Reboux Gabriel, Piarroux Renaud, Roussel Sandrine, Millon Laurence, Bardonnet Karine, Dalphin Jean-Charles
Department of Mycology, University Hospital, Besançon, France.
Department of Respiratory Disease, University Hospital, Besançon, France.
J Med Microbiol. 2007 Oct;56(Pt 10):1317-1321. doi: 10.1099/jmm.0.46953-0.
Farmers' lung disease (FLD) is a pulmonary disease that results from repeated inhalation of antigens from mouldy hay or straw. The objective of this prospective study was to assess the reliability of four serological techniques in FLD diagnosis. Sera from 15 consecutive patients with FLD, 15 healthy control farmers and 30 urban controls were analysed using four serological techniques [electrosyneresis (ES), Ouchterlony double diffusion (DD), ELISA and Western blot (WB)] with four antigens (Absidia corymbifera, Eurotium amstelodami, Wallemia sebi and Saccharopolyspora rectivirgula). In the authors' region, ES on cellulose acetate with A. corymbifera antigen was the most relevant diagnostic tool for discriminating FLD patients from healthy exposed farmers (sensitivity 87 %, specificity 100 %). DD tests were in accordance with ES, but their discriminatory power was lower. No threshold indicating both good sensitivity and specificity could be established with ELISA. WB analysis failed to identify specific bands for FLD. This study demonstrates the efficacy of determining precipitin levels with an appropriate technique, using a panel of antigens consistent with the specific exposure of a given area.
农民肺疾病（FLD）是一种因反复吸入发霉干草或稻草中的抗原而导致的肺部疾病。这项前瞻性研究的目的是评估四种血清学技术在FLD诊断中的可靠性。使用四种血清学技术[电渗析（ES）、双向琼脂扩散试验（DD）、酶联免疫吸附测定（ELISA）和蛋白质印迹法（WB）]以及四种抗原（伞枝犁头霉、阿姆斯特丹散囊菌、西弗列尼亚菌和直丝糖多孢菌）对15例连续的FLD患者、15名健康对照农民和30名城市对照者的血清进行了分析。在作者所在地区，以伞枝犁头霉抗原在醋酸纤维素上进行的ES是区分FLD患者与健康暴露农民的最相关诊断工具（敏感性87%，特异性100%）。DD试验与ES结果一致，但其鉴别能力较低。ELISA无法确定同时具有良好敏感性和特异性的阈值。WB分析未能识别出FLD的特异性条带。本研究证明了使用与特定区域的特定暴露相一致的一组抗原，通过适当技术测定沉淀素水平的有效性。
