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Am J Respir Cell Mol Biol 2020 Apr 14. Epub 2020 Apr 14.

Quebec Heart and Lung Institute, 55973, Quebec, Quebec, Canada.

Background: In a proportion of patients with hypersensitivity pneumonitis, biological and environmental factors sustaining inflammation are ill-defined, resulting in no effective treatment option. Bioaerosols found in occupational settings are complex and often include Toll-like receptor ligands, such as endotoxins. How Toll-like receptor ligands contribute to the persistence of hypersensitivity pneumonitis, however, remains poorly understood. Read More

Rev Med Chil 2019 Nov;147(11):1458-1467

Instituto Nacional del Tórax, Santiago, Chile.

Interstitial lung diseases are a broad, diverse, challenging group of diseases, most of them chronic whose prognosis is not good. In the last two decades there have been considerable advances in the knowledge of the epidemiology, pathological and genetic bases and treatment of several of these diseases. This article summarizes and presents updated information about their classification, new knowledge on genetics and treatments in idiopathic pulmonary fibrosis, advances in the diagnosis and management of hypersensitivity pneumonitis and a review of the broad spectrum of interstitial diseases associated with connective tissue diseases. Read More

Ecotoxicol Environ Saf 2020 May 5;194:110416. Epub 2020 Mar 5.

Department of Pneumonology, Oncology and Allergology, Medical University of Lublin, Lublin, Poland.

Pantoea agglomerans is gram-negative bacteria widely distributed in nature. It predominates in inhalable dust from grain, herbs, and flax, and was identified as the most important cause of hypersensitivity pneumonitis (HP) in eastern Poland. To better understand the molecular mechanism of HP development studies focused on the interactions between P. Read More

Chest 2020 Jun 17;157(6):1506-1512. Epub 2020 Jan 17.

Department of Medicine, University of California, San Francisco, CA.

Background: Chronic hypersensitivity pneumonitis (CHP) is an immune-mediated interstitial lung disease (ILD) caused by inhalational exposure to environmental antigens, resulting in parenchymal fibrosis. By definition, a diagnosis of CHP assumes a history of antigen exposure, but only half of all patients eventually diagnosed with CHP will have a causative antigen identified. Individual clinician variation in eliciting a history of antigen exposure may affect the frequency and confidence of CHP diagnosis. Read More

Respir Res 2020 Jan 9;21(1):12. Epub 2020 Jan 9.

Centre for Interstitial and Rare Lung Diseases, Pneumology and Respiratory Critical Care Medicine, Thoraxklinik, University of Heidelberg, Röntgenstr. 1, D-69126, Heidelberg, Germany.

Introduction: Chronic Hypersensitivity Pneumonitis (cHP) is a fibrotic interstitial lung disease (ILD) resulting from repeated exposure to an offending antigen. Prognostication in cHP remains challenging, and the relationship between comorbidities and survival has yet to be characterized. The aim of this study was to describe the relationship between comorbid conditions and survival in patients with cHP. Read More

Ann Agric Environ Med 2019 Dec 13;26(4):644-655. Epub 2019 Dec 13.

Department of Pneumonology, Oncology and Allergology, Medical University, Lublin, Poland.

Case Description: Five workers (2 males and 3 females) employed in a furniture factory located in eastern Poland developed hypersensitivity pneumonitis (HP) after the pine wood used for furniture production was replaced by birch wood. All of them reported onset of respiratory and general symptoms (cough, shortness of breath, general malaise) after inhalation exposure to birch dust, showed crackles at auscultation, ground-glass attenuations in HRCT examination, and lymphocytosis in the BAL examination. The diagnosis of acute HP was set in 4 persons and the diagnosis of subacute HP in one. Read More

Rev Mal Respir 2020 Jan 20;37(1):80-85. Epub 2019 Dec 20.

Service de pneumologie, oncologie et allergologie respiratoires, Hôpital universitaire de Besançon, CHU de Besançon, CHU Jean-Minjoz, 3, boulevard Fleming, 25000 Besançon, France; UMR-CNRS 6249 Chrono-environnement, université de Franche-Comté, 25000 Besançon, France.

