miyazaki, Y. et al. Clinical predictors and histologic appearance of acute exacerbations in chronic hypersensitivity pneumonitis. Chest 134, 1265–1270 (2008).
pubmed: 18689595
Walscher, J. et al. Comorbidities and survival in patients with chronic hypersensitivity pneumonitis. Respir. Res. 21, 12 (2020).
pubmed: 31918716
pmcid: 6953142
Ojanguren, I. et al. Long-term outcomes in chronic hypersensitivity pneumonitis. Allergy 74, 944–952 (2019).
pubmed: 30515826
Winstone, T. et al. Biopsy-proven recurrent, acute, familial hypersensitivity pneumonitis: a case report and literature review. Respir. Med. Case Rep. 24, 173–175 (2018).
pubmed: 29977789
pmcid: 6010641
Asai, N., Kaneko, N., Ohkuni, Y., Aoshima, M. & Kawamura, Y. Familial summer-type hypersensitivity pneumonitis: a review of 25 families and 50 cases in Japan. Intern. Med. 55, 279–283 (2016). This review of familial HP in Japan provides strong evidence that genetic factors contribute to the development of HP.
pubmed: 26831024
Newton, C. A. et al. Telomere-related lung fibrosis is diagnostically heterogeneous but uniformly progressive. Eur. Respir. J. 48, 1710–1720 (2016).
pubmed: 27540018
pmcid: 5433348
Camarena, A. et al. Major histocompatibility complex and tumor necrosis factor-alpha polymorphisms in pigeon breeder’s disease. Am. J. Respir. Crit. Care Med. 163, 1528–1533 (2001).
pubmed: 11401868
Falfan-Valencia, R. et al. Genetic susceptibility to multicase hypersensitivity pneumonitis is associated with the TNF-238 GG genotype of the promoter region and HLA-DRB1*04 bearing HLA haplotypes. Respir. Med. 108, 211–217 (2014).
pubmed: 24291122
Camarena, A. et al. PSMB8 (LMP7) but not PSMB9 (LMP2) gene polymorphisms are associated to pigeon breeder’s hypersensitivity pneumonitis. Respir. Med. 104, 889–894 (2010).
pubmed: 20153157
Aquino-Galvez, A. et al. Transporter associated with antigen processing (TAP) 1 gene polymorphisms in patients with hypersensitivity pneumonitis. Exp. Mol. Pathol. 84, 173–177 (2008).
pubmed: 18342853
Ley, B. et al. The MUC5B promoter polymorphism and telomere length in patients with chronic hypersensitivity pneumonitis: an observational cohort-control study. Lancet Respir. Med. 5, 639–647 (2017). This study shows that a MUC5B promoter polymorphism is associated with increased risk for chronic HP and reduced survival.
pubmed: 28648751
pmcid: 5555581
Reed, C. E. & Barbee, R. A. Pigeon-Breeders’ lung: a newly observed interstitial pulmonary disease. JAMA 193, 261–265 (1965).
pubmed: 14310345
Davies, D. Bird fancier’s disease. Br. Med. J. 287, 1239–1240 (1983).
Sutton, P. P., Pearson, A. & du Bois, R. M. Canary fancier’s lung. Clin. Allergy 14, 429–431 (1984).
pubmed: 6488513
Hargreave, F. E. & Pepys, J. Allergic respiratory reactions in bird fanciers provoked by allergen inhalation provocation tests. Relation to clinical features and allergic mechanisms. J. Allergy Clin. Immunol. 50, 157–173 (1972).
pubmed: 4626166
McCluskey, J. D., Haight, R. R. & Brooks, S. M. Cockatiel-induced hypersensitivity pneumonitis. Env. Health Perspect. 110, 735–738 (2002).
Funke, M. & Fellrath, J. M. Hypersensitivity pneumonitis secondary to lovebirds: a new cause of bird fancier’s disease. Eur. Respir. J. 32, 517–521 (2008).
pubmed: 18669792
Borderias, L. et al. Starling-induced hypersensitivity pneumonitis: minimal but persistent antigen exposure [Spanish]. Arch. Bronconeumol. 46, 607–609 (2010).
pubmed: 20044195
Kokkarinen, J., Tukiainen, H., Seppa, A. & Terho, E. O. Hypersensitivity pneumonitis due to native birds in a bird ringer. Chest 106, 1269–1271 (1994).
pubmed: 7924510
Choy, A. C., Patterson, R., Ray, A. H. & Roberts, M. Hypersensitivity pneumonitis in a raptor handler and a wild bird fancier. Ann. Allergy Asthma Immunol. 74, 437–441 (1995).
pubmed: 7749976
Merget, R., Sander, I., Ewig, S., Sennekamp, J. & Bruening, T. Consort hypersensitivity pneumonitis. Eur. Respir. J. 33, 1223–1225 (2009).
pubmed: 19407057
Meyer, F. J., Bauer, P. C. & Costabel, U. Feather wreath lung: chasing a dead bird. Eur. Respir. J. 9, 1323–1324 (1996).
pubmed: 8804956
Koschel, D., Wittstruck, H., Renck, T., Muller-Wening, D. & Hoffken, G. Presenting features of feather duvet lung. Int. Arch. Allergy Immunol. 152, 264–270 (2010).
pubmed: 20150744
Koschel, D., Lutzkendorf, L., Wiedemann, B. & Hoffken, G. Antigen-specific IgG antibodies in feather duvet lung. Eur. J. Clin. Invest. 40, 797–802 (2010).
pubmed: 20597960
Inase, N. et al. Chronic bird fancier’s lung presenting with acute exacerbation due to use of a feather duvet. Intern. Med. 43, 835–837 (2004).
pubmed: 15497520
Craig, T. J. et al. Bird antigen persistence in the home environment after removal of the bird. Ann. Allergy 69, 510–512 (1992).
pubmed: 1471783
Greinert, U., Lepp, U. & Becker, W. Bird keeper’s lung without bird keepinge. Eur. J. Med. Res. 5, 124 (2000).
pubmed: 10756167
Campbell, J. M. Acute symptoms following work with hay. Br. Med. J. 2, 1143–1144 (1932).
