Farmer's lung in a 10-year-old boy.
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Biomedical subjects
Publications and source records attributed to J N Fink.
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Cell sap (CS) of the pathogenic fungus Aspergillus fumigatus strain Ag-507 was fractionated by Sephadex G-200 column chromatography. A protein fraction designated CS3 was partially characterized by two dimensional electrophoresis (2-DE) and analytical ultracentrifugation. CS3 consisted mainly of low molecular weight components (14 K-43 K) of the whole CS, and produced one peak in analytical ultracentrifugation with an Sapp of 4.25. CS3 was demonstrated to be different from a previously characterized CS fraction designated as CS2, by 2-DE, and by CS2 and CS3 specific antisera. CS3 gave precipitin reactions with three aspergilloma patient sera and 100% of sera from allergic bronchopulmonary aspergillosis (ABPA) patients. Significantly, three ABPA patient sera reacted with CS3 and not CS2. The CS of A. fumigatus strains Ag-515 and Ag-534, were also examined for the presence of CS3 components as were CS preparations of five additional Aspergillus species; A. flavus, A. fischeri, A. terreus, Neosartorya (Aspergillus) fennelliae, and A. niger, and three fungal taxa; Penicillium notatum, Candida albicans, and Saccharomyces cerevisiae. 2-DE, immunoelectrophoresis and double diffusion (DD) analyses of the CS preparations provided complementary information. The immunochemical similarity of CS2 and CS3 components of different aspergilli appears to reflect the taxonomic relatedness of the aspergilli. Additionally, aspergilli exhibiting CS2 and CS3 components most similar to A. fumigatus strain Ag-507 are more frequently isolated from aspergillosis patients. There may be an association of these components with incidence of involvement of the organisms in aspergillosis. DD analysis of the cross-reactivity of CS of all taxa with ABPA and aspergilloma patient sera supported the 2-DE and absorption data.
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One hundred patients with CF were screened for ABPA. Forty-eight male patients and 52 female patients with age range of 2 to 34 yr (mean 14.2) were studied. Patients were evaluated for skin reactivity and serum precipitating antibodies to Af, predominant sputum organisms, total blood eosinophil levels, total serum IgE, and Af-specific IgE and IgG, as well as abnormalities of pulmonary function and chest x-ray films. Careful evaluation of all patients with CF demonstrated that 10% had features indicative of ABPA, which is another potentially destructive pulmonary disorder. Thus careful evaluation of patients with CF, especially those with asthma, may be rewarding in uncovering a disorder that may slow progression of CF when it is appropriately treated.
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We examined the immunologic phenotype and function of bronchoalveolar lymphocytes isolated from 4 pigeon breeders who developed symptoms of hypersensitivity pneumonitis on exposure to pigeons, and 6 asymptomatic but equally exposed individuals. Similar numbers of bronchoalveolar lymphocytes were found in symptomatic breeders compared with the asymptomatic, and the percent of T11, T4, and T8 bearing cells as well as the T4/T8 ratios were similar in both groups. Despite these similarities, the groups had significantly different functional activity. Bronchoalveolar lymphocytes from symptomatic breeders demonstrated a marked (p less than 0.001) increase in blastogenic activity to both phytohemagglutinin and pigeon serum stimulation when compared with asymptomatic breeders. In addition, enriched bronchoalveolar T-cells suppressed the response of autologous preincubated peripheral blood lymphocytes to both phytohemagglutinin and pigeon serum in the asymptomatic compared with the symptomatic breeders. These studies suggest a discrepancy between the phenotype and function of immunoregulatory T-cell subsets in bronchoalveolar lavage lymphocytes in pigeon breeder's disease, and support a role for functional immunoregulatory imbalances in the pathogenesis of hypersensitivity pneumonitis.
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Street marijuana, commercial cigarettes and pipe tobaccos were studied for the presence of fungi and actinomycetes associated with hypersensitivity pneumonitis. Aspergillus species and thermophilic actinomycetes were isolated from the smoking materials. In addition, Aspergillus fumigatus spores were isolated from marijuana smoke, indicating the potential hazard involved in developing serious disease. Precipitin antibodies against fungi, particularly Aspergillus, showed a higher prevalence in marijuana smokers, whereas only very few cigarette smokers and nonsmokers demonstrated antibodies to fungi. Cigarette smokers and nonsmokers showed more or less similar prevelance of antibodies against thermophilic actinomycetes.
The possible role of marijuana (MJ) in inducing sensitization to Aspergillus organisms was studied in 28 MJ smokers by evaluating their clinical status and immune responses to microorganisms isolated from MJ. The spectrum of illnesses included one patient with systemic aspergillosis and seven patients with a history of bronchospasm after the smoking of MJ. Twenty-one smokers were asymptomatic. Fungi were identified in 13 of 14 MJ samples and included Aspergillus fumigatus, A. flavus, A. niger, Mucor, Penicillium, and thermophilic actinomycetes. Precipitins to Aspergillus antigens were found in 13 of 23 smokers and in one of 10 controls, while significant blastogenesis to Aspergillus was demonstrated in only three of 23 MJ smokers. When samples were smoked into an Andersen air sampler, A. fumigatus passed easily through contaminated MJ cigarettes. Thus the use of MJ assumes the risks of both fungal exposure and infection, as well as the possible induction of a variety of immunologic lung disorders.
This article describes four cases of exercise-induced anaphylaxis occurring only in temporal relationship to the ingestion of food. One individual developed anaphylaxis if exercise followed the ingestion of any food within 2 hr. Three other individuals had symptoms only if celery was ingested in relation to exercise. Skin reactivity to fresh celery extracts was demonstrated in all three individuals. The episodes were prevented by avoidance of food ingestion in relation to exercise. This syndrome appears to be a variant of exercised-induced anaphylaxis.
The relative diagnostic value of ST and RAST was evaluated in 97 patients with BSH. Eighteen patients had LRs, 79 showed SRs including 18 with urticaria, 26 had bronchospasm, and 35 had anaphylactic shock. ST but not the RAST reactivity was strongly related to the severity of the clinical reaction (p less than or equal to 0.001) and found superior to the RAST in identifying patients with SRs in whom venom therapy was indicated.
Culture filtrate antigens of Aspergillus fumigatus Ag 534 were purified by preparative isoelectric focusing and affinity chromatography. One of the pooled antigen fractions from the preparative isoelectric focusing step (pool 2) was passed through a concanavalin A column and yielded two components, designated antigens IIa and IIb. Antigen IIb reacted more strongly than antigen IIa with all of the aspergilloma and allergic bronchopulmonary aspergillosis sera tested by enzyme-linked immunosorbent assay. The glycoprotein nature of antigen IIb was shown by the concanavalin A binding properties and staining reactions of the components.
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Occupational asthma from exposure to laboratory animals has recently been recognized as a compensable prescribed disease in Britain. Current American employer attitudes and policies regarding laboratory animal allergy were surveyed by questionnaire and the findings compiled from 155 institutions. Laboratory animal allergy was reported as a workplace disease of animal house employees by 108 facilities (70%), with rat and rabbit exposure the most frequent cause. While 103 of 155 animal research facilities required a preemployment medical examination, only six of these included hypersensitivity screening. Applicants for jobs involving animal contact were rarely disqualified because of an allergic history. A uniform policy regarding the problem of allergy to laboratory animals in U.S. animal facilities is not presently apparent.
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