Hypersensitivity pneumonitis and allergic bronchopulmonary aspergillosis are two forms of lung disease with presumed distinct immunoallergic mechanisms. We report the observation of a 38-year-old French farmer who, for one month, had fever and dyspnoea resistant to antibiotic therapy. A diagnosis of farmer's lung, and allergic bronchopulmonary aspergillosis was made on clinical, biological, functional and radiological evidence and according to the criteria established. Read More

BMJ Case Rep 2019 Dec 19;12(12). Epub 2019 Dec 19.

Critical Care Services, Sandwell and West Birmingham Hospitals NHS Trust, Birmingham, UK.

Hypersensitivity pneumonitis (HP), also known as extrinsic allergic alveolitis, is a granulomatous, non-IgE-mediated hypersensitivity reaction of the alveoli and distal bronchioles presenting as an acute, subacute or chronic condition. It is most commonly associated with exposure to extrinsic allergens (eg, avian dust, mould and tobacco) and medications including antiarrhythmics (eg, amiodarone), cytotoxics (eg, methotrexate) and antiepileptics (eg, carbamazepine). Individuals diagnosed with this condition can present with severe hypoxia and respiratory failure. Read More

N Z Med J 2019 01 18;132(1488):62-64. Epub 2019 Jan 18.

Medical Officer of Health, Bay of Plenty District Health Board.

BMC Pulm Med 2019 Dec 16;19(1):247. Epub 2019 Dec 16.

Department of Respiratory Medicine, Graduate School of Medicine, Kyoto University, 54 Shogoin Kawahara-cho, Sakyo-ku, Kyoto, 606-8507, Japan.

Background: The intensity and frequency of cough remain unclear in interstitial lung disease (ILD). The aim of this study was to evaluate the intensity and frequency of cough in idiopathic interstitial pneumonias (IIPs), connective tissue disease-associated interstitial lung disease (CTD-ILD), and chronic hypersensitivity pneumonia (CHP), and examine their associations with clinical indices.

Methods: In this cross-sectional study, the intensity and frequency of cough were evaluated using a 100-mm visual analogue scale. Read More

J Bras Pneumol 2019 12 9;45(6):e20190343. Epub 2019 Dec 9.

. Universidade Federal do Rio de Janeiro, Rio de Janeiro (RJ) Brasil.

BMJ Open Respir Res 2019 3;6(1):e000469. Epub 2019 Dec 3.

Chest Clinic, Wythenshawe Hospital, Manchester, UK.

Background: Establishing whether patients are exposed to a 'known cause' is a key element in both the diagnostic assessment and the subsequent management of hypersensitivity pneumonitis (HP).

Objective: This study surveyed British interstitial lung disease (ILD) specialists to document current practice and opinion in relation to establishing causation in HP.

Methods: British ILD consultants (pulmonologists) were invited by email to take part in a structured questionnaire survey, to provide estimates of demographic data relating to their service and to rate their level of agreement with a series of statements. Read More

BMC Pulm Med 2019 Nov 27;19(1):223. Epub 2019 Nov 27.

Department of Medicine, University of British Columbia, Vancouver, Canada.

Background: The CAnadian REgistry for Pulmonary Fibrosis (CARE-PF) is a multi-center, prospective registry designed to study the natural history of fibrotic interstitial lung disease (ILD) in adults. The aim of this cross-sectional sub-study was to describe the baseline characteristics, risk factors, and comorbidities of patients enrolled in CARE-PF to date.

Methods: Patients completed study questionnaires and clinical measurements at enrollment and each follow-up visit. Read More

Lakartidningen 2019 Nov 26;116. Epub 2019 Nov 26.

Sahlgrenska Academy - Public Health and community medicine Gothenburg, Sweden Sahlgrenska Academy - Public Health and community medicine Gothenburg, Sweden.

Occupational exposures to gas, fumes, dust and chemicals contribute to non-malignant respiratory diseases like asthma, chronic obstructive pulmonary disease, idiopathic pulmonary fibrosis and community-acquired pneumonia in more than one in ten patients. They may be sick due to inhaling various particles, gases, fumes, or chemicals in the workplace. Hence, these exposures should be considered in all patients with non-malignant respiratory diseases. Read More

BMJ Case Rep 2019 Nov 18;12(11). Epub 2019 Nov 18.

