Craig T J, Hershey J, Engler R J, Davis W, Carpenter G B, Salata K
Walter Reed Army Medical Center, Allergy-Immunology Service, Washington, DC.
Ann Allergy. 1992 Dec;69(6):510-2.
Hypersensitivity pneumonitis (HP) secondary to bird exposure is treated with glucocorticosteroids and avoidance. Despite therapy, symptoms may persist for a prolonged time. Just as cat antigen, Fel d 1, may persist for greater than 20 weeks after cat removal, there may be persistent bird antigen to explain prolonged symptoms in bird HP. It was the intent of this study to determine household distribution and persistence of bird antigen after removal of the bird from the patient's home. The homes of patients with birds were followed serially after bird removal with multiple samples collected using a hand-held vacuum cleaner. Bird antigen levels were determined by an inhibition enzyme-linked immunoassay. In five homes the antigen declined gradually despite extensive environmental control measures, with high levels still detectable at 18 months in one home. This data suggests that high levels of bird antigen can be detected for prolonged periods of time after bird removal and environmental cleanup. The antigen may account for the persistence of disease in some patients with HP. In severe HP, the preferred therapy may be temporary relocation of the patient away from the room in which the bird was housed, in addition to corticosteroids, until the patient's environment is demonstrated to be relatively bird antigen-free.
因接触鸟类继发的过敏性肺炎（HP）采用糖皮质激素治疗并避免接触过敏原。尽管进行了治疗，症状可能会持续很长时间。正如猫过敏原Fel d 1在移除猫后可能持续超过20周一样，鸟类HP中也可能存在持续性鸟类抗原，以解释症状持续时间延长的原因。本研究旨在确定从患者家中移除鸟类后，鸟类抗原在家庭环境中的分布情况及其持续性。在移除鸟类后，对养鸟患者的家庭进行连续跟踪，使用手持式吸尘器采集多个样本。通过抑制酶联免疫测定法测定鸟类抗原水平。在五个家庭中，尽管采取了广泛的环境控制措施，抗原水平仍逐渐下降，其中一个家庭在18个月时仍可检测到高水平的抗原。该数据表明，在移除鸟类并进行环境清理后，长时间内仍可检测到高水平的鸟类抗原。这种抗原可能是导致一些HP患者疾病持续存在的原因。在重症HP中，除了使用糖皮质激素外，首选的治疗方法可能是让患者暂时搬离饲养鸟类的房间，直到证明患者所处环境相对无鸟类抗原。
