title: Utility of immunological tests for bird-related hypersensitivity pneumonitis.
abstract: BACKGROUND
  The reaction of specific antibodies and sensitized lymphocytes to antigens is important in hypersensitivity pneumonitis (HP). However, there are no known studies evaluating the utility of the lymphocyte proliferation test (LPT) or specific antibodies to avian antigens in diagnosing bird-related HP. In this study, we examined the sensitivity and specificity of these two tests.
  
  
  METHODS
  Patients with acute bird-related HP (n=10), chronic bird-related HP (n=35), acute summer-type HP (n=14), and other interstitial pneumonia (IP) (n=76) were evaluated. The optimal cutoff values were determined by receiver operating curve (ROC) analyses of specific antibodies in serum and bronchoalveolar lavage fluid (BALF), and by conducting the LPT on mononuclear cells in peripheral blood and BALF.
  
  
  RESULTS
  The sensitivity and specificity of the antibodies were 80-100% and 92-100% in acute bird-related HP, and 26-79% and 73-93% in chronic bird-related HP, respectively. The sensitivity and specificity of the LPT were 50-100% and 100% in acute bird-related HP, and 46% and 91% in chronic bird-related HP, respectively.
  
  
  CONCLUSIONS
  Specific antibodies and the LPT are quite useful for diagnosing acute bird-related HP. The presence of specific antibodies in BALF and the results of LPT with peripheral blood mononuclear cells are particularly useful for diagnosing chronic bird-related HP.
authors.affiliation: Department of Respiratory Medicine, Tokyo Medical and Dental University, 1-5-45, Yushima, Bunkyo-ku, Tokyo 113-8519, Japan.
authors.forename: Kozo
authors.initials: K
authors.lastname: Suhara
authors.affiliation: Department of Respiratory Medicine, Tokyo Medical and Dental University, 1-5-45, Yushima, Bunkyo-ku, Tokyo 113-8519, Japan. Electronic address: miyazaki.pilm@tmd.ac.jp.
authors.forename: Yasunari
authors.initials: Y
authors.lastname: Miyazaki
authors.affiliation: Department of Respiratory Medicine, Tokyo Medical and Dental University, 1-5-45, Yushima, Bunkyo-ku, Tokyo 113-8519, Japan.
authors.forename: Tsukasa
authors.initials: T
authors.lastname: Okamoto
authors.affiliation: Department of Respiratory Medicine, Tokyo Medical and Dental University, 1-5-45, Yushima, Bunkyo-ku, Tokyo 113-8519, Japan.
authors.forename: Makito
authors.initials: M
authors.lastname: Yasui
authors.affiliation: Department of Respiratory Medicine, Tokyo Medical and Dental University, 1-5-45, Yushima, Bunkyo-ku, Tokyo 113-8519, Japan.
authors.forename: Kimitake
authors.initials: K
authors.lastname: Tsuchiya
authors.affiliation: Department of Respiratory Medicine, Tokyo Medical and Dental University, 1-5-45, Yushima, Bunkyo-ku, Tokyo 113-8519, Japan.
authors.forename: Naohiko
authors.initials: N
authors.lastname: Inase
mesh_terms: D000208:Acute Disease; D000328:Adult; D000368:Aged; D000818:Animals; D000906:Antibodies / Q000032:analysis* / Q000097:blood*; D000941:Antigens / Q000276:immunology*; D015415:Biomarkers / Q000032:analysis / Q000097:blood; D001716:Bird Fancier's Lung / Q000175:diagnosis* / Q000276:immunology*; D001717:Birds / Q000276:immunology*; D001992:Bronchoalveolar Lavage Fluid / Q000276:immunology; D002908:Chronic Disease; D005260:Female; D006801:Humans; D007159:Immunologic Tests / Q000379:methods*; D007963:Leukocytes, Mononuclear / Q000276:immunology; D008214:Lymphocytes / Q000276:immunology; D008297:Male; D008875:Middle Aged; D012680:Sensitivity and Specificity
chemical_list: D000906:Antibodies; D000941:Antigens; D015415:Biomarkers
keywords: Hypersensitivity pneumonitis; Lymphocyte proliferation test; Pigeon; Specific antibody