Hypersensitivity pneumonitis: A new strategy for serodiagnosis and environmental surveys

Anne-Pauline Bellanger (1, 2) , Gabriel Reboux (1, 2) , Adeline Rouzet (1, 2) , Coralie Barrera (1, 2) , Steffi Rocchi (1, 2) , Emeline Scherer (1, 2) , Laurence Millon (1, 2)

1 LCE - Laboratoire Chrono-environnement (UMR 6249)
2 Service de parasitologie et mycologie [CHRU de Besançon]

We propose a strategy for serodiagnosis of hypersensitivity pneumonitis (HP): 1) question patients about their private or occupational activity, or visit him on site; 2) select panels of six somatic specific antigens appropriate for each type of exposure; 3) and use ELISA to test concomitantly two recombinant antigens highly specific to Farmer's lung, Metalworking-fluid HP, and for Bird fancier's lung. The serodiagnosis provides an immunological argument that may complete radiological, functional lung exploration and clinical features; 4) If the serodiagnosis is negative but the suspicion of HP is strong, a microbial analysis of the patient's specific exposure is conducted; 5) "A la carte" antigens are produced from the microorganisms isolated in the patient's environment sample and tested; 6) Finally, the patient may be asked to undergo a specific inhalation challenge with the offending antigens in a safety cabin, or to avoid his usual environment for a few days.

Mots clés: Environmental survey; Etiologic agents; Hypersensitivity pneumonitis; Recombinant antigen; Serodiagnosis

Domaines: Santé

Anne-Pauline Bellanger, Gabriel Reboux, Adeline Rouzet, Coralie Barrera, Steffi Rocchi, et al.. Hypersensitivity pneumonitis: A new strategy for serodiagnosis and environmental surveys. Respiratory Medicine, 2019, 150, pp.101-106. ⟨10.1016/j.rmed.2019.02.019⟩. ⟨hal-02307827⟩