Respiratory Medicine, Aberdeen Royal Infirmary, Aberdeen, UK

A 43-year-old non-smoker was referred with a 3-month history of malaise, fatigue and breathlessness. Blood avian precipitins were strongly positive. Lung function testing confirmed a restrictive pattern with impaired gas transfer. Read More

Pulmonology 2020 Jan - Feb;26(1):3-9. Epub 2019 Nov 14.

Interstitial lung disease clinic. Hospital María Ferrer Buenos Aires, Argentina.

Introduction: Chronic hypersensitivity pneumonitis (CHP) is an interstitial lung disease with limited treatment response and bad prognosis. Sometimes it is indistinguishable from idiopathic pulmonary fibrosis (IPF) becoming one of the main differential diagnosis. The aim of our study is to compare survival and functional decline between these two entities. Read More

Int J Occup Med Environ Health 2020 Jan 30;33(1):119-123. Epub 2019 Oct 30.

University of Siena, Siena, Italy (Department of Medicine, Surgery and Neuroscience, Unit of Diagnostic Imaging, University Hospital of Siena).

Occupational hypersensitivity pneumonitis (OHP) is an interstitial lung disease caused by sensitization to an inhaled antigen. Polyethylene terephthalate (PET) is mainly used for disposable beverage bottles. A clinical case of hypersensitivity pneumonitis (HP) in a 66-year-old patient in the follow-up as a worker formerly exposed to asbestos is presented. Read More

Allergy Asthma Proc 2019 11;40(6):425-428

Hypersensitivity pneumonitis (HP), also referred to as extrinsic allergic alveolitis, is characterized by non-immunoglobulin E mediated inflammation of the parenchyma, alveoli, and terminal airways of the lung initiated by inhaled antigens in a susceptible host. Etiologic agents of HP are either organic high-molecular-weight compounds (e.g. Read More

Lung India 2019 Nov-Dec;36(6):476-482

Department of Medicine, Center for Interstitial Lung Diseases, University of Washington, Seattle, WA 98195, USA.

Context: Multiple environmental factors are associated with development of hypersensitivity pneumonitis (HP), and diagnostic algorithms for the diagnosis of HP have been proposed in recent perspectives.

Aims: We analyzed the data of patients with HP from interstitial lung disease (ILD)-India registry. The analysis was performed to (1) find the prevalence of HP, (2) reclassify HP as per a recently proposed classification criterion to assess the level of diagnostic certainty, and (3) identify the causative agents for HP. Read More

Transplant Proc 2019 Nov 13;51(9):3189-3190. Epub 2019 Oct 13.

Division of Transplant Surgery, Royal Papworth Hospital NHS Foundation Trust, Cambridge, England.

A 43-year-old woman with chronic hypersensitivity pneumonitis was referred for lung transplant assessment. An echocardiogram as part of her work-up revealed a large left atrial myxoma, presenting a conundrum on how best to manage her combined pathology. Because of the level of pulmonary disease, early intervention to remove the myxoma was not thought be viable without postoperative support. Read More

Lung 2019 12 15;197(6):715-720. Epub 2019 Oct 15.

Laboratorio de Biología Molecular, Instituto Nacional de Enfermedades Respiratorias, Ismael Cosío Villegas, Mexico City, Mexico.

Introduction: Idiopathic pulmonary fibrosis (IPF) is a lethal disease with an unclear pathogenic mechanism. Components of the renin-angiotensin system (RAS) have a role in the pathogenesis of IPF, specifically, the aspartyl protease renin acts as a profibrotic factor in the lung. However, the concentration of the RAS components renin and soluble (pro)renin receptor (sPRR) have not been previously evaluated neither in serum nor in bronchoalveolar lavage fluid (BAL) of patients with IPF or chronic Hypersensitivity pneumonitis (cHP), a disease which may be confused with IPF. Read More

Clin Rev Allergy Immunol 2019 Dec;57(3):449-455

Division of Rheumatology, Allergy and Clinical Immunology, University of California at Davis, Davis, CA, 95616, USA.

In recent years, mold has been blamed for many symptoms or a constellation of symptoms. These symptoms are usually vague and subjective and difficult or impossible to measure or quantify. Moreover, there is no scientific evidence that mold has anything to do with these symptoms. Read More

WMJ 2019 Jul;118(2):95-97

Essentia Health, Fargo, North Dakota.

