Common respiratory viruses in lower airways of patients with acute hypersensitivity pneumonitis

被引:50
作者
Dakhama, A
Hegele, RG
Laflamme, G
Israël-Assayag, E
Cormier, Y
机构
[1] Univ Laval, Hop Laval, Ctr Pneumol, Ctr Rech, St Foy, PQ G1V 4G5, Canada
[2] Univ British Columbia, St Pauls Hosp, Pulm Res Lab, Vancouver, BC V5Z 1M9, Canada
关键词
D O I
10.1164/ajrccm.159.4.9807085
中图分类号
R4 [临床医学];
学科分类号
1002 ; 100602 ;
摘要
Hypersensitivity pneumonitis (HP), a lung disease with "flulike" symptoms, results from repeated exposures to well defined, nonpathogenic antigens, This study examined whether respiratory viruses are present in the lower airways, the likely site of hypersensitivity reaction, in patients with HP. The polymerase chain reaction (PCR) method was used to test for 10 common respiratory viruses in bronchoalveolar lavage (BAL) cells obtained from patients with acute HP and from unexposed healthy volunteers. Immunocytochemistry was subsequently used to localize viral proteins within BAL cells. The results of PCR showed that influenza A virus was the most frequently detected virus in the BAL cells of our study patients (six of 13) and control subjects (two of six). Influenza A proteins were detected within alveolar macrophages in nine of 13 patients and in two of six control subjects. The number of total BAL cells, but not lymphocytes, was higher in patients with documented influenza A proteins than in patients with no influenza A proteins (p = 0.017) and correlated with the proportion of influenza-A-positive alveolar macrophages (r = 0.7; p = 0.036). This report documents the presence of viruses in the lower airways of patients with acute HP. The findings may imply a potential role for influenza A in the modulation of HP during antigen exposure.
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页码:1316 / 1322
页数:7
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