Amishima M, Munakata M, Ohtsuka Y, Satoh A, Takahashi T, Taguchi H, Nasuhara Y, Ohe M, Doi I, Homma Y
First Department of Medicine, School of Medicine, Hokkaido University, Sapporo, Japan.
Am J Respir Crit Care Med. 1995 Jun;151(6):1794-8. doi: 10.1164/ajrccm.151.6.7767522.
Patients with farmer's lung disease (FLD) and dairy farmers have nonspecific bronchial hyperresponsiveness. To examine the factors determining bronchial hyperresponsiveness among dairy farmers, we studied airway functions, airway responses to inhaled methacholine, serum total IgE levels, and antigen-specific IgE levels in 37 dairy farmers and 11 local control subjects. The 37 dairy farmers consisted of three groups; 12 farmers with episodes of FLD (FLD group), 13 farmers with serum antibody to Micropolyspora faeni (MF) and/or Thermoactinomyces vulgaris (TV) but without episodes of FLD (Ab(+) group), and 12 farmers without serum antibodies to MF and TV and without episodes of FLD (Ab(-) group). Pulmonary function tests showed small airways disorders among farmers (each of the three groups versus control subjects; p < 0.05). Methacholine provocation test, utilizing PD35Grs (a cumulative dose of methacholine that induces 35% reduction in respiratory conductance [Grs]), showed bronchial hyperresponsiveness in each group of dairy farmers compared with that in control subjects (Log PD35Grs, mean +/- SEM: 1.22 +/- 0.18, 1.00 +/- 0.17, and 1.20 +/- 0.20, respectively, versus 2.10 +/- 0.09; p < 0.001). However, there was no statistically significant difference in bronchial responsiveness among the three groups of dairy farmers. In addition, there was no significant difference in serum total IgE levels and specific IgE antibodies among the four groups. These results suggest that the bronchial hyperresponsiveness to methacholine among dairy farmers is not due to past episodes of FLD or sensitization to MF and/or TV, but is possibly due to the occupational environment of dairy farming.
患有农民肺疾病（FLD）的患者以及奶农存在非特异性支气管高反应性。为了研究决定奶农支气管高反应性的因素，我们对37名奶农和11名当地对照者进行了气道功能、对吸入乙酰甲胆碱的气道反应、血清总IgE水平以及抗原特异性IgE水平的研究。37名奶农分为三组；12名有FLD发作的农民（FLD组），13名有针对嗜热放线菌（MF）和/或普通嗜热放线菌（TV）的血清抗体但无FLD发作的农民（抗体阳性组），以及12名无针对MF和TV的血清抗体且无FLD发作的农民（抗体阴性组）。肺功能测试显示农民中存在小气道疾病（三组中的每组与对照者相比；p<0.05）。使用PD35Grs（诱导呼吸传导率[Grs]降低35%的乙酰甲胆碱累积剂量）进行的乙酰甲胆碱激发试验显示，与对照者相比，每组奶农均存在支气管高反应性（Log PD35Grs，均值±标准误：分别为1.22±0.18、1.00±0.17和1.20±0.20，而对照者为2.10±0.09；p<0.001）。然而，三组奶农之间的支气管反应性在统计学上无显著差异。此外，四组之间的血清总IgE水平和特异性IgE抗体无显著差异。这些结果表明，奶农对乙酰甲胆碱的支气管高反应性并非由于过去的FLD发作或对MF和/或TV的致敏，而可能是由于奶农的职业环境所致。