Introduction: Hypersensitivity pneumonitis is a complex syndrome characterized by non-Immunoglobulin E-mediated inflammation of lung parenchyma in response to an antigen.

Case Report: A 60-year-old white man presented with acute onset of hypoxia, dyspnea, and nonproductive cough. After extensive workup, he was diagnosed with hypersensitivity pneumonitis. Read More

Am J Respir Crit Care Med 2020 01;201(2):250-253

University of California, DavisSacramento, California.

Fungal Genet Biol 2019 12 9;133:103267. Epub 2019 Sep 9.

Laboratório Especial de Micologia, Disciplina de Infectologia, Universidade Federal de São Paulo, São Paulo, SP, Brazil. Electronic address:

Trichosporon asahii has recently been recognized as an emergent fungal pathogen able to cause invasive infections in neutropenic cancer patients as well as in critically ill patients submitted to invasive medical procedures and broad-spectrum antibiotic therapy. T. asahii is the main pathogen associated with invasive trichosporonosis worldwide. Read More

Occup Med (Lond) 2019 Dec;69(8-9):632-634

Parasitology Mycology Department, Jean Minjoz University Hospital, Besançon, France.

Hypersensitivity pneumonitis (HP) is a chronic inflammatory lung disease caused by repeated inhalation of antigenic substances. We present a case of metalworking fluids (MWFs)-HP sensitized to Pseudomonas oleovorans in a cystic fibrosis patient. This case illustrates that HP diagnosis remains challenging, especially in patients with another pulmonary disease, and that serodiagnosis contributes to identifying the precise microorganism involved. Read More

Clin Respir J 2019 Dec 3;13(12):791-794. Epub 2019 Sep 3.

Cambridge Interstitial Lung Disease Service, Royal Papworth Hospital NHS Foundation Trust, Cambridge, UK.

Introduction: The optimal pharmacological management of chronic hypersensitivity pneumonitis (cHP) is unknown. Corticosteroids are often used as first line therapy but can be associated with side effects. There is a paucity of data examining the role of steroid-sparing agents in cHP. Read More

Am J Respir Crit Care Med 2019 12;200(12):1542-1543

Department of Radiology and.

Am J Respir Crit Care Med 2019 11;200(9):1086-1087

Medical SchoolNational and Kapodistrian University of AthensAthens, Greece.

PLoS One 2019 1;14(8):e0220462. Epub 2019 Aug 1.

Department of Respiratory Medicine, Tokyo Medical and Dental University, Bunkyo-ku, Tokyo, Japan.

The clinical course of chronic hypersensitivity pneumonitis (HP) with fibrosis is similar to that of idiopathic pulmonary fibrosis (IPF). Current research is expected to identify biomarkers effective in predicting the deterioration of lung function in a clinical setting. Our group analyzed the relationships between the following parameters in chronic bird-related HP: patient characteristics, serum markers, lung function, HRCT findings, BALF profiles, and the worsening of lung function. Read More

Pediatr Pulmonol 2019 11 25;54(11):1781-1786. Epub 2019 Jul 25.

Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, India.

Rationale: A variety of inhaled antigens have been implicated to cause hypersensitivity pneumonitis (HP). We observed that children force-fed with lentil-based weaning food had persistent respiratory symptoms and radiology similar to HP.

Objectives: To describe the clinical features of lentil HP. Read More

Eur Respir J 2019 Jul 25;54(1). Epub 2019 Jul 25.

Fondazione Policlinico A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy.

Clin Exp Dermatol 2020 Mar 22;45(2):250-253. Epub 2019 Jul 22.

Department of Dermatology, Chelsea and Westminster Hospital, London, UK.

J Assoc Physicians India 2019 Mar;67(3):19-21

Consultant Microbiologist, PD Hinduja Hospital, Mumbai, Maharashtra.

Aim: Trichosporon species are the major emerging opportunistic pathogen in immunocompromised patients. Its diverse refractoriness to conventional antifungal drugs and association with high mortality rate is worrisome. The present study aims to determine the risk factors, treatment outcome and antifungal susceptibility pattern of Trichosporon species in blood stream infections. Read More

APMIS 2019 Sep;127(9):616-626

Department of Histopathology, PGIMER, Chandigarh, India.

