title: Bronchial inflammation in hypersensitivity pneumonitis after antigen-specific inhalation challenge.
abstract: OBJECTIVE
  The aim of this study is to compare the inflammatory profile before and after specific inhalation challenge (SIC) in induced sputum from patients with hypersensitivity pneumonitis (HP) and to investigate whether different causal antigens define the resulting profile.
  
  
  METHODS
  A prospective study was conducted in 27 patients with HP: 15 patients due to exposure to birds (BHP) and 12 due to exposure to fungi (FHP), confirmed by SIC. Induced sputum was obtained before and/or 24 h after SIC. Cell types were determined by differential cell count using optical microscopy. Interferon-γ, interleukin (IL)-12p70, IL-2, IL-10, IL-8, IL-6, IL-4, IL-5, IL-1β, tumour necrosis factor (TNF)-α and TNF-β levels were measured in the supernatants.
  
  
  RESULTS
  Following SIC, higher sputum neutrophilia levels (P = 0.048) and an increase in IL-8 levels (P = 0.017) were found in patients with FHP than in those with BHP. FHP patients also showed increased IL-1β, IL12-p70 and IL5 levels (P = 0.011, P = 0.036 and P = 0.018, respectively) after SIC. In BHP, a trend towards increases in sputum eosinophils and TH2 cytokines (IL4, IL5) was seen following SIC (P = 0.059, P = 0.068 and P = 0.075 respectively).
  
  
  CONCLUSIONS
  This study shows that bronchial inflammation is present in patients with HP evidenced by increases in sputum neutrophils and eosinophils following exposure to the offending antigen during SIC.
authors.affiliation: Department of Medicine, Pulmonology Unit, Vall d'Hebron University Hospital, Barcelona, Spain; Network for Biomedical Research in Respiratory Disease (CIBER Enfermedades Respiratorias or CIBERES), Salud Carlos III Health Institute, Barcelona, Spain.
authors.forename: Ana
authors.initials: A
authors.lastname: Villar
authors.forename: Xavier
authors.initials: X
authors.lastname: Muñoz
authors.forename: Sara
authors.initials: S
authors.lastname: Sanchez-Vidaurre
authors.forename: Susana
authors.initials: S
authors.lastname: Gómez-Ollés
authors.forename: Ferran
authors.initials: F
authors.lastname: Morell
authors.forename: María-Jesús
authors.initials: MJ
authors.lastname: Cruz
mesh_terms: D000280:Administration, Inhalation; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000542:Alveolitis, Extrinsic Allergic / Q000150:complications* / Q000503:physiopathology; D000818:Animals; D000941:Antigens / Q000008:administration & dosage / Q000009:adverse effects*; D000946:Antigens, Fungal / Q000008:administration & dosage / Q000009:adverse effects*; D001717:Birds / Q000276:immunology; D001985:Bronchial Provocation Tests / Q000379:methods*; D001991:Bronchitis / Q000175:diagnosis* / Q000378:metabolism / Q000473:pathology*; D016207:Cytokines / Q000378:metabolism; D004804:Eosinophils / Q000473:pathology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009504:Neutrophils / Q000473:pathology; D011446:Prospective Studies; D012129:Respiratory Function Tests; D013183:Sputum / Q000166:cytology / Q000378:metabolism
chemical_list: D000941:Antigens; D000946:Antigens, Fungal; D016207:Cytokines
keywords: bird; cytokine; fungus; induced sputum; neutrophil