Abstract:
PURPOSE OF REVIEW:Hypersensitivity pneumonitis (HP), also known as extrinsic allergic alveolitis, is a granulomatous, inflammatory disease of the lungs caused by the inhalation of antigenic organic particles or fumes. The disease may present as an acute, subacute, or chronic illness. Episodes of acute and subacute HP usually resolve following cessation of antigen exposure. Chronic HP may be progressive, irreversible, and result in debilitating fibrotic lung disease. This review discusses current concepts regarding the diagnosis, pathogenesis, and treatment of HP. RECENT FINDINGS:The pathogenesis of HP involves both type III and type IV hypersensitivity reactions that are mediated by immune complexes and Th1 T cells, respectively. Proinflammatory cytokines and chemokines activate alveolar macrophages, cause an influx of CD8+ lymphocytes into the lungs, facilitate granuloma formation, and promote the development of pulmonary fibrosis. IFN-gamma is essential for the development of HP and IL-10 appears to modulate the severity of disease. TNF-alpha and TGF-beta have been implicated in development of the pulmonary fibrosis that is seen in chronic HP. It has been shown that pigeon fanciers with HP have an increase in the frequency of HLA-DRB1*1305 and HLA-DQB1*0501 alleles, a decrease in the frequency of the HLA-BRB1*0802 allele, and an increased frequency of the TNF-2 (-308) polymorphism of the TNF-alpha promoter gene. SUMMARY:A careful environmental and occupational history and establishment of exposure to a known inciting antigen are key factors in making the diagnosis of HP. Serum precipitating antibodies, bronchoalveolar lavage, and lung biopsy may be helpful in making the diagnosis. Avoidance of organic antigen exposure is the most important factor in the management of HP. Corticosteroids are indicated for the treatment of severe acute and subacute HP and for chronic HP that is severe or progressive. Long-term corticosteroid therapy for the treatment of chronic HP should be considered only if objective improvement in clinical signs, pulmonary function, or radiographic abnormalities is documented.
journal_name
Curr Opin Pulm Medjournal_title
Current opinion in pulmonary medicineauthors
Mohr LCdoi
10.1097/01.mcp.0000135675.95674.29keywords:
subject
Has Abstractpub_date
2004-09-01 00:00:00pages
401-11issue
5eissn
1070-5287issn
1531-6971pii
00063198-200409000-00014journal_volume
10pub_type
杂志文章,评审abstract::Pulmonary embolism occurs in more than 175,000 patients each year in the United States. The objectives of treatment are to prevent death from the existing embolus, to prevent death and morbidity from recurrent pulmonary embolism, and to prevent morbidity from recurrent deep-vein thrombosis. For patients with adequate ...
journal_title:Current opinion in pulmonary medicine
pub_type: 杂志文章,评审
doi:10.1097/00063198-199907000-00007
更新日期:1999-07-01 00:00:00
abstract::Patients infected with HIV are at risk of developing a variety of infectious and malignant pleuropulmonary disorders. The three most common causes of AIDS-related pleural effusions are parapneumonic effusions or empyemas, tuberculosis, and Kaposi's sarcoma. However, the relative frequency of these conditions varies fr...
journal_title:Current opinion in pulmonary medicine
pub_type: 杂志文章,评审
doi:10.1097/00063198-199707000-00014
更新日期:1997-07-01 00:00:00
abstract:PURPOSE OF REVIEW:Pulmonary hypertension has been reported to complicate the course of a number of fibrotic lung diseases, including idiopathic pulmonary fibrosis, chronic hypersensitivity pneumonitis and nonspecific interstitial pneumonitis. Most commonly, mild elevations in the mean pulmonary artery pressure are seen...
journal_title:Current opinion in pulmonary medicine
pub_type: 杂志文章,评审
doi:10.1097/MCP.0000000000000599
更新日期:2019-09-01 00:00:00
abstract:PURPOSE OF REVIEW:The objective is to discuss recent progress in our understanding of the role of the indoor environment in asthma, focusing on the special role of cat allergens. RECENT FINDINGS:Sensitization to Fel d 1 is the dominant event in inhalant responses to cat; however, there are also IgE responses to the li...
