Markers of treatment outcome in hypersensitivity pneumonitis patients

Abstract

Limited number od studies concerning markers of treatment outcome in hypersensitivity pneumonitis (HP) patients was published. Aim: To detect possible markers of treatment outcome in bronchoalveolar lavage of HP patients. 24 HP patients have been prospectively enrolled. All of them were treatment naive at the time of diagnosis, when pulmonary function tests (PFT) and bronchoalveolar lavage (BAL) were assessed. Concentrations of MMP-7, IL-4R, PAR-2 and TNF-α in BAL fluid (BALF) were measured by ELISA. Initiation of pharmacological treatment ( systemic corticosteroids in an initial dose 0,5 mg/kg/day slowly tappering) was based on respiratory specialist decision in 14 patients, 10 patients were adviced to avoid further antigen exposure only. Repeated PFT were gained 6 months after diagnosis establishment and vital capacity (VC) values trends were assessed. Patients were divided into 4 group according to treatment and VC trend in 6 months period: pharmacological treatment - VC decline (n=7); nontreated - VC decline (n=1), pharmacological treatment - VC increase (n=7), nontreated – VC increase (n=9). Cytokine concentrations were compared among groups. Results: BALF concentrations of IL-4R and PAR-2 at the time of diagnosis might help us to define populations of HP patients with favourable prognosis.