Incidence of serum precipitins against organic-dust antigens in different populations by counterimmunoelectrophoresis

Occurrence of farmer's lung disease is relevant to meteorological conditions: a 20-year follow-up field survey analysis

BACKGROUND

A field survey on farmer's lung disease (FLD) in a dairy farming community in the northernmost district of Japan has been in progress since 1978.

METHODS

The correlation between the number of FLD occurrences year by year and dairy farming conditions and meteorological data were compared.

RESULTS

Thirty-four FLD cases had occurred in a 20 years period. Average number of days below freezing during the harvest season the year prior to FLD occurrence were significantly smaller than other years (2.1 +/- 0.7 [SE] days, 4.6 +/- 0.7 days, P < 0.05, respectively). Average annual sum of the sunlight hours in the years before the years with FLD occurrence was significantly smaller than those without FLD occurrence (1457.1 +/- 114.0 hr, 1811.3 +/- 97.7 hr, P < 0.05, respectively) and was also significantly smaller for the sunlight hours during a harvest season (821.9 +/- 60.2 hr, 1023.2 +/- 52.7 hr, P < 0.05, respectively).

CONCLUSIONS

Temperature and sunlight hours closely associated with the FLD occurrence.

Serum KL-6 concentrations in dairy farmers

STUDY OBJECTIVES

Serum KL-6 (Krebs von den Lungen-6) has been recognized to be a marker for the activity of diffuse interstitial lung diseases. The purpose of the study is to evaluate serum KL-6 measurement as a marker for farmer's lung disease (FLD).

DESIGN

A cross-sectional survey of a cohort of dairy farmers. Retrospective measurement of KL-6 stored serum samples from those dairy farmers previously screened for FLD.

SETTING

University hospital screening project for FLD within a dairy-farming community in Japan.

PARTICIPANTS

Four hundred seventy-two dairy farmers were invited to attend a local clinic.

MEASUREMENTS AND RESULTS

We examined serum KL-6 concentrations in 272 farmers. Subjects were classified into three groups: (1) 5 farmers with FLD, (2) 30 farmers with positive serum precipitating antibodies to Saccharopolyspora rectivirgula and/or Thermoactinomyces vulgaris without FLD (Ab(+)), and (3) 237 farmers without these antibodies (Ab(-)). Serum KL-6 concentrations in the FLD group were significantly higher than those in the Ab(+) and the Ab(-) groups (1,263 +/- 288 [SEM], 328 +/- 57, and 207 +/- 6 U/mL, respectively, p < 0.001). Serum KL-6 concentrations in those with FLD were significantly higher than KL-6 concentrations from stored screening samples from the same individual when FLD was not diagnosed (1,263 +/- 288 and 419 +/- 209 U/mL, respectively, p < 0.05). Serum KL-6 concentrations of the Ab(+) group were significantly higher than those of the Ab(-) group (p < 0.001). In the Ab(+) group, farmers with high serum KL-6 concentrations had lower permeability coefficients than farmers with normal serum KL-6 concentrations (p < 0.05). These results may suggest that subclinical FLD can be detected in farmers with high KL-6 concentrations and precipitating antibodies.

CONCLUSION

Serum KL-6 concentration can be a useful marker for assessing the activity of FLD and may be able to be used to detect subclinical disease.

Personal spore sampling and indirect immunofluorescent test for exploration of hypersensitivity pneumonitis due to mould spores

Sensitization to mould spores was investigated in six patients with hypersensitivity pneumonitis, eight patients with idiopathic lung fibrosis, and six healthy controls by immunodiffusion and immunofluorescent testing of personal spore samples. The new technique of personal spore sampling with the Burkard personal volumetric air sampler and indirect immunofluorescent test for detection of spore-specific IgG and IgM confirmed that five patients with hypersensitivity pneumonitis and four with lung fibrosis were actually exposed and sensitized to moulds. Personal spore sampling and subsequent immunofluorescent tests represent sensitive tools for detection of individual mould sensitization and air quality control.