journal_title:Current opinion in pulmonary medicine
pub_type: 杂志文章,评审
doi:10.1097/MCP.0b013e32834db10d
更新日期:2012-01-01 00:00:00
abstract:PURPOSE OF REVIEW:Recent work demonstrates that patients with refractory asthma are likely to be sensitized to environmental fungi and that specific antifungal treatments may be of benefit to this group. RECENT FINDINGS:The relationships among fungal sensitization, exposure and asthma severity are imperfectly understo...
journal_title:Current opinion in pulmonary medicine
pub_type: 杂志文章,评审
doi:10.1097/MCP.0b013e328333900a
更新日期:2010-01-01 00:00:00
abstract::Interstitial lung diseases are characterized by disruption of the distal pulmonary parenchyma. The clinical history manifestations, cough and dyspnea, and physical exam manifestations, inspiratory crackles, are nonspecific. Pulmonary function testing aids in the evaluation and management of patients with interstitial ...
journal_title:Current opinion in pulmonary medicine
pub_type: 杂志文章,评审
doi:10.1097/00063198-200009000-00003
更新日期:2000-09-01 00:00:00
abstract:PURPOSE OF REVIEW:Asthma is a heterogeneous disorder presenting with many phenotypes. Precise phenotypic definition has eluded the medical research community for years, despite recognition of different disease subtypes. Improved phenotypic characterization and knowledge of underlying pathobiology is necessary for linka...
journal_title:Current opinion in pulmonary medicine
pub_type: 杂志文章,评审
doi:10.1097/MCP.0b013e328011b84b
更新日期:2007-01-01 00:00:00
abstract:PURPOSE OF REVIEW:Treatment of hepatic hydrothorax is challenging because of its rapid symptomatic recurrence. This review will focus on potential therapeutic approaches to hepatic hydrothorax. RECENT FINDINGS:Hepatic hydrothorax is refractory to salt restriction and diuretics in approximately 25% of cases. Primary ma...
journal_title:Current opinion in pulmonary medicine
pub_type: 杂志文章,评审
doi:10.1097/MCP.0000000000000058
更新日期:2014-07-01 00:00:00
abstract:PURPOSE OF REVIEW:Smoking is a major risk factor for lung cancer, which is the leading cause of cancer-related deaths both in the USA and worldwide. Chronic obstructive pulmonary disease and emphysema are comorbid conditions often found in lung cancer patients. The inflammatory pathways that link chronic obstructive pu...
journal_title:Current opinion in pulmonary medicine
pub_type: 杂志文章,评审
doi:10.1097/MCP.0b013e32832c975a
更新日期:2009-07-01 00:00:00
abstract:PURPOSE OF REVIEW:The purpose of this review is to summarize recent advances in our understanding of the impact sleep disturbances have on our health, with particular focus on the brain. The present review considers the influence of sleep disturbance on the neurovascular unit; the role of sleep disturbance in neurodege...
journal_title:Current opinion in pulmonary medicine
pub_type: 杂志文章,评审
doi:10.1097/MCP.0000000000000323
更新日期:2016-11-01 00:00:00
abstract:PURPOSE OF REVIEW:This article reviews current data on pathophysiologic mechanisms by which sleep-disordered breathing during pregnancy may cause harm, and explores biological pathways for associated adverse maternal and fetal outcomes, especially pregnancy-induced hypertension and gestational diabetes. RECENT FINDING...
journal_title:Current opinion in pulmonary medicine
pub_type: 杂志文章,评审
doi:10.1097/MCP.0b013e32833f0d55
更新日期:2010-11-01 00:00:00
abstract:PURPOSE OF REVIEW:Patients with lung cancer are particularly vulnerable to lung injury associated with immune checkpoint inhibition and often present with more frequent and more severe manifestations of lung disease compared to patients with other tumor types. The present review explores the reasons for increased susce...
journal_title:Current opinion in pulmonary medicine
pub_type: 杂志文章,评审
doi:10.1097/MCP.0000000000000689
更新日期:2020-07-01 00:00:00
abstract::Some time ago, the Th2 cytokine, interleukin (IL)-13, was identified as a critical regulator of the allergic response. Initial studies in animal models of disease provided compelling evidence that IL-13, independent from other Th2 cytokines, was necessary and sufficient to induce all features of allergic asthma. This ...
