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Respir Investig 2021 Jun 7. Epub 2021 Jun 7.

Department of Respiratory Medicine and Allergy, Tosei General Hospital, 160 Nishioiwake-cho, Seto, Aichi, 489-8642, Japan. Electronic address:

ERJ Open Res 2021 Apr 7;7(2). Epub 2021 Jun 7.

Clinical and Translational Research Unit, National Jewish Health, Denver, CO, USA.

Hypersensitivity pneumonitis (HP) is an immunologically mediated form of lung disease resulting from inhalational exposure to any of a large variety of antigens. A subgroup of patients with HP develops pulmonary fibrosis (fibrotic HP; FHP), a significant cause of morbidity and mortality. This study will evaluate the safety and efficacy of the antifibrotic pirfenidone in treating FHP. Read More

ERJ Open Res 2021 Apr 7;7(2). Epub 2021 Jun 7.

Dept of Paediatrics, Faculty of Medicine, Ain Shams University, Cairo, Egypt.

Background: Childhood interstitial and diffuse lung diseases (chILD) encompass a broad spectrum of rare pulmonary disorders. In most developing Middle Eastern countries, chILD is still underdiagnosed. Our objective was to describe and investigate patients diagnosed with chILD in a tertiary university hospital in Egypt. Read More

J Coll Physicians Surg Pak 2021 Jun;30(6):735-736

Department of Pediatric Medicine, Nishtar Medical University, Multan, Pakistan.

Hypersensitivity pneumonitis (HP) is a rarely diagnosed interstitial lung disease with variable manifestations. It results from repeated inhalation of certain antigens, e.g. Read More

ERJ Open Res 2021 Apr 31;7(2). Epub 2021 May 31.

Dept of Pulmonology, St Antonius ILD Center of Excellence, St Antonius Hospital, Nieuwegein, The Netherlands.

Pulmonary fibrosis is strongly associated with telomere shortening and increased DNA damage. Key cells in the pathogenesis involve alveolar type 2 (AT2) cells, club cells and myofibroblasts; however, to what extent these cells are affected by telomere shortening and DNA damage is not yet known. We sought to determine the degree of, and correlation between, telomere shortening and DNA damage in different cell types involved in the pathogenesis of progressive fibrosing interstitial lung disease. Read More

Eur Respir J 2021 Jun 3. Epub 2021 Jun 3.

Division of Pulmonary and Critical Care Medicine, Department of Medicine, University of California, San Francisco, USA.

Hypersensitivity pneumonitis (HP) is a relatively new construct, first reported in the early 20th century, despite major aetiologic factors (farming, bird husbandry) being part of human activities for millennia. Initial confirmed HP reports include exposure to farming and forestry (1932) and bird exposure (1965), much more recently in time than is often assumed. Later changes in occupational and living practices have led to HP associated with isocyanates, machine coolants, indoor mould, hot tubs, and other exposures. Read More

J Bras Pneumol 2021 31;47(3):e20200096. Epub 2021 May 31.

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

Many conditions result in chronic interstitial lung disease (ILD), being classified as fibrosing ILDs, including idiopathic pulmonary fibrosis, connective tissue diseases, sarcoidosis, and fibrotic hypersensitivity pneumonitis. HRCT plays an important role in the clinical evaluation of fibrosing ILDs. Current treatment perspectives are encouraging and reinforce the need for HRCT scans of adequate technical quality for early detection of fibrosing ILD. Read More

Cureus 2021 Apr 25;13(4):e14684. Epub 2021 Apr 25.

Pulmonology, Gulab Devi Chest Hospital, Lahore, PAK.

Introduction Interstitial lung disease (ILD) is a heterogeneous group of over 200 parenchymal lung diseases with a myriad of etiologies. Interstitial lung disease registries from around the world show varying prevalence and incidence of these diseases. The aim of this study was to determine the epidemiology and characteristics of ILD in Pakistan. Read More

Rheumatol Int 2021 May 29. Epub 2021 May 29.

Rheumatology Department, Clermont-Ferrand University Hospital, Clermont-Ferrand, France.