Pepys, J., Riddell, R. W., Citron, K. M. & Clayton, Y. M. Precipitins against extracts of hay and moulds in the serum of patients with farmer’s lung, aspergillosis, asthma, and sarcoidosis. Thorax 17, 366–374 (1962).
pmcid: 1018726
Pepys, J. et al. Farmer’s lung. Thermophilic actinomycetes as a source of “Farmer’s Lung Hay” antigen. Lancet 2, 607–611 (1963).
pubmed: 14054440
Duchaine, C., Meriaux, A., Brochu, G., Bernard, K. & Cormier, Y. Saccharopolyspora rectivirgula from Quebec dairy barns: application of simplified criteria for the identification of an agent responsible for farmer’s lung disease. J. Med. Microbiol. 48, 173–180 (1999).
pubmed: 9989646
Roussel, S. et al. Microbiological evolution of hay and relapse in patients with Farmer’s lung. Occup. Env. Med. 61, e3 (2004).
Erkinjuntti-Pekkanen, R., Reiman, M., Kokkarinen, J. I., Tukiainen, H. O. & Terho, E. O. IgG antibodies, chronic bronchitis, and pulmonary function values in farmer’s lung patients and matched controls. Allergy 54, 1181–1187 (1999).
pubmed: 10604554
Yoshida, K. et al. Hypersensitivity pneumonitis resulting from Aspergillus fumigatus in a greenhouse. Arch. Env. Health 48, 260–262 (1993).
Vincken, W. & Roels, P. Hypersensitivity pneumonitis due to Aspergillus fumigatus in compost. Thorax 39, 74–75 (1984).
pubmed: 6364446
pmcid: 459727
Moreno-Ancillol, A., Dominguez-Noche, C., Gil-Adrados, A. C. & Cosmes, P. M. Hypersensitivity pneumonitis due to occupational inhalation of fungi-contaminated corn dust. J. Investig. Allergol. Clin. Immunol. 14, 165–167 (2004).
pubmed: 15301309
Banaszak, E. F., Thiede, W. H. & Fink, J. N. Hypersensitivity pneumonitis due to contamination of an air conditioner. N. Engl. J. Med. 283, 271–276 (1970).
pubmed: 4193468
Deutsche Gesetzliche Unfallversicherung. DGUV Statistics 2018 - Figures and long-term trends. DGUV https://publikationen.dguv.de/zahlen-fakten/ueberblick/3674/dguv-statistics-2018-figures-and-long-term-trends (2018).
Koschel, D., Stark, W., Karmann, F., Sennekamp, J. & Muller-Wening, D. Extrinsic allergic alveolitis caused by misting fountains. Respir. Med. 99, 943–947 (2005).
pubmed: 15950134
Embil, J. et al. Pulmonary illness associated with exposure to Mycobacterium-avium complex in hot tub water. Hypersensitivity pneumonitis or infection? Chest 111, 813–816 (1997).
pubmed: 9118726
Kahana, L. M., Kay, J. M., Yakrus, M. A. & Waserman, S. Mycobacterium avium complex infection in an immunocompetent young adult related to hot tub exposure. Chest 111, 242–245 (1997).
pubmed: 8996025
From the Centers for Diseases Control and Prevention. Respiratory illness in workers exposed to metalworking fluid contaminated with nontuberculous mycobacteria — Ohio, 2001. JAMA 287, 3073–3074 (2002).
Israel-Biet, D., Venet, A., Sandron, D., Ziza, J. M. & Chretien, J. Pulmonary complications of intravesical Bacille Calmette-Guerin immunotherapy. Am. Rev. Respir. Dis. 135, 763–765 (1987).
pubmed: 3826901
Metzger, F. et al. Hypersensitivity pneumonitis due to molds in a saxophone player. Chest 138, 724–726 (2010).
pubmed: 20822994
Metersky, M. L. et al. Trombone player’s lung: a probable new cause of hypersensitivity pneumonitis. Chest 138, 754–756 (2010).
pubmed: 20823006
Moller, J., Hyldgaard, C., Kronborg-White, S. B., Rasmussen, F. & Bendstrup, E. Hypersensitivity pneumonitis among wind musicians - an overlooked disease? Eur. Clin. Respir. J. 4, 1351268 (2017).
pubmed: 28815004
pmcid: 5553096
Davidson, J. et al. Musical instruments, fungal spores and hypersensitivity pneumonitis. QJM 112, 287–289 (2019). This report highlights the potential of contaminated wind instruments as a cause of HP in musicians.
pubmed: 30649525
King, J., Richardson, M., Quinn, A. M., Holme, J. & Chaudhuri, N. Bagpipe lung; a new type of interstitial lung disease? Thorax 72, 380–382 (2017).
pubmed: 27552781
Girard, M., Israel-Assayag, E. & Cormier, Y. Impaired function of regulatory T-cells in hypersensitivity pneumonitis. Eur. Respir. J. 37, 632–639 (2011).
pubmed: 20650993
Ye, Q., Nakamura, S., Sarria, R., Costabel, U. & Guzman, J. Interleukin 12, interleukin 18, and tumor necrosis factor alpha release by alveolar macrophages: acute and chronic hypersensitivity pneumonitis. Ann. Allergy Asthma Immunol. 102, 149–154 (2009).
pubmed: 19230467
Yamasaki, H., Ando, M., Brazer, W., Center, D. M. & Cruikshank, W. W. Polarized type 1 cytokine profile in bronchoalveolar lavage T cells of patients with hypersensitivity pneumonitis. J. Immunol. 163, 3516–3523 (1999).
pubmed: 10477626
Balogh, E. et al. Impaired immunosuppressive effect of bronchoalveolar mesenchymal stem cells in hypersensitivity pneumonitis: preliminary findings. Cytometry B Clin. Cytom. 94, 363–368 (2018).
pubmed: 27792269
Laflamme, C., Israel-Assayag, E. & Cormier, Y. Apoptosis of bronchoalveolar lavage lymphocytes in hypersensitivity pneumonitis. Eur. Respir. J. 21, 225–231 (2003).