journal_title:Current opinion in pulmonary medicine
pub_type: 杂志文章,评审
doi:10.1097/00063198-200301000-00004
更新日期:2003-01-01 00:00:00
abstract:PURPOSE OF REVIEW:In this review, we describe the 'state-of-the-art' in our knowledge of asthma and what gaps exist, which can be exploited in the future for effective translation of our knowledge from the bench or population studies to diagnosis and therapy. RECENT FINDINGS:The advent of microbiome research has expan...
journal_title:Current opinion in pulmonary medicine
pub_type: 杂志文章,评审
doi:10.1097/MCP.0b013e32834dccc0
更新日期:2012-01-01 00:00:00
abstract:PURPOSE OF REVIEW:Since the introduction especially of multidetector computed tomography scanners, detection of peripheral pulmonary nodules as small as 2-3 mm is now a frequent event even in individuals without a significant smoking history. This preponderance of small indeterminate nodules has necessitated reconsider...
journal_title:Current opinion in pulmonary medicine
pub_type: 杂志文章,评审
doi:10.1097/MCP.0b013e3281c9b107
更新日期:2007-07-01 00:00:00
abstract:PURPOSE OF REVIEW:The purpose of this review was to evaluate the consequence of obstructive sleep apnea (OSA) in pulmonary hypertension by reviewing the current literature and understanding potential pathophysiological mechanisms. RECENT FINDINGS:Small studies have suggested a high prevalence of comorbid OSA in those ...
journal_title:Current opinion in pulmonary medicine
pub_type: 杂志文章,评审
doi:10.1097/MCP.0000000000000206
更新日期:2015-11-01 00:00:00
abstract:PURPOSE OF REVIEW:Although currently available drugs to treat asthma are effective in most patients, a proportion of patients do not respond or experience side-effects; which is partly genetically determined. Pharmacogenetics is the study of how genetic variations influence drug response. In this review, we summarize p...
journal_title:Current opinion in pulmonary medicine
pub_type: 杂志文章,评审
doi:10.1097/MCP.0000000000000335
更新日期:2017-01-01 00:00:00
abstract::The progressive breakdown of the cell-mediated immunity, which characterizes the natural history of HIV infection, invariably leads to the development of miscellaneous opportunistic infections or neoplasms involving a number of tissues, including the respiratory tract. In particular, given the extent and the severity ...
journal_title:Current opinion in pulmonary medicine
pub_type: 杂志文章,评审
doi:
更新日期:1995-09-01 00:00:00
abstract::The bacillary population described in tuberculous pleuritis is small, and its most likely pathogenetic mechanism is essentially immunologic. This explains why, until now, the diagnostic identification of tuberculous pleuritis (TP) has been based on the presence of granulomas in pleural biopsy. Correcting this diagnost...
journal_title:Current opinion in pulmonary medicine
pub_type: 杂志文章,评审
doi:10.1097/00063198-200007000-00002
更新日期:2000-07-01 00:00:00
abstract:PURPOSE OF REVIEW:Lung cancer is the leading cause of cancer mortality in men and women. Most patients present with advanced disease and face significant morbidity, with many reporting distressing symptoms throughout the course of their illness. The purpose of this review is to highlight the recent studies that support...
journal_title:Current opinion in pulmonary medicine
pub_type: 杂志文章,评审
doi:10.1097/MCP.0b013e3283620e76
更新日期:2013-07-01 00:00:00
abstract:PURPOSE OF REVIEW:Malignant pleural effusion (MPE) poses a common and significant clinical problem. Its pathogenesis is poorly understood and therapeutic options are limited. Herein are summarized animal models of MPE and their contributions in unveiling new aspects of the pathobiology of the condition. RECENT FINDING...
journal_title:Current opinion in pulmonary medicine
pub_type: 杂志文章,评审
doi:10.1097/MCP.0b013e32832af07c
更新日期:2009-07-01 00:00:00
abstract:PURPOSE OF REVIEW:The aim of this article is to review recent observations in the area of infectious lung complications in individuals with human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS). Since the immunodeficiency was first characterized, it has been associated with enhanced susceptibilit...