There is no consensus on the classification of the diagnostic certainty of hypersensitivity pneumonitis (HP) based on the histopathological findings. This retrospective study aimed to describe the clinical and histopathological spectrum of HP. Herein, we also propose different grades of diagnostic certainty. Read More

Am J Respir Crit Care Med 2019 11;200(9):1154-1163

Department of Medicine.

Rare genetic variants in telomere-related genes have been identified in familial, idiopathic, and rheumatoid arthritis-associated pulmonary fibrosis. Short peripheral blood leukocyte (PBL) telomere length predicts poor outcomes in chronic hypersensitivity pneumonitis (CHP). Determine the prevalence and clinical relevance of rare protein-altering variants in telomere-related genes in patients with CHP. Read More

Rom J Morphol Embryol 2019 ;60(1):325-331

Department of Occupational Medicine, Faculty of Medicine, University of Medicine and Pharmacy of Craiova, Romania; Department of Medical Psychology, Faculty of Medicine, University of Medicine and Pharmacy of Craiova, Romania;

Extrinsic allergic alveolitis is an occupational condition intensively studied and published about, unlike cutaneous leukocytoclastic angiitis. The coexistence of these two diseases is even more rare in the same patient with exposure to occupational pollutants of animal origin. We present the case of a 44-year-old man, a pigeon breeder admitted to hospital with a pruritic purpuric eruption and lower limb paresthesia, dyspnea on exertion, polymyalgia rheumatica, mixed polyarthralgias. Read More

BMJ Open Respir Res 2019 4;6(1):e000439. Epub 2019 Jun 4.

Respiratory Medicine, University of Nottingham, Clinical Sciences Building, Nottingham City Hospital, Hucknall Road, Nottingham, UK.

Introduction: The Its Not JUST Idiopathic pulmonary fibrosis Study (INJUSTIS) is a multicentre, prospective, observational cohort study. The aims of this study are to identify genetic, serum and other biomarkers that may identify specific molecular mechanisms, reflecting disease endotypes that are shared among patients with progressive pulmonary fibrosis regardless of aetiology. Furthermore, it is anticipated that these biomarkers will help predict fibrotic activity that may identify patterns of disease behaviour with greater accuracy than current clinical phenotyping. Read More

J Investig Allergol Clin Immunol 2019 Jun;29(3):243-244

Serviço de Imunoalergologia, Centro Hospitalar de São João, Porto, Portugal.

Biomed Res Int 2019 14;2019:1803278. Epub 2019 May 14.

The Military Institute of Injury and Reparation, The Seventh Medical Center of PLA General Hospital, Beijing 100700, China.

is the major pathogen causing invasive trichosporonosis. Conventional methods of its detection are time-consuming or costly and often require complex DNA extraction and purification steps, which hinders rapid clinical diagnosis. In this study, we evaluated colony PCR, which directly uses colonies or trace clinical samples as the template for amplification, for rapid detection of infection. Read More

BMJ Case Rep 2019 Jun 18;12(6). Epub 2019 Jun 18.

Respiratory Disease Center, Tazuke Kofukai Foundation, Medical Research Institute, Kitano Hospital, Osaka, Japan.

Association between pulmonary disease and IgA nephropathy (IgAN) has been previously reported. However, no association has been reported between hypersensitivity pneumonitis (HP) and IgAN. Here, we report about a patient with no particular medical history, who experienced worsening dyspnoea in the course of 1 month, with ground-glass opacity on chest CT and no improvement after antibiotic therapy. Read More

Rev Mal Respir 2019 Jun 13;36(6):747-751. Epub 2019 Jun 13.

Service de pneumologie, hôpital Pontchaillou, université de Rennes 1, 2, rue Henri-Le-Guilloux, 35033 Rennes cedex 9, France; IRSET UMR 1085, université de Rennes 1, 2, avenue du Pr-Léon-Bernard, 35043 Rennes, France.

Introduction: Hypersensitivity pneumonitis (HP) are typically subacute in their presentation and the diagnosis may be difficult.

Method: We report a case of a hypersensitivity pneumonitis in a 27-years-old woman, caused by exposure to mould in an insalubrious mobile home. The initial presentation was with acute respiratory distress syndrome complicating RSV pneumonia, treated with ribavirin and corticosteroids in winter 2013-2014. Read More

Intern Med 2019 Sep 7;58(18):2679-2682. Epub 2019 Jun 7.

