Ando M
First Department of Internal Medicine, Kumamoto University School of Medicine, Japan.
Nihon Kyobu Shikkan Gakkai Zasshi. 1993 Dec;31 Suppl:5-11.
Summer-type hypersensitivity pneumonitis (SHP) is the most prevalent type of HP in Japan, and the major causative agent of the disease is T. cutaneum. The major antigenic substance of the yeast is serotype-related polysaccharide. Home environmental factors indicate that SHP is a sick house syndrome. Immunologically, both humoral and cellular hypersensitivities are involved in the induction of the disease. The levels of specific IgG and IgA antibodies and complements in BAL fluids from SHP patients are well correlated to the clinical course. On the other hand, BAL lymphocytes in SHP patients are mostly T lymphocytes, mainly due to an increase in CD8+ subpopulations of lymphocytes; this leads to a decrease in the ratio of CD4+ to CD8+. These T cells belong to CD45RO+ memory T lymphocytes and LFA-11 alpha high+ cytotoxic T lymphocytes as assessed by their cell surface phenotypes. However, functions of these BAL T lymphocytes remain undefined. Host factors such as HLA-DQw3 and cigarette smoking may participate in the development of the disease. In conclusion, the pathogenesis of SHP is considered to be a combination of immune complex disease and cellular hypersensitivity to T. cutaneum.
夏季型过敏性肺炎（SHP）是日本最常见的过敏性肺炎类型，该病的主要病原体是皮肤毛癣菌。该酵母菌的主要抗原物质是血清型相关多糖。家庭环境因素表明SHP是一种病态建筑综合症。在免疫学上，体液和细胞超敏反应均参与该病的诱发过程。SHP患者支气管肺泡灌洗（BAL）液中特异性IgG和IgA抗体以及补体的水平与临床病程密切相关。另一方面，SHP患者的BAL淋巴细胞大多为T淋巴细胞，主要是由于淋巴细胞CD8 +亚群增加；这导致CD4 +与CD8 +的比例降低。根据其细胞表面表型评估，这些T细胞属于CD45RO +记忆T淋巴细胞和LFA-11α高+细胞毒性T淋巴细胞。然而，这些BAL T淋巴细胞的功能仍不明确。宿主因素如HLA-DQw3和吸烟可能参与该病的发展。总之，SHP的发病机制被认为是免疫复合物疾病和对皮肤毛癣菌的细胞超敏反应的结合。
