Kasr Alainy, Faculty of Medicine, Cairo University, Almaadi, Cairo, Egypt.
Sci Rep. 2023 May 31;13(1):8868. doi: 10.1038/s41598-023-35871-5.
Hypersensitivity pneumonitis (HP) is an interstitial lung disease that develops after inhalation of a variety antigens in susceptible individuals. The nasal mucosa is constantly exposed to these antigens that can irritate the respiratory mucosa. So, the purpose of this study was to study nasal histopathological changes in order to identify any shared pathological changes between the upper airways and the well-known pathological features of HP. 40 HP patients diagnosed at the Chest Department, Kasr Alainy hospital following ATS/JRS/ALAT guidelines were included. Patients were subjected to thorough history, high-resolution computed tomography, spirometry, cough evaluation test (CET), sinonasal outcome test-22 (SNOT-22), sinonasal examination and nasal mucosal biopsy by an otolaryngologist under visualization by a rigid nasal endoscope. The mean age of the patients was 46.2 ± 13.5 (85% were females and 15% were males). 90% of patients presented with cough and the mean CET was 17.15 ± 5.59.77.5% of patients suffered from sinonasal symptoms and the mean SNOT-22 was 12.18 ± 3.8. There was a significant correlation between the burden of sinonasal symptoms represented by the SNOT-22 and the severity of the cough represented by CET (r 0.40, p 0.01). 87.5% of HP patients had chronic inflammation of the nasal mucosa with predominant lymphocytic infiltration in 72.5% of patients. 77.5% of HP patients had a high burden of sinonasal symptoms which is positively associated with cough severity. 72.5% of patients had predominately lymphocytic infiltration of the nasal mucosa.Trial registration: retrospectively registered, registration number is NCT05723796, date of registration 13/02/2023.
过敏性肺炎 (HP) 是一种间质性肺疾病，发生于易感个体吸入多种抗原后。鼻黏膜持续暴露于这些抗原，可刺激呼吸道黏膜。因此，本研究旨在研究鼻组织病理学变化，以确定上呼吸道与 HP 已知的病理学特征之间是否存在共同的病理变化。 40 例 HP 患者根据 ATS/JRS/ALAT 指南在 Kasr Alainy 医院胸科被诊断为 HP。患者接受了详细的病史、高分辨率计算机断层扫描、肺活量测定、咳嗽评估测试 (CET)、鼻窦结局测试-22 (SNOT-22)、鼻窦检查和鼻黏膜活检，由耳鼻喉科医生在刚性鼻内窥镜可视化下进行。患者的平均年龄为 46.2±13.5 岁（85%为女性，15%为男性）。90%的患者表现为咳嗽，平均 CET 为 17.15±5.59。77.5%的患者有鼻窦症状，平均 SNOT-22 为 12.18±3.8。SNOT-22 代表的鼻窦症状负担与 CET 代表的咳嗽严重程度之间存在显著相关性（r0.40，p0.01）。87.5%的 HP 患者有鼻黏膜慢性炎症，72.5%的患者以淋巴细胞浸润为主。77.5%的 HP 患者有较高的鼻窦症状负担，与咳嗽严重程度呈正相关。72.5%的患者鼻黏膜以淋巴细胞浸润为主。试验注册：回顾性注册，注册号为 NCT05723796，注册日期为 2023 年 2 月 13 日。