Recent advances in pathogenesis of allergic alveolitis

The animal-model studies discussed above appear to suggest that AA develops as the result of a complex series of immunologically specific events, involving initial sensitization, and the development of granulomatous inflammatory response by a series of genetically determined immunostimulatory events. Modulation of experimental granulomatous lesions by several of the means previously discussed may offer some important clues to the incidence and clinical course of AA in man and to future therapy and/or prevention of the disease. For example, in the animal models discussed previously in which chronic exposure to aerosolized antigen resulted in specific 'desensitization' it is possible that such repeated challenge in man may be refined to the point of inducing similar lengthy refractory periods and a decrease in pulmonary inflammation. The demonstration that hypersensitivity-type pulmonary granulomas in mice are markedly suppressed by inhibitors possessing antilipoxygenase activity, such as nafazatrom and nordihydroguairetic acid and by cyclosporine, may also open the door to investigation of such agents in the experimental treatment of granulomatous pulmonary diseases in man. It is obvious that a better understanding of these mechanisms in man can provide important information to increase our understanding of the possible prevention, modulation, and therapy of chronic granulomatous pulmonary disease.

Detection of antigen-specific antibodies on lung tissue in a patient with hypersensitivity pneumonitis

A patient with hypersensitivity pneumonitis showed positive Ouchterlony's immunodiffusion tests against pigeon faecal extract, Cephalosporium and Pullularia antigens. Deposits of immunoglobulins-IgG and IgM antibodies-were detected in a subendothelial position in arterial and venous vessels and on alveolar macrophages in the lung tissue. The IgG deposits in blood vessels belonged to IgG1, IgG2 and IgG3 subclasses and the absorbed IgG on alveolar macrophages to all IgG subclasses. The detection of allergen specific antibodies in lung tissue was made by indirect immunofluorescent staining with FITC conjugated antigen extracts from pigeon faeces and demonstrated the aetiology of this hypersensitivity pneumonitis.

The absence of a relationship between serum precipitins and pulmonary disease in a community

To study the role of serum precipitins in respiratory illness in a community, sera obtained from 3,047 residents of Tucson, Ariz., were tested for the presence of precipitating antibody to a battery of antigens. Positive reactions were obtained in 54 subjects (1.8 percent), a lower incidence than has been reported previously. The majority of these subjects were older than 54 years of age, an age distribution significantly older than the entire sample (P less than 0.01). Pulmonary function among the subjects with positive precipitin reactions was not significantly different from that of the asymptomatic nonsmokers of the entire sample. None of the subjects who were lifelong residents of Arizona had serum precipitins to any of the thermophilic actinomycetes antigens which were used in the testing. These antigens have been found in association with extrinsic allergic alveolitis, most frequently among patients living in the north central United States and were derived from strains of Micropolyspora faeni, Thermoactinomycetes candidus and vulgaris. Each subject with precipitins to one or more of the tested antigens was matched by age, sex, and socioeconomic class with two subjects from the sample who had negative precipitin reactions. The groups did not differ in their prevalence of respiratory symptoms or abnormalities of pulmonary function. We conclude that the presence of precipitating serum antibodies among subjects in a community is not indicative of the presence of immunologic pulmonary disease but merely reflects previous exposure to the tested antigen. In addition, individuals whose sera contain precipitating antibody appear to have no increased tendency to develop other types of pulmonary disease.

Counterimmunoelectrophoresis in biology and medicine

The review will initially focus on the historical development of counterimmunoelectrophoresis (CIE). A part of the manuscript will be devoted to methodological considerations of CIE as well as a discussion of the antisera used. The body of the review will detail each test procedure for which CIE is applicable and discuss unique elements of technique and limits of detection, as well as clinical interpretation of results. The final section will summarize potential applications of CIE in microbiology.

Counterimmunoelectrophoresis and opportunistic fungal infections

Sera from 35 apparently normal humans, 37 compromised human patients, 30 hedgehogs and 30 sheep, were examined for precipitating antibodies to four opportunistic fungi - Absidia corymbifera, Aspergillus fumigatus, Candida albicans and Rhizopus arrhizus-using counterimmunoelectrophoresis (CIE). Precipitins to A. fumigatus were almost exclusively confined to specimens obtained from the compromised human group (51% of those examined) while Candida precipitating antibodies were detected in the sera of both normal (26%) and compromised (49%) humans and in 10% of the hedgehog specimens. Serum precipitins against the two phycomycetes included in the investigations were rare. Because of the complexity of most fungal antigen extracts, it appears the two phycomycetes included in the investigations were rare. Beause of the complexity of most fungal antigen extracts, it appears essential that sera be tested against a number of different antigen concentrations if CIE is to be used with confidence in fungal serology.