pubmed: 12608434
Selman, M. et al. Gene expression profiles distinguish idiopathic pulmonary fibrosis from hypersensitivity pneumonitis. Am. J. Respir. Crit. Care Med. 173, 188–198 (2006).
pubmed: 16166619
Petersen, H. J. & Smith, A. M. The role of the innate immune system in granulomatous disorders. Front. Immunol. 4, 120 (2013).
pubmed: 23745122
pmcid: 3662972
Kishi, J. et al. Blockade of Th1 chemokine receptors ameliorates pulmonary granulomatosis in mice. Eur. Respir. J. 38, 415–424 (2011).
pubmed: 21273392
Villar, A. et al. Bronchial inflammation in hypersensitivity pneumonitis after antigen-specific inhalation challenge. Respirology 19, 891–899 (2014).
pubmed: 24890329
Ishizuka, M. et al. Interleukin-17A and neutrophils in a murine model of bird-related hypersensitivity pneumonitis. PLoS ONE 10, e0137978 (2015).
pubmed: 26367130
pmcid: 4569356
Hariri, L. P. et al. Distinct histopathology of acute onset or abrupt exacerbation of hypersensitivity pneumonitis. Hum. Pathol. 43, 660–668 (2012).
pubmed: 21855112
Johansson, E., Boivin, G. P. & Yadav, J. S. Early immunopathological events in acute model of mycobacterial hypersensitivity pneumonitis in mice. J. Immunotoxicol. 14, 77–88 (2017).
pubmed: 28094581
Cormier, Y., Belanger, J. & Laviolette, M. Persistent bronchoalveolar lymphocytosis in asymptomatic farmers. Am. Rev. Respir. Dis. 133, 843–847 (1986).
pubmed: 3706895
Gao, H., Neff, T. & Ward, P. A. Regulation of lung inflammation in the model of IgG immune-complex injury. Annu. Rev. Pathol. 1, 215–242 (2006).
pubmed: 18039114
Dakhama, A., Hegele, R. G., Laflamme, G., Israel-Assayag, E. & Cormier, Y. Common respiratory viruses in lower airways of patients with acute hypersensitivity pneumonitis. Am. J. Respir. Crit. Care Med. 159, 1316–1322 (1999).
pubmed: 10194183
Girard, M., Israel-Assayag, E. & Cormier, Y. Mature CD11c(+) cells are enhanced in hypersensitivity pneumonitis. Eur. Respir. J. 34, 749–756 (2009).
pubmed: 19282343
Cormier, Y. & Israel-Assayag, E. The role of viruses in the pathogenesis of hypersensitivity pneumonitis. Curr. Opin. Pulm. Med. 6, 420–423 (2000).
pubmed: 10958233
Hoppin, J. A. et al. Pesticides and other agricultural factors associated with self-reported farmer’s lung among farm residents in the Agricultural Health Study. Occup. Env. Med. 64, 334–341 (2007).
Singh, S. et al. Hypersensitivity pneumonitis and its correlation with ambient air pollution in urban India. Eur. Respir. J. 53, 1801563 (2019).
pubmed: 30464015
Bustos, M. L. et al. Local and circulating microchimerism is associated with hypersensitivity pneumonitis. Am. J. Respir. Crit. Care Med. 176, 90–95 (2007).
pubmed: 17431225
Yuseff, M. I., Pierobon, P., Reversat, A. & Lennon-Dumenil, A. M. How B cells capture, process and present antigens: a crucial role for cell polarity. Nat. Rev. Immunol. 13, 475–486 (2013).
pubmed: 23797063
Lemieszek, M. K. et al. Age influence on hypersensitivity pneumonitis induced in mice by exposure to Pantoea agglomerans. Inhal. Toxicol. 25, 640–650 (2013).
pubmed: 24044680
Golec, M. et al. Middle age enhances expression of innate immunity genes in a female mouse model of pulmonary fibrosis. Biogerontology 18, 253–262 (2017).
pubmed: 28093691
Ohtsuka, Y. et al. Smoking promotes insidious and chronic farmer’s lung disease, and deteriorates the clinical outcome. Intern. Med. 34, 966–971 (1995).
pubmed: 8563097
Mooney, J. J. et al. Radiographic fibrosis score predicts survival in hypersensitivity pneumonitis. Chest 144, 586–592 (2013).
pubmed: 23392130
Churg, A., Sin, D. D., Everett, D., Brown, K. & Cool, C. Pathologic patterns and survival in chronic hypersensitivity pneumonitis. Am. J. Surg. Pathol. 33, 1765–1770 (2009).
pubmed: 19809277
Adegunsoye, A. et al. Predictors of survival in coexistent hypersensitivity pneumonitis with autoimmune features. Respir. Med. 114, 53–60 (2016).
pubmed: 27109811
pmcid: 4845760
Buendia-Roldan, I. et al. A major genetic determinant of autoimmune diseases is associated with the presence of autoantibodies in hypersensitivity pneumonitis. Eur. Respir. J. https://doi.org/10.1183/13993003.01380-2019 (2020).
doi: 10.1183/13993003.01380-2019
pubmed: 32646919
Adegunsoye, A. et al. Autoimmune hypothyroidism as a predictor of mortality in chronic hypersensitivity pneumonitis. Front. Med. 4, 170 (2017).
Barrera, L. et al. Functional diversity of T-cell subpopulations in subacute and chronic hypersensitivity pneumonitis. Am. J. Respir. Crit. Care Med. 177, 44–55 (2008). This paper provides evidence that a switch from a T
pubmed: 17947613
Wan, Y. Y. & Flavell, R. A. Regulatory T-cell functions are subverted and converted owing to attenuated Foxp3 expression. Nature 445, 766–770 (2007).
pubmed: 17220876
Wynn, T. A. Integrating mechanisms of pulmonary fibrosis. J. Exp. Med. 208, 1339–1350 (2011).
pubmed: 21727191
pmcid: 3136685
Mitaka, K. et al. Th2-biased immune responses are important in a murine model of chronic hypersensitivity pneumonitis. Int. Arch. Allergy Immunol. 154, 264–274 (2011).
