scholarly journals R ole of interleukin 4 and its receptor in clinical presentation of chronic extrinsic allergic alveolitis: a pilot study

Author(s):  
Martina Sterclova ◽  
Radoslav Matej ◽  
Petra Mandakova ◽  
Jelena Skibova ◽  
Martina Vasakova
2013 ◽  
Vol 8 ◽  
Author(s):  
Martina Sterclova ◽  
Radoslav Matej ◽  
Petra Mandakova ◽  
Jelena Skibova ◽  
Martina Vasakova

Background: Th-2 cytokine milieu including interleukin 4 (IL-4) was detected in fibrotic lung diseases. Chronic extrinsic allergic alveolitis (EAA) may be also accompanied by marked fibrogenesis. The aim of this study was to determine if IL-4 and its receptor (IL-4R-alpha) play any role in the clinical presentation and pathogenesis of chronic EAA. Methods: Twenty patients originally investigated for interstitial lung disease and finally diagnosed affected with chronic EAA and sarcoidosis were prospectively enrolled into the study. Concentrations of IL-4, IL-4R-aplha and total protein were assessed in the bronchoalveolar lavage fluid (BALF) of all enrolled subjects as well as high resolution computed tomography (HRCT) scores and pulmonary function tests. Results: BALF IL-4R-alpha and total protein concentrations were significantly higher in chronic EAA patients (p < 0.05). Concentrations of BALF IL-4R-alpha were significantly higher in men than in women (p < 0.05) in EAA group. Total protein BALF levels were significantly elevated in ex-smokers with EAA compared to nonsmokers (p < 0.05). A positive correlation (p < 0.01) between IL-4R-alpha BALF concentrations and HRCT interstitial scores were observed in chronic EAA group; the IL-4R-alpha/total protein ratio showed the same significant positive correlation. A negative correlation between lung function results and IL-4R-alpha, and IL-4R-alpha/total protein as well, was also found (p < 0.05). Conclusions: We suggest a clinical relevance for the IL-4/IL-4R axis in the etiopathogenesis of chronic EAA. IL-4R-alpha could serve as a potential biomarker of lung fibrogenesis.


2019 ◽  
Vol 12 (12) ◽  
pp. e230724 ◽  
Author(s):  
Gursharan Virdee ◽  
John Bleasdale ◽  
Mohammed Ikramullah ◽  
Emma Graham-Clarke

Hypersensitivity pneumonitis (HP), also known as extrinsic allergic alveolitis, is a granulomatous, non-IgE-mediated hypersensitivity reaction of the alveoli and distal bronchioles presenting as an acute, subacute or chronic condition. It is most commonly associated with exposure to extrinsic allergens (eg, avian dust, mould and tobacco) and medications including antiarrhythmics (eg, amiodarone), cytotoxics (eg, methotrexate) and antiepileptics (eg, carbamazepine). Individuals diagnosed with this condition can present with severe hypoxia and respiratory failure. The fundamental principle of management is to remove the causative allergen. Evidence implicating selective serotonin reuptake inhibitors as a causative agent is limited, and this case report describes a rare clinical presentation of HP associated with sertraline, how it was diagnosed and subsequently treated. It is anticipated that raising awareness of this interaction will assist multidisciplinary teams, managing patients diagnosed with HP, to be more cognisant of sertraline as being an aetiological factor for this condition.


1999 ◽  
Vol 37 (4) ◽  
pp. 285-289 ◽  
Author(s):  
V. Filipello Marchisio ◽  
F. Sulotto ◽  
G. C. Botta ◽  
A. Chiesa ◽  
D. Airaudi ◽  
...  

PEDIATRICS ◽  
1987 ◽  
Vol 79 (6) ◽  
pp. 1027-1029
Author(s):  
STEPHEN J. WOLF ◽  
ALLAN STILLERMAN ◽  
MILES WEINBERGER ◽  
WILBUR SMITH

Chronic interstitial lung disease is an uncommon clinical entity in childhood. The onset is frequently insidious with progressive tachypnea, dyspnea, cyanosis, clubbing, weight loss, and hypoxia. More than 100 different occupational and environmental agents have been identified as causes, although two thirds of cases are reported as idiopathic.1 Assessment can involve invasive procedures such as bronchoalveolar lavage and open lung biopsy. Treatment of the idiopathic forms includes use of corticostenoids and cytotoxic agents, and response is variable with progression to pulmonary fibrosis being a common end stage. In contrast to this grim prognosis, the similar clinical pattern associated with hypersensitivity pneumonitis, also identified as "extrinsic allergic alveolitis," can be rapidly reversed if the offending antigen is identified and eliminated.


2010 ◽  
pp. 3434-3446
Author(s):  
D.J. Hendrick ◽  
G.P. Spickett

Extrinsic allergic alveolitis is an uncommon inflammatory disorder of the lungs that results from hypersensitivity responses to inhaled environmental agents. Most varieties are occupational in origin, but sporadic cases arise in domestic settings or from recreational activities. Causal agents chiefly comprise allergenic microbial spores that contaminate stored vegetable produce (e.g. farmer’s lung caused by ...


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