Department of Respiratory Medicine, Kanagawa Cardiovascular and Respiratory Center, Japan.

We herein report a 45-year-old woman with lung adenocarcinoma stage IV (cT4N3M1a). She was treated with pemetrexed (PEM) monotherapy following four cycles of first-line treatment with carboplatin, paclitaxel, and veliparib. After three cycles of PEM treatment, she presented with dyspnea, and chest computed tomography showed diffuse ground-glass attenuation (GGA), suggesting hypersensitivity pneumonia (HP). Read More

Am J Respir Crit Care Med 2019 08;200(3):301-308

7Center for Interstitial Lung Diseases, University of Washington Medical Center, Seattle, Washington.

BMC Microbiol 2019 05 28;19(1):113. Epub 2019 May 28.

Key Laboratory of Animal Disease and Human Health of Sichuan Province, College of Veterinary Medicine, Sichuan Agricultural University, Chengdu, 611130, China.

Background: Trichosporon is the dominant genus of epidermal fungi in giant pandas (Ailuropoda melanoleuca) and causes local and deep infections. To provide the information needed for the diagnosis and treatment of trichosporosis in giant pandas, the sequence of ITS, D1/D2, and IGS1 loci in 29 isolates of Trichosporon spp. which were isolated from the body surface of giant pandas were combination to investigate interspecies identification and genotype. Read More

Medicine (Baltimore) 2019 May;98(21):e15779

Respiratory Department, Hospital General Universitario Gregorio Marañón, Facultad de Medicina, Universidad Complutense de Madrid (UCM), Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM).

To assess characteristics and outcomes of patients hospitalized with interstitial lung diseases (ILD) and to analyze patient's comorbidities, procedures, and in-hospital outcomes.We identified patients hospitalized with idiopathic pulmonary fibrosis and others ILD such as hypersensitivity pneumonitis, cryptogenic organizing pneumonia, lymphangioleiomyomatosis, pulmonary Langerhans cell histiocytosis, and sarcoidosis in Spain during 2014 and 2015.We identified 14,565 discharges among patients admitted for ILD in Spain during the study period: idiopathic pulmonary fibrosis (IPF) in 42. Read More

J Pediatric Infect Dis Soc 2019 Dec;8(6):574-577

Universite Claude Bernard Lyon 1, Hospices Civils de Lyon, France.

Lung Cancer 2019 06 10;132:79-86. Epub 2019 Apr 10.

Department of Radiology, Brigham and Women's Hospital and Dana-Farber Cancer Institute, Harvard Medical School, 450 Brookline Ave, Boston, MA, USA. Electronic address:

Introduction: We evaluated the incidence of pneumonitis in clinical trials of anaplastic lymphoma kinase (ALK) inhibitors in patients with advanced non-small cell lung cancer (NSCLC) and compared the incidence among different cohorts, in order to identify possible predisposing factors for ALK inhibitor-related pneumonitis.

Methods: MEDLINE and EMBASE search up to 1/30/18 using the keywords, "alectinib", "ceritinib", "crizotinib", "brigatinib", and "lung cancer", resulting in a total of 20 eligible cohorts with 2261 patients treated with ALK inhibitor monotherapy for advanced NSCLC. The pooled incidences of all-grade, high-grade, and grade 5 pneumonitis were calculated. Read More

Chest 2019 11 30;156(5):887-895. Epub 2019 Apr 30.

Department of Medicine, University of British Columbia, Vancouver, BC, Canada; Centre for Heart Lung Innovation, St. Paul's Hospital, Vancouver, BC, Canada. Electronic address:

Background: Fibrotic interstitial lung diseases (ILDs) are highly morbid chronic disorders that frequently occur in working age individuals. The goal of this study was to determine workplace productivity loss, its determinants, and its estimated costs in patients with fibrotic ILD.

Methods: Patients with idiopathic pulmonary fibrosis, chronic hypersensitivity pneumonitis, idiopathic nonspecific interstitial pneumonia, or unclassifiable ILD were identified from the six-center Canadian Registry for Pulmonary Fibrosis (CARE-PF). Read More