To assess, by means of a questionnaire, the effectiveness of a therapeutic education session on rheumatoid arthritis patients' knowledge about methotrexate. Retrospective study of data collected in routine care. STROBE guidelines were used. Read More

Pediatr Pulmonol 2021 May 28. Epub 2021 May 28.

Department of Pediatric Pneumology, Dr. von Haunersches Kinderspital, German Center for Lung Research, University of Munich, Munich, Germany.

Introduction: Hypersensitivity pneumonitis (HP) in children is a severe interstitial lung disease and potentially, a chronic condition, if not treated appropriately. No evidence-based guidelines are available; in particular, the role of systemic glucocorticoid therapy is unclear.

Methods: The aim of this randomized, double-blind, placebo-controlled, parallel-group, multi-center, phase II trial in pediatric HP was to assess the outcome of HP in children after 6 months of treatment and to compare 3 months of treatment with oral prednisolone or placebo. Read More

Zhonghua Yi Xue Za Zhi 2021 Jun;101(20):1453-1457

Department of Respiratory and Critical Care Medicine, Affiliated Hospital of Xuzhou Medical University, Xuzhou 221000, China.

Interstitial lung disease (ILD), consisting of more than 200 subtypes of diseases, is a large group of heterogeneous diseases characterized by varying degrees of alveolitis and pulmonary parenchymal fibrosis. There are many challenges in its diagnosis and treatment. In recent years, new understanding of the clinical classification, disease behavior, early diagnosis, and treatment of ILD has been obtained. Read More

Front Med (Lausanne) 2021 10;8:680997. Epub 2021 May 10.

Division of Pulmonary, Critical Care, and Sleep Medicine, University of California, Davis, Davis, CA, United States.

Interstitial lung disease (ILD) comprises a heterogenous group of diffuse lung disorders that commonly result in irreversible pulmonary fibrosis. While idiopathic pulmonary fibrosis (IPF) is the prototypical progressive fibrosing ILD (PF-ILD), a high proportion of patients with other ILD subtypes develop a PF-ILD phenotype. Evidence exists for shared pathobiology leading to progressive fibrosis, suggesting that biomarkers of disease activity may prove informative across the wide spectrum of ILDs. Read More

Sci Total Environ 2021 May 18;788:147832. Epub 2021 May 18.

Health and Safety Executive, Science and Research Centre, Buxton SK17 9JN, UK.

Different types of pots and growing and casing media, including biodegradable materials, are used for plant and mushroom production. The fungus Peziza ostracoderma has gained attention for its visible growth on growing media for plants and casing media for mushrooms. Through a review of the literature we aim to evaluate whether exposure to fungi from recyclable pots and different growing and casing media occurs and causes occupational health effects. Read More

Am J Respir Crit Care Med 2021 May 25. Epub 2021 May 25.

Tosei General Hospital, 37091, Respiratory Medicine and Allergy, Seto, Japan;

Handb Exp Pharmacol 2021 May 25. Epub 2021 May 25.

Institute for Prevention and Occupational Medicine of the German Statutory Accident Insurance, Institute of the Ruhr University of Bochum (IPA), Bochum, Germany.

Occupational allergies are among the most common recorded occupational diseases. The skin and the upper and lower respiratory tract are the classical manifestation organs. More than 400 occupational agents are currently documented as being potential "respiratory sensitizers" and new reported causative agents are reported each year. Read More

Respir Res 2021 May 24;22(1):162. Epub 2021 May 24.

Hôpital Louis Pradel, Centre National de Référence des Maladies Pulmonaires Rares, Hospices Civils de Lyon, Lyon, OrphaLung, RespiFil, ERN-LUNG, Claude Bernard University Lyon 1, 28 Avenue du Doyen Lepine, 69677, Lyon Cedex, France.

Background: There is a paucity of data on the epidemiology, survival estimates and healthcare resource utilisation and associated costs of patients with progressive fibrosing interstitial lung disease (PF-ILD) in France. An algorithm for extracting claims data was developed to indirectly identify and describe patients with PF-ILD in the French national administrative healthcare database.

