Robert A. Cooke memorial lecture. Hypersensitivity pneumonitis.

摘要: Hypersensitivity pneumonitis (extrinsic allergic al- veolitis) is a descriptive phrase that characterizes spectrum of lymphocytic and granulomatous intersti- tial alveolar filling pulmonary disorders associated with intense often prolonged exposure to wide range inhaled organic dusts related occupa- tional antigens. The traditional sources antigen in the classic forms this disease, such as farmer's lung bagassosis, have been decaying, actinomycete- laden composts moldy hay bagasse. A vegetable animal dusts, some inorganic simple chemicals, are now known cause disease. Many these agents listed Table I. This group diseases characterized by several common features: (1) They predominantly involve peripheral airways, features hilar lymph- adenopathy systemic organ involvement, noted sarcoidosis, not present. (2) lesions mononuclear cell interstitial infiltrates predominance T-lym- phocytes macrophages an evolution into gran- uloma formation. (3) Alveolar present within markedly "activated," subacute cases studied date, suppres- sor/cytotoxic T-lymphocyte subset predominates, contrast sarcoidosis which helper/inducer T cells constitute majority type." 2 (4) high levels serum-pre- cipitating antibodies against appropriate offending dust antigen, both serum bronchial wash IgG, IgA, IgM, but IgE, elevated. 3 (5) There considerable evidence for lym- phokine production bronchoalveolar symptomatic patients. 4' 5 Etiologic agents--Special characteristics