Immunopathogenesis of the Extrinsic Allergic Alveolitis Syndrom induced by Fungal Allergens.

Author: Nunu Mitskevich
Co-authors: Ketevan machavariani
Keywords: Extrinsic Allegic Alveolitis, Broncial Asthma, Allergic rinithis, Respiratory System Allergy, Fungal allergens, Sensitization, Immunoglobulins
Annotation:

The aimb of our study was to investigate the epidemiology and Immunology of the different RAD (Bronchial Asthma (BA), Allergic Rhinitis (AR), Extrinsic Allergic Alveolitis (EAA) syndrome) in poultry industry workers having contact with organic dust. The immunopathogenesis of EAA, wich has recently become the focus of many investigations, has not yet studied in Georgia. Method: We questioned 450 poultry workers, aged 21-67 years with working experience from 1 to 40 years; 49% were females, 51%-males. They were questioned y three-stage questionnaire for revealing of RAD. 375 of the questioned had a direct contact with chickens. 175 from them had a specific allergic examination -skin tests by CS(chicken serum), PF(pillow feather) and DD(domestic dust) allergens. Workers with RAD had to go through spyrometric analysis with the flow-volume test. 42 poultry workers, with a positive skin tests and the clinical manifestations of RAD were examined for serum immunoglobulin levels. The data was studied statistically using the method of multi-factorial dispersion analysis. Results: The incidence of RAD was varied from 1,2% to 6%: The highest was in case of AR, it was lower for EAA syndrome (4,8%) and even lower for BA (1,2%). In these workers the incidence of monosensitisation to CS allergen was 27,3%, for PF 9,1%; Polysensitisation to CS and PF allergens was equal 36,4 % to CS, PF and DD – 27,3%, to CS and DD allergens – 7,69%. The correlation between the development of RAD and intensity and duration of the contact with allergens was following: In workers with contact for <5 years EAA was not detected, AR was 18,2% and BA-9,1%. The highest incidence of EAA syndrome (22,7%) was in group - with 5-15 years. In group with >15 years EAA was slightly lower (18,2%), BA(13,6%) and AR(9,1%). The concentration of immunoglobulin in workers with EAA syndrome had significantly increased IgG levels. IgM and IgG concentrations were slightly increased. In workers with BA IgE was significantly increased, whilst IgG was found to be moderately increased. In the AR group there were elevated levels of IgM and IgE and lowered IgA and IgG levels. In the serum of the workers with EAA the IgG1 subclass level was increased. Conclusions: Therefore, in workers exposed to organic dust(duration 5-15 years) EAA syndrome seems to develop with a significant increase in serum IgG levels and IgG1 play an important role in the pathogenesis of the disease.