pubmed: 20861649
Lee, C. G. et al. Interleukin-13 induces tissue fibrosis by selectively stimulating and activating transforming growth factor β
pubmed: 11560996
pmcid: 2195954
Firszt, R. et al. Interleukin-13 induces collagen type-1 expression through matrix metalloproteinase-2 and transforming growth factor-β1 in airway fibroblasts in asthma. Eur. Respir. J. 43, 464–473 (2014).
pubmed: 23682108
Simonian, P. L. et al. Regulatory role of γδ T cells in the recruitment of CD4
pubmed: 16982878
Simonian, P. L. et al. Th17-polarized immune response in a murine model of hypersensitivity pneumonitis and lung fibrosis. J. Immunol. 182, 657–665 (2009).
pubmed: 19109199
pmcid: 2766086
Hasan, S. A. et al. Role of IL-17A and neutrophils in fibrosis in experimental hypersensitivity pneumonitis. J. Allergy Clin. Immunol. 131, 1663–1673 (2013).
pubmed: 23453796
Pardo, A. et al. Increase of lung neutrophils in hypersensitivity pneumonitis is associated with lung fibrosis. Am. J. Respir. Crit. Care Med. 161, 1698–1704 (2000).
pubmed: 10806177
Garcia de Alba, C. et al. Fibrocytes contribute to inflammation and fibrosis in chronic hypersensitivity pneumonitis through paracrine effects. Am. J. Respir. Crit. Care Med. 191, 427–436 (2015).
pubmed: 25531246
Yasui, M. et al. Epithelial-mesenchymal transition in chronic hypersensitivity pneumonitis. J. Med. Dent. Sci. 59, 29–41 (2012).
pubmed: 23896962
Seibold, M. A. et al. A common MUC5B promoter polymorphism and pulmonary fibrosis. N. Engl. J. Med. 364, 1503–1512 (2011).
pubmed: 21506741
pmcid: 3379886
Moore, C. et al. Resequencing study confirms that host defense and cell senescence gene variants contribute to the risk of idiopathic pulmonary fibrosis. Am. J. Respir. Crit. Care Med. 200, 199–208 (2019).
pubmed: 31034279
pmcid: 6635791
Vogel, V. Unraveling the mechanobiology of extracellular matrix. Annu. Rev. Physiol. 80, 353–387 (2018).
pubmed: 29433414
Estany, S. et al. Lung fibrotic tenascin-C upregulation is associated with other extracellular matrix proteins and induced by TGFβ1. BMC Pulm. Med. 14, 120 (2014).
pubmed: 25064447
pmcid: 4123829
Wight, T. N., Kang, I. & Merrilees, M. J. Versican and the control of inflammation. Matrix Biol. 35, 152–161 (2014).
pubmed: 24513039
pmcid: 4039577
Pardo, A., Cabrera, S., Maldonado, M. & Selman, M. Role of matrix metalloproteinases in the pathogenesis of idiopathic pulmonary fibrosis. Respir. Res. 17, 23 (2016).
pubmed: 26944412
pmcid: 4779202
Willems, S. et al. Multiplex protein profiling of bronchoalveolar lavage in idiopathic pulmonary fibrosis and hypersensitivity pneumonitis. Ann. Thorac. Med. 8, 38–45 (2013).
pubmed: 23440593
Hill, M. R. et al. Promoter variants in tissue inhibitor of metalloproteinase-3 (TIMP-3) protect against susceptibility in pigeon breeders’ disease. Thorax 59, 586–590 (2004).
pubmed: 15223866
pmcid: 1747078
Miyazaki, Y., Tsutsui, T. & Inase, N. Treatment and monitoring of hypersensitivity pneumonitis. Expert. Rev. Clin. Immunol. 12, 953–962 (2016).
pubmed: 27117830
Tateishi, T. et al. Serial high-resolution computed tomography findings of acute and chronic hypersensitivity pneumonitis induced by avian antigen. J. Comput. Assist. Tomogr. 35, 272–279 (2011).
pubmed: 21412103
Tsutsui, T. et al. Antigen avoidance tests for diagnosis of chronic hypersensitivity pneumonitis. Respir. Investig. 53, 217–224 (2015).
pubmed: 26344611
Kolb, M. et al. Acute exacerbations of progressive-fibrosing interstitial lung diseases. Eur. Respir. Rev. 27, 180071 (2018).
pubmed: 30578331
Terho, E. O. Diagnostic criteria for farmer’s lung disease. Am. J. Ind. Med. 10, 329 (1986).
Richerson, H. B. et al. Guidelines for the clinical evaluation of hypersensitivity pneumonitis. Report of the subcommittee on hypersensitivity pneumonitis. J. Allergy Clin. Immunol. 84, 839–844 (1989).
pubmed: 2809034
Cormier, Y. & Lacasse, Y. Keys to the diagnosis of hypersensitivity pneumonitis: the role of serum precipitins, lung biopsy, and high-resolution computed tomography. Clin. Pulm. Med. 3, 72–77 (1996).
Schuyler, M. & Cormier, Y. The diagnosis of hypersensitivity pneumonitis. Chest 111, 534–536 (1997).
pubmed: 9118683
Quirce, S. et al. Occupational hypersensitivity pneumonitis: an EAACI position paper. Allergy 71, 765–779 (2016). This position paper by a multinational expert panel provides guidance for the diagnosis and management of occupational HP.
pubmed: 26913451
Vasakova, M., Morell, F., Walsh, S., Leslie, K. & Raghu, G. Hypersensitivity Pneumonitis: perspectives in diagnosis and management. Am. J. Respir. Crit. Care Med. 196, 680–689 (2017).
pubmed: 28598197
Salisbury, M. L. et al. Diagnosis and treatment of fibrotic hypersensitivity pneumonia. Where we stand and where we need to go. Am. J. Respir. Crit. Care Med. 196, 690–699 (2017).
pubmed: 28002680
pmcid: 5620675
Morisset, J. et al. Identification of diagnostic criteria for chronic hypersensitivity pneumonitis: an international modified Delphi survey. Am. J. Respir. Crit. Care Med. 197, 1036–1044 (2018).
pubmed: 29172641
pmcid: 6839923
Seifert, S. A., Von Essen, S., Jacobitz, K., Crouch, R. & Lintner, C. P. Organic dust toxic syndrome: a review. J. Toxicol. Clin. Toxicol. 41, 185–193 (2003).