Methods: The French healthcare database, the Système National des Données de Santé (SNDS), includes data related to ambulatory care, hospitalisations and death for 98. Read More

Arch Environ Occup Health 2021 May 24:1-5. Epub 2021 May 24.

Department of Occupational Medicine, University General Hospital of Alexandroupolis, Alexandroupolis, Greece.

This case report describes a 60-year-old male, who presented to the Respiratory Outpatient Unit due to dyspnea on exertion and persistent dry cough, worsened during the preceding 6 months. He was nonsmoker with an otherwise unremarkable medical history and had been working in a sheep/goat slaughterhouse for the last 25 years. He recalled a number of episodes of flu-like symptoms in the past that subsided without any specific treatment. Read More

Intern Med 2021 May 22. Epub 2021 May 22.

Division of Pulmonary Medicine, Department of Medicine, Tokai University School of Medicine, Japan.

Hypersensitivity pneumonitis (HP) sometimes develops in people working in specific environments. We herein report a case of occupation-related HP in a citrus farmer in Japan. A 66-year-old man developed a fever, dyspnea, and general malaise in March after working near a trash dump filled with moldy tangerines. Read More

Clin Chest Med 2021 Jun;42(2):321-335

Department of Medicine and Surgery, University of Milan Bicocca; Pneumology Unit, Ospedale "S. Gerardo", ASST Monza, Monza, Italy.

Nonidiopathic pulmonary fibrosis (non-IPF) progressive fibrotic interstitial lung diseases (PF-ILDs) are a heterogeneous group of ILDs, often challenging to diagnose, although an accurate diagnosis has significant implications for both treatment and prognosis. A subgroup of these patients experiences progressive deterioration in lung function, physical performance, and quality of life after conventional therapy. Risk factors for ILD progression include older age, lower baseline pulmonary function, and a usual interstitial pneumonia pattern. Read More

Clin Chest Med 2021 Jun;42(2):311-319

Department of Medicine, University of Calgary, Calgary, Alberta, Canada; Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada.

Fibrotic hypersensitivity pneumonitis (fHP) is a chronic, often progressive fibrosing form of interstitial lung disease caused by inhaled antigenic exposures. fHP can lead to impaired respiratory function, reduced disease-related quality of life, and early mortality. Management of fHP should start with exposure remediation where possible, with systemic immunosuppression and antifibrotic therapy considered in patients with symptomatic or progressive disease. Read More

Chest 2021 Apr 6;159(4):e215-e219. Epub 2021 Apr 6.

Department of Medicine, Division of Pulmonary and Critical Care, Medical College of Wisconsin, Milwaukee, WI. Electronic address:

Case Presentation: A woman in her late 40s with a history of recurrent deep vein thromboses and hypersensitivity pneumonitis (HP) presented to the ED with progressive exertional dyspnea and productive cough. She recently had started oral corticosteroids after HP was confirmed via transbronchial lung cryobiopsy from both the right upper and lower lobes, which showed poorly formed granulomas with mild interstitial and perivascular lymphocytic infiltrates. A causative antigen for her HP was never clearly identified. Read More

Respir Res 2021 May 20;22(1):152. Epub 2021 May 20.

Department of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-Ro 43-Gil, Songpa-gu, Seoul, 05505, Republic of Korea.

Background: Patients with fibrotic hypersensitivity pneumonitis (HP) show variable clinical courses, and some experience rapid deterioration (RD), including acute exacerbation (AE). However, little is known about AE in fibrotic HP. Here, we retrospectively examined the incidence, risk factors, and outcomes of AE in fibrotic HP. Read More

ERJ Open Res 2021 Apr 4;7(2). Epub 2021 May 4.

Interstitial Lung Diseases Centre of Excellence, Dept of Pulmonology, St Antonius Hospital, Nieuwegein, The Netherlands.

https://bit.ly/3pU0PeC. Read More

J Asthma Allergy 2021 10;14:501-511. Epub 2021 May 10.

Pharmacy Practice Department, Faculty of Pharmacy, Tabuk University and Al-Azhar University, Nasr City, Egypt.

