Gangwar M, Khan Z U, Gaur S N, Randhawa H S
Department of Medical Mycology, Vallabhbhai Patel Chest Institute, University of Delhi, India.
Antonie Van Leeuwenhoek. 1991 Apr;59(3):167-75. doi: 10.1007/BF00580656.
The study was prompted by the lack of information on the role of thermophilic actinomycetes in hypersensitivity pneumonitis in India. It reports the occurrence of precipitating antibodies against clinically important thermophilic actinomycetes in the sera of a population sample of dairy herd workers, Nangali, Delhi. Of 112 workers investigated, 28 (25%) showed precipitins against Faenia rectivirgula, 4 (3.2%) against Saccharomonospora viridis, 2 against Thermoactinomyces thalpophilus and one each against T. vulgaris and T. sacchari. The results of enzyme-linked immunosorbent assay (ELISA) indicated that IgG antibody activity against F. rectivirgula was significantly higher in the symptomatic group than in the asymptomatic group (p less than 0.05) of workers and the controls (p less than 0.01). Significant difference in F. rectivirgula IgG activity was also obtained between the precipitin-positive symptomatic group and the precipitin-positive asymptomatic group (p less than 0.05). In strong contrast, the IgG antibody activity against T. thalpophilus was found to be uniformly low. A limited aeromicrobiological sampling of the dairy farm revealed S. viridis (55.8%) to be the commonest species followed by T. vulgaris (19.2%), T. thalpophilus (18.5%), F. rectivirgula (5%) and T. sacchari (1.5%). On the basis of suggestive clinical and laboratory findings, farmer's lung disease was suspected in four dairy herd workers. A comprehensive clinical evaluation including pulmonary function studies on the dairy herd workers and their long-term follow-up is indicated to determine the extent of respiratory morbidity caused by F. rectivirgula, S. viridis, T. thalpophilus, T. sacchari and T. vulgaris in India.
由于印度缺乏关于嗜热放线菌在过敏性肺炎中作用的信息,促使开展了这项研究。该研究报告了德里楠加利奶牛场工人人群样本血清中针对临床上重要嗜热放线菌的沉淀抗体的出现情况。在接受调查的112名工人中,28人(25%)显示出针对直形嗜热放线菌的沉淀素,4人(3.2%)针对绿色糖单孢菌,2人针对嗜热栖热放线菌,各有1人针对普通嗜热放线菌和糖嗜热放线菌。酶联免疫吸附测定(ELISA)结果表明,有症状组工人和对照组中针对直形嗜热放线菌的IgG抗体活性显著高于无症状组(有症状组p小于0.05,对照组p小于0.01)。在沉淀素阳性有症状组和沉淀素阳性无症状组之间,直形嗜热放线菌IgG活性也存在显著差异(p小于0.05)。形成强烈对比的是,发现针对嗜热栖热放线菌的IgG抗体活性一直很低。对奶牛场进行的有限空气微生物采样显示,绿色糖单孢菌(55.8%)是最常见的菌种,其次是普通嗜热放线菌(19.2%)、嗜热栖热放线菌(18.5%)、直形嗜热放线菌(5%)和糖嗜热放线菌(1.5%)。根据提示性的临床和实验室检查结果,怀疑4名奶牛场工人患有农民肺疾病。需要对奶牛场工人进行包括肺功能研究在内的全面临床评估及其长期随访,以确定直形嗜热放线菌、绿色糖单孢菌、嗜热栖热放线菌、糖嗜热放线菌和普通嗜热放线菌在印度引起的呼吸道发病程度。