pubmed: 12733858
Malmberg, P. Health effects of organic dust exposure in dairy farmers. Am. J. Ind. Med. 17, 7–15 (1990).
pubmed: 2407117
Tanaka, H. et al. Workplace-related chronic cough on a mushroom farm. Chest 122, 1080–1085 (2002).
pubmed: 12226058
Walsh, S. L. F. et al. Multicentre evaluation of multidisciplinary team meeting agreement on diagnosis in diffuse parenchymal lung disease: a case-cohort study. Lancet Respir. Med. 4, 557–565 (2016).
pubmed: 27180021
Spagnolo, P. et al. Hypersensitivity pneumonitis: a comprehensive review. J. Investig. Allergol. Clin. Immunol. 25, 237–250 (2015).
pubmed: 26310038
Ohtani, Y. et al. Inhalation provocation tests in chronic bird fancier’s lung. Chest 118, 1382–1389 (2000).
pubmed: 11083690
Ramirez-Venegas, A., Sansores, R. H., Perez-Padilla, R., Carrillo, G. & Selman, M. Utility of a provocation test for diagnosis of chronic pigeon Breeder’s disease. Am. J. Respir. Crit. Care Med. 158, 862–869 (1998).
pubmed: 9731018
Munoz, X. et al. Diagnostic yield of specific inhalation challenge in hypersensitivity pneumonitis. Eur. Respir. J. 44, 1658–1665 (2014).
pubmed: 25142480
Polke, M. et al. A comparison of existing questionnaires for identifying the causes of interstitial and rare lung diseases. Respiration 99, 119–124 (2020).
pubmed: 32000164
Inase, N. et al. A clinical study of hypersensitivity pneumonitis presumably caused by feather duvets. Ann. Allergy Asthma Immunol. 96, 98–104 (2006).
pubmed: 16440540
Chiba, S. et al. Chronic hypersensitivity pneumonitis with a usual interstitial pneumonia-like pattern: correlation between histopathologic and clinical findings. Chest 149, 1473–1481 (2016).
pubmed: 26836921
Chung, J. H. et al. Presence of air trapping and mosaic attenuation on chest computed tomography predicts survival in chronic hypersensitivity pneumonitis. Ann. Am. Thorac. Soc. 14, 1533–1538 (2017).
pubmed: 28513215
Silva, C. I. et al. Chronic hypersensitivity pneumonitis: differentiation from idiopathic pulmonary fibrosis and nonspecific interstitial pneumonia by using thin-section CT. Radiology 246, 288–297 (2008).
pubmed: 18096541
Lynch, D. A., Newell, J. D., Logan, P. M., King, T. E. Jr. & Muller, N. L. Can CT distinguish hypersensitivity pneumonitis from idiopathic pulmonary fibrosis? AJR Am. J. Roentgenol. 165, 807–811 (1995).
pubmed: 7676971
Lynch, D. A., Rose, C. S., Way, D. & King, T. E. Jr. Hypersensitivity pneumonitis: sensitivity of high-resolution CT in a population-based study. AJR Am. J. Roentgenol. 159, 469–472 (1992).
pubmed: 1503007
Hartman, T. E. The HRCT features of extrinsic allergic alveolitis. Semin. Respir. Crit. Care Med. 24, 419–426 (2003).
pubmed: 16088561
Salisbury, M. L. et al. Development and validation of a radiological diagnosis model for hypersensitivity pneumonitis. Eur. Respir. J. 52, 1800443 (2018).
pubmed: 29946001
pmcid: 6181129
Cormier, Y., Brown, M., Worthy, S., Racine, G. & Muller, N. L. High-resolution computed tomographic characteristics in acute farmer’s lung and in its follow-up. Eur. Respir. J. 16, 56–60 (2000).
pubmed: 10933085
Erkinjuntti-Pekkanen, R. et al. Long-term risk of emphysema in patients with farmer’s lung and matched control farmers. Am. J. Respir. Crit. Care Med. 158, 662–665 (1998).
pubmed: 9700147
Hapke, E. J., Seal, R. M., Thomas, G. O., Hayes, M. & Meek, J. C. Farmer’s lung. A clinical, radiographic, functional, and serological correlation of acute and chronic stages. Thorax 23, 451–468 (1968).
pubmed: 4971361
pmcid: 471821
Hanak, V., Golbin, J. M. & Ryu, J. H. Causes and presenting features in 85 consecutive patients with hypersensitivity pneumonitis. Mayo Clin. Proc. 82, 812–816 (2007).
pubmed: 17605960
Morell, F. et al. Bird fancier’s lung: a series of 86 patients. Medicine 87, 110–130 (2008).
pubmed: 18344808
Schwaiblmair, M., Beinert, T., Vogelmeier, C. & Fruhmann, G. Cardiopulmonary exercise testing following hay exposure challenge in farmer’s lung. Eur. Respir. J. 10, 2360–2365 (1997).
pubmed: 9387965
Lalancette, M. et al. Farmer’s lung. Long-term outcome and lack of predictive value of bronchoalveolar lavage fibrosing factors. Am. Rev. Respir. Dis. 148, 216–221 (1993).
pubmed: 8317802
Freedman, P. M. & Ault, B. Bronchial hyperreactivity to methacholine in farmers’ lung disease. J. Allergy Clin. Immunol. 67, 59–63 (1981).
pubmed: 7451772
Jacobs, R. L., Andrews, C. P. & Jacobs, F. O. Hypersensitivity pneumonitis treated with an electrostatic dust filter. Ann. Intern. Med. 110, 115–118 (1989).
pubmed: 2909203
Reboux, G. et al. Assessment of four serological techniques in the immunological diagnosis of farmers’ lung disease. J. Med. Microbiol. 56, 1317–1321 (2007).
pubmed: 17893167
Miyake, S., Hamaoka, A. & Yoshizawa, Y. Clinical usefulness of antigen-captured ELISA method using mouse anti-Trichosporon asahii monoclonal antibody D-8 for diagnosis of summer-type hypersensitivity pneumonitis [Japanese]. Nihon Kokyuki Gakkai Zasshi 39, 7–11 (2001).
pubmed: 11296391
Mizobe, T., Adachi, S., Hamaoka, A. & Andoh, M. Evaluation of the enzyme-linked immunosorbent assay system for sero-diagnosis of summer-type hypersensitivity pneumonitis [Japanese]. Arerugi 51, 20–23 (2002).
pubmed: 11877959
Raulf, M. et al. Update of reference values for IgG antibodies against typical antigens of hypersensitivity pneumonitis. Allergo J. Int. 28, 192–203 (2019).