journal_title:Current opinion in pulmonary medicine
pub_type: 杂志文章,评审
doi:10.1097/01.mcp.0000156992.53246.f8
更新日期:2005-05-01 00:00:00
abstract::Corticosteroids were the mainstay of therapy for idiopathic pulmonary fibrosis (IPF) for more than four decades, but their efficacy is unproven and toxicities are substantial. The course of IPF is characterized by progressive respiratory insufficiency, leading to death within 3 to 8 years from the onset of symptoms. A...
journal_title:Current opinion in pulmonary medicine
pub_type: 杂志文章,评审
doi:10.1097/00063198-200109000-00009
更新日期:2001-09-01 00:00:00
abstract::Lung cancer is the leading cause of cancer-related death worldwide. For patients diagnosed with early-stage lung cancer, complete surgical resection remains the best hope for cure. Limited resections are avoided when possible because of higher recurrence rates and potentially worse long-term survival. Traditionally, a...
journal_title:Current opinion in pulmonary medicine
pub_type: 杂志文章,评审
doi:10.1097/00063198-200207000-00007
更新日期:2002-07-01 00:00:00
abstract::Acute bronchitis in previously fit individuals is a common condition that is usually mild and self limiting. Chronic bronchitis remains a common cause of morbidity and mortality, and the cost to the nation due to lost working days and to health services is enormous. Cigarette smoking is the major etiologic factor, alt...
journal_title:Current opinion in pulmonary medicine
pub_type: 杂志文章,评审
doi:
更新日期:1995-05-01 00:00:00
abstract:PURPOSE OF REVIEW:Exacerbations of asthma in children are most frequently precipitated by respiratory infections with a seasonal pattern. However, management takes little account of the underlying infective or other precipitant abnormality. RECENT FINDINGS:Interactions between environmental triggers, the airway microb...
journal_title:Current opinion in pulmonary medicine
pub_type: 杂志文章,评审
doi:10.1097/MCP.0000000000000223
更新日期:2016-01-01 00:00:00
abstract:PURPOSE OF REVIEW:Adherence to asthma therapies is poor leading to unnecessary morbidity and increased use of emergency and hospital resources. Strategies to improve adherence have not been successful. RECENT FINDINGS:Asthma adherence disease management is a clinical method to improve adherence for asthma patients. Th...
journal_title:Current opinion in pulmonary medicine
pub_type: 杂志文章,评审
doi:10.1097/MCP.0000000000000128
更新日期:2015-01-01 00:00:00
abstract:PURPOSE OF REVIEW:Telomere attrition has been proposed as one of the aging hallmarks in pulmonary fibrosis. Telomere shortening and telomerase gene mutations have been widely evaluated in recent years. Reduced telomere length may be identified in a quarter of patients with sporadic idiopathic pulmonary fibrosis (IPF) a...
journal_title:Current opinion in pulmonary medicine
pub_type: 杂志文章,评审
doi:10.1097/MCP.0000000000000506
更新日期:2018-09-01 00:00:00
abstract::Apoptosis, also known as activation-induced cell death or programmed cell death, is an active suicide mechanism that is involved in normal tissue turnover during embryogenesis and adult life. There are many examples of apoptosis in the immune system, including programmed cell death of T cells during negative intrathym...
journal_title:Current opinion in pulmonary medicine
pub_type: 杂志文章,评审
doi:10.1097/00063198-199809000-00004
更新日期:1998-09-01 00:00:00
abstract:PURPOSE OF REVIEW:Glucocorticosteroids (GCSs) remain the cornerstone of therapy for treating the inflammatory component of asthma. Clinical response to GCS is heterogeneous, varying both within asthma 'endotypes', as well as the same individual. Different factors and micro-environment can alter the canonical GCS-induce...
journal_title:Current opinion in pulmonary medicine
pub_type: 杂志文章,评审
doi:10.1097/MCP.0000000000000337
更新日期:2017-01-01 00:00:00