Background: Hypersensitivity pneumonitis (HP) is an immune-mediated disorder that causes inflammation of interstitial lung, bronchioles, and alveoli. Although corticosteroids have been used as first line treatment for HP for many years, it does not provide satisfactory results in all patients. The aim of this study is to compare the effect of oral methylprednisolone on different radiological patterns of HP to identify the most adequate candidates for corticosteroids. Read More

Am J Manag Care 2021 05;27(7 Suppl):S147-S154

University of Kansas Medical Center, Kansas City, KS. Email:

Progressive fibrosing interstitial lung diseases (ILDs) encompass a wide range of diseases, including hypersensitivity pneumonitis, occupational diseases, granulomatous diseases, drug-induced diseases, and idiopathic pneumonitis. Given the vast number of progressive fibrosing ILDs and the disparities in clinical patterns and disease features, understanding their clinical and economic impact presents significant challenges. Historically, treatment options for progressive fibrosing ILDs include anti-inflammatory drugs and immunosuppressive. Read More

Diagn Interv Radiol 2021 May;27(3):329-335

Department of Diagnostic Imaging and U.O. of Multi Medical Radiology IRCCS, Milan, Italy.

Purpose: Mediastinal lymph node (MLN) enlargement detected on chest computed tomography (CT) is frequent in patients with interstitial lung disease (ILD) and is shown in approximately 70% of cases of idiopathic pulmonary fibrosis (IPF). We hypothesized that enlarged MLNs might be a predictor of poor prognosis, associated with lower survival and stronger disease severity.

Methods: This study included patients with idiopathic pulmonary fibrosis (IPF) or nonspecific interstitial pneumonia (NSIP) from January 2009 to December 2018. Read More

PLoS One 2021 17;16(5):e0251237. Epub 2021 May 17.

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

Cathelicidin (CRAMP) is a defence peptide with a wide range of biological responses including antimicrobial, immunomodulatory and wound healing. Due to its original properties the usefulness of CRAMP in the treatment of pulmonary fibrosis was assessed in a murine model of hypersensitivity pneumonitis (HP). The studies were conducted on mouse strain C57BL/6J exposed to a saline extract of Pantoea agglomerans cells (HP inducer). Read More

Front Oncol 2021 30;11:681997. Epub 2021 Apr 30.

Department of Medical Oncology, Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan.

Currently, only a few reports exist on the cytokine release syndrome (CRS) as one of the severe immune-related adverse events (irAEs) induced by immune checkpoint inhibitors (ICIs). Notably, it is very rare that grade 4 CRS related to ICI therapy overlaps with the drug-induced hypersensitivity syndrome (DiHS). A 46-year old woman with metastatic kidney cancer had grade 3 interstitial pneumonitis induced by four cycles of combination therapy of anti-programmed death-1 and anti-cytotoxic T lymphocyte-4 antibodies after right cytoreductive nephrectomy. Read More

Respir Med 2021 May 6;184:106444. Epub 2021 May 6.

Department of Medicine, University of Calgary, Calgary, Alberta, Canada; Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada. Electronic address: https://twitter.com/KerriBerriKerri.

Antigen identification is important for establishing a confident diagnosis of hypersensitivity pneumonitis (HP). There are no systematically curated lists of HP-associated exposures that inform clinical relevance or disease phenotype. We sought to systematically identify all reported causes of HP in the literature and evaluate their clinical relevance. Read More

Rev Mal Respir 2021 May 3. Epub 2021 May 3.

Service de pneumologie, cliniques universitaires Saint-Luc, Avenue Hippocrate, 10, 1200 Bruxelles, Belgique; Institut de recherche expérimentale et clinique, université catholique de Louvain, Bruxelles, Belgique. Electronic address:

Introduction: Hypersensitivity pneumonitis (HP) is one of the most common interstitial lung diseases, characterized by an inflammatory and/or fibrotic reaction to inhaled antigens.

Background: The heterogeneity of presentation and the lack of international guidelines makes management complex. In addition, the current treatment, based on antigen eviction and immunosuppressive drugs, is less effective in the fibrotic forms of HP. Read More