Cormier, Y., Letourneau, L. & Racine, G. Significance of precipitins and asymptomatic lymphocytic alveolitis: a 20-yr follow-up. Eur. Respir. J. 23, 523–525 (2004).
pubmed: 15083748
Burrell, R. & Rylander, R. A critical review of the role of precipitins in hypersensitivity pneumonitis. Eur. J. Respir. Dis. 62, 332–343 (1981).
pubmed: 7047184
Suhara, K. et al. Utility of immunological tests for bird-related hypersensitivity pneumonitis. Respir. Investig. 53, 13–21 (2015).
pubmed: 25542599
Haslam, P. L. Bronchoalveolar lavage in extrinsic allergic alveolitis. Eur. J. Respir. Dis. Suppl. 154, 120–135 (1987).
pubmed: 3322873
Haslam, P. L. et al. Mast cells, atypical lymphocytes, and neutrophils in bronchoalveolar lavage in extrinsic allergic alveolitis. Comparison with other interstitial lung diseases. Am. Rev. Respir. Dis. 135, 35–47 (1987).
pubmed: 2432812
Semenzato, G., Bjermer, L., Costabel, U., Haslam, P. L. & Olivieri, D. Clinical guidelines and indications for bronchoalveolar lavage (BAL): extrinsic allergic alveolitis. Eur. Respir. J. 3, 945–946 (1990).
pubmed: 2292296
Ohtani, Y. et al. Chronic bird fancier’s lung: histopathological and clinical correlation. An application of the 2002 ATS/ERS consensus classification of the idiopathic interstitial pneumonias. Thorax 60, 665–671 (2005).
pubmed: 16061708
pmcid: 1747497
Gaxiola, M. et al. Morphologic diversity of chronic pigeon breeder’s disease: clinical features and survival. Respir. Med. 105, 608–614 (2011).
pubmed: 21167698
Schildge, J., Nagel, C. & Grun, C. Bronchoalveolar lavage in interstitial lung diseases: does the recovery rate affect the results? Respiration 74, 553–557 (2007).
pubmed: 17496412
Ohshimo, S. et al. Significance of bronchoalveolar lavage for the diagnosis of idiopathic pulmonary fibrosis. Am. J. Respir. Crit. Care Med. 179, 1043–1047 (2009).
pubmed: 19246718
Adderley, N. et al. Bronchoalveolar lavage fluid lymphocytosis in chronic hypersensitivity pneumonitis: a systematic review and meta-analysis. Eur. Respir. J. https://doi.org/10.1183/13993003.00206-2020 (2020).
doi: 10.1183/13993003.00206-2020
pubmed: 32265306
Costabel, U. The alveolitis of hypersensitivity pneumonitis. Eur. Respir. J. 1, 5–9 (1988).
pubmed: 3284760
Drent, M. et al. Relationship between plasma cell levels and profile of bronchoalveolar lavage fluid in patients with subacute extrinsic allergic alveolitis. Thorax 48, 835–839 (1993).
pubmed: 8105558
pmcid: 464717
Costabel, U., Bross, K. J., Ruhle, K. H., Lohr, G. W. & Matthys, H. Ia-like antigens on T-cells and their subpopulations in pulmonary sarcoidosis and in hypersensitivity pneumonitis. Analysis of bronchoalveolar and blood lymphocytes. Am. Rev. Respir. Dis. 131, 337–342 (1985).
pubmed: 3156547
Ando, M., Konishi, K., Yoneda, R. & Tamura, M. Difference in the phenotypes of bronchoalveolar lavage lymphocytes in patients with summer-type hypersensitivity pneumonitis, farmer’s lung, ventilation pneumonitis, and bird fancier’s lung: report of a nationwide epidemiologic study in Japan. J. Allergy Clin. Immunol. 87, 1002–1009 (1991).
pubmed: 1902851
Lacasse, Y., Fraser, R. S., Fournier, M. & Cormier, Y. Diagnostic accuracy of transbronchial biopsy in acute farmer’s lung disease. Chest 112, 1459–1465 (1997).
pubmed: 9404739
Hutchinson, J. P., McKeever, T. M., Fogarty, A. W., Navaratnam, V. & Hubbard, R. B. Surgical lung biopsy for the diagnosis of interstitial lung disease in England: 1997–2008. Eur. Respir. J. 48, 1453–1461 (2016).
pubmed: 27660509
Hutchinson, J., Hubbard, R. & Raghu, G. Surgical lung biopsy for interstitial lung disease: when considered necessary, should these be done in larger and experienced centres only? Eur. Respir. J. 53, 190002 (2019).
Coleman, A. & Colby, T. V. Histologic diagnosis of extrinsic allergic alveolitis. Am. J. Surg. Pathol. 12, 514–518 (1988).
pubmed: 3389449
Churg, A., Muller, N. L., Flint, J. & Wright, J. L. Chronic hypersensitivity pneumonitis. Am. J. Surg. Pathol. 30, 201–208 (2006).
pubmed: 16434894
Trahan, S., Hanak, V., Ryu, J. H. & Myers, J. L. Role of surgical lung biopsy in separating chronic hypersensitivity pneumonia from usual interstitial pneumonia/idiopathic pulmonary fibrosis: analysis of 31 biopsies from 15 patients. Chest 134, 126–132 (2008).
pubmed: 18339775
Lima, M. S. et al. Subacute and chronic hypersensitivity pneumonitis: histopathological patterns and survival. Respir. Med. 103, 508–515 (2009).
pubmed: 19179061
Akashi, T. et al. Histopathologic analysis of sixteen autopsy cases of chronic hypersensitivity pneumonitis and comparison with idiopathic pulmonary fibrosis/usual interstitial pneumonia. Am. J. Clin. Pathol. 131, 405–415 (2009).
pubmed: 19228646
Pereira, C. A., Gimenez, A., Kuranishi, L. & Storrer, K. Chronic hypersensitivity pneumonitis. J. Asthma Allergy 9, 171–181 (2016).
pubmed: 27703382
pmcid: 5036552
Ohshimo, S., Bonella, F., Guzman, J. & Costabel, U. Hypersensitivity pneumonitis. Immunol. Allergy Clin. North. Am. 32, 537–556 (2012).
pubmed: 23102065
Soumagne, T. et al. Emphysema in active farmer’s lung disease. PLoS ONE 12, e0178263 (2017).
pubmed: 28614400
pmcid: 5470683
Sahin, H. et al. Chronic hypersensitivity pneumonitis: CT features comparison with pathologic evidence of fibrosis and survival. Radiology 244, 591–598 (2007).
pubmed: 17641377
Lynch, D. A. CT phenotypes in hypersensitivity pneumonitis. Chest 155, 655–656 (2019).
pubmed: 30955565
Walsh, S. L., Sverzellati, N., Devaraj, A., Wells, A. U. & Hansell, D. M. Chronic hypersensitivity pneumonitis: high resolution computed tomography patterns and pulmonary function indices as prognostic determinants. Eur. Radiol. 22, 1672–1679 (2012).
pubmed: 22466512
Hanak, V., Golbin, J. M., Hartman, T. E. & Ryu, J. H. High-resolution CT findings of parenchymal fibrosis correlate with prognosis in hypersensitivity pneumonitis. Chest 134, 133–138 (2008).
pubmed: 18403660
Jacob, J. et al. Evaluation of visual and computer-based CT analysis for the identification of functional patterns of obstruction and restriction in hypersensitivity pneumonitis. Respirology 22, 1585–1591 (2017).
pubmed: 28699237
Jacob, J. et al. Chronic hypersensitivity pneumonitis: identification of key prognostic determinants using automated CT analysis. BMC Pulm. Med. 17, 81 (2017).
pubmed: 28472939
pmcid: 5418678
Jacob, J. et al. Automated computer-based CT stratification as a predictor of outcome in hypersensitivity pneumonitis. Eur. Radiol. 27, 3635–3646 (2017). This is the first report on automated CT analytic variables to predict mortality in HP.
pubmed: 28130610
Vourlekis, J. S. et al. The effect of pulmonary fibrosis on survival in patients with hypersensitivity pneumonitis. Am. J. Med. 116, 662–668 (2004).
pubmed: 15121492
Koschel, D. S., Cardoso, C., Wiedemann, B., Hoffken, G. & Halank, M. Pulmonary hypertension in chronic hypersensitivity pneumonitis. Lung 190, 295–302 (2012).
pubmed: 22258419
Oliveira, R. K. F. et al. Pulmonary haemodynamics and mortality in chronic hypersensitivity pneumonitis. Eur. Respir. J. 51, 1800430 (2018).
pubmed: 29622570
Ishikawa, N., Hattori, N., Yokoyama, A. & Kohno, N. Utility of KL-6/MUC1 in the clinical management of interstitial lung diseases. Respir. Investig. 50, 3–13 (2012).
pubmed: 22554854
Ohnishi, H., Miyamoto, S., Kawase, S., Kubota, T. & Yokoyama, A. Seasonal variation of serum KL-6 concentrations is greater in patients with hypersensitivity pneumonitis. BMC Pulm. Med. 14, 129 (2014).
pubmed: 25098177
pmcid: 4132281
Long, X. et al. Serum YKL-40 as predictor of outcome in hypersensitivity pneumonitis. Eur. Respir. J. 49, 1501924 (2017).
pubmed: 27836954
Miyazaki, Y. et al. Higher serum CCL17 may be a promising predictor of acute exacerbations in chronic hypersensitivity pneumonitis. Resp. Res. 14, 57 (2013).
Ley, B. et al. Rare protein-altering telomere-related gene variants in patients with chronic hypersensitivity pneumonitis. Am. J. Respir. Crit. Care Med. 200, 1154–1163 (2019).
pubmed: 31268371
Dalphin, J. C. et al. Influence of mode of storage and drying of fodder on thermophilic actinomycete aerocontamination in dairy farms of the Doubs region of France. Thorax 46, 619–623 (1991).
pubmed: 1948788
pmcid: 463340
Rose, C. S. Water-related lung diseases. Occup. Med. 7, 271–286 (1992).
pubmed: 1615363
Yoshida, K., Ando, M., Sakata, T. & Araki, S. Prevention of summer-type hypersensitivity pneumonitis: effect of elimination of Trichosporon cutaneum from the patients’ homes. Arch. Env. Health 44, 317–322 (1989).
Braun, S. R. et al. Farmer’s lung disease: long-term clinical and physiologic outcome. Am. Rev. Respir. Dis. 119, 185–191 (1979).
pubmed: 434591
Cormier, Y. & Belanger, J. Long-term physiologic outcome after acute farmer’s lung. Chest 87, 796–800 (1985).
pubmed: 3996070
Hendrick, D. J., Marshall, R., Faux, J. A. & Krall, J. M. Protective value of dust respirators in extrinsic allergic alveolitis: clinical assessment using inhalation provocation tests. Thorax 36, 917–921 (1981).
pubmed: 7336370
pmcid: 471860
Muller-Wening, D. & Neuhauss, M. Protective effect of respiratory devices in farmers with occupational asthma. Eur. Respir. J. 12, 569–572 (1998).
pubmed: 9762781
Rose, C. & King, T. E. Jr. Controversies in hypersensitivity pneumonitis. Am. Rev. Respir. Dis. 145, 1–2 (1992).
pubmed: 1731569
Yoshizawa, Y. et al. A follow-up study of pulmonary function tests, bronchoalveolar lavage cells, and humoral and cellular immunity in bird fancier’s lung. J. Allergy Clin. Immunol. 96, 122–129 (1995).
pubmed: 7622754
Kokkarinen, J. I., Tukiainen, H. O. & Terho, E. O. Effect of corticosteroid treatment on the recovery of pulmonary function in farmer’s lung. Am. Rev. Respir. Dis. 145, 3–5 (1992).
pubmed: 1731594
Monkare, S. Influence of corticosteroid treatment on the course of farmer’s lung. Eur. J. Respir. Dis. 64, 283–293 (1983).
pubmed: 6861923
de Gracia, J., Morell, F., Bofill, J. M., Curull, V. & Orriols, R. Time of exposure as a prognostic factor in avian hypersensitivity pneumonitis. Respir. Med. 83, 139–143 (1989).
pubmed: 2602597
Fink, J. N., Sosman, A. J., Barboriak, J. J., Schlueter, D. P. & Holmes, R. A. Pigeon breeders’ disease. A clinical study of a hypersensitivity pneumonitis. Ann. Intern. Med. 68, 1205–1219 (1968).
pubmed: 4231667
Adegunsoye, A. et al. Outcomes of immunosuppressive therapy in chronic hypersensitivity pneumonitis. ERJ Open Res. 3, 00016-2017 (2017).
pubmed: 28845429
pmcid: 5570511
The Idiopathic Pulmonary Fibrosis Clinical Research Network. Prednisone, azathioprine, and N-acetylcysteine for pulmonary fibrosis. N. Engl. J. Med. 366, 1968–1977 (2012).
pmcid: 3422642
Keir, G. J. et al. Rituximab in severe, treatment-refractory interstitial lung disease. Respirology 19, 353–359 (2014).
pubmed: 24286447
Vasakova, M. et al. Hypersensitivity pneumonitis: current concepts of pathogenesis and potential targets for treatment. Am. J. Respir. Crit. Care Med. 200, 301–308 (2019).
pubmed: 31150272
King, T. E. Jr. et al. A phase 3 trial of pirfenidone in patients with idiopathic pulmonary fibrosis. N. Engl. J. Med. 370, 2083–2092 (2014).
pubmed: 24836312
Richeldi, L. et al. Efficacy and safety of nintedanib in idiopathic pulmonary fibrosis. N. Engl. J. Med. 370, 2071–2082 (2014).
pubmed: 24836310
Flaherty, K. R. et al. Nintedanib in progressive fibrosing interstitial lung diseases. N. Engl. J. Med. 381, 1718–1727 (2019).
pubmed: 31566307
Maher, T. M. et al. Pirfenidone in patients with unclassifiable progressive fibrosing interstitial lung disease: a double-blind, randomised, placebo-controlled, phase 2 trial. Lancet Respir. Med. 8, 147–157 (2020).
pubmed: 31578169
Mateos-Toledo, H. et al. An open-label study with pirfenidone on chronic hypersensitivity pneumonitis. Arch. Bronconeumol. 56, 163–169 (2020).
pubmed: 31784348
Kern, R. M. et al. Lung transplantation for hypersensitivity pneumonitis. Chest 147, 1558–1565 (2015).
pubmed: 25412059
World Health Organization. WHOQOL: measuring quality of life. WHO https://www.who.int/healthinfo/survey/whoqol-qualityoflife/en/ (1995).
Ware, J. E. Jr. & Sherbourne, C. D. The MOS 36-item short-form health survey (SF-36). I. Conceptual framework and item selection. Med. Care 30, 473–483 (1992).
pubmed: 1593914
Patel, A. S. et al. The development and validation of the King’s brief interstitial lung disease (K-BILD) health status questionnaire. Thorax 67, 804–810 (2012).
pubmed: 22555278
Lubin, M. et al. A comparison of health-related quality of life in idiopathic pulmonary fibrosis and chronic hypersensitivity pneumonitis. Chest 145, 1333–1338 (2014).
pubmed: 24458311
pmcid: 4042514
Cheng, J. Z. et al. Cough is less common and less severe in systemic sclerosis-associated interstitial lung disease compared to other fibrotic interstitial lung diseases. Respirology 22, 1592–1597 (2017).
pubmed: 28544079
Barber, C. M., Wiggans, R. E. & Fishwick, D. Impaired quality of life in chronic hypersensitivity pneumonitis. Chest 147, e230 (2015).
pubmed: 26033140
Paris, C. et al. Working with argan cake: a new etiology for hypersensitivity pneumonitis. BMC Pulm. Med. 15, 18 (2015).
pubmed: 25888313
pmcid: 4369362
Troy, L. K. et al. Diagnostic accuracy of transbronchial lung cryobiopsy for interstitial lung disease diagnosis (COLDICE): a prospective, comparative study. Lancet Respir. Med. 8, 171–181 (2019).
pubmed: 31578168
Raghu, G. et al. Use of a molecular classifier to identify usual interstitial pneumonia in conventional transbronchial lung biopsy samples: a prospective validation study. Lancet Respir. Med. 7, 487–496 (2019).
pubmed: 30948346
Wang, L. J., Cai, H. R., Xiao, Y. L., Wang, Y. & Cao, M. S. Clinical characteristics and outcomes of hypersensitivity pneumonitis: a population-based study in China. Chin. Med. J. 132, 1283–1292 (2019).
pubmed: 31021982
pmcid: 6629344
De Sadeleer, L. J. et al. Impact of BAL lymphocytosis and presence of honeycombing on corticosteroid treatment effect in Fibrotic Hypersensitivity Pneumonitis: a retrospective cohort study. Eur. Respir. J. 55, 1901983 (2020).
pubmed: 31949120
Okamoto, T. et al. Seasonal variation of serum KL-6 and SP-D levels in bird-related hypersensitivity pneumonitis. Sarcoidosis Vasc. Diffuse Lung Dis. 31, 364–367 (2015).
pubmed: 25591150
Nukui, Y. et al. Periostin as a predictor of prognosis in chronic bird-related hypersensitivity pneumonitis. Allergol. Int. 68, 363–369 (2019).
pubmed: 30871804
Ishizuka, M. et al. Validation of inhalation provocation test in chronic bird-related hypersensitivity pneumonitis and new prediction score. Ann. Am. Thorac. Soc. 12, 167–173 (2015).
pubmed: 25562381