Studies on the etiologic agent and pathogenesis of summer-type hypersensitivity pneumonitis

目的探讨夏季型超敏性肺炎（HP）的病因及发病机制。我们的研究结果如下：夏季型HP患者家中真菌发病率与对照组比较发现，夏季型HP患者的家庭环境中广泛分布有皮癣毛霉（一种形成关节孢子的酵母菌），而正常对照组的家庭环境中没有。分离得到的皮癣菌对患者血清有较高的反应性。几乎所有的患者都对皮肤t.菌培养滤液抗原的吸入攻击有反应。这些结果清楚地表明，皮绦虫是夏季型HP的病原。皮锥虫引起的HP是HP类群中的一种新疾病。夏季型HP发病机制的研究。环境研究表明，夏季型HP多发生在老木结构房屋的居民中，在雨季过后的潮湿夏季，皮癣菌在房屋内的旧潮湿木材、地垫、被褥或虎皮猴粪便上生长。换句话说，夏季型的惠普在日本是一种疗养院综合症。本文研究了66例由皮癣菌引起的日本夏季型HP患者的主要组织相容性复合体A、B、C、DR和DQ位点的表型，并与472名正常健康受试者的结果进行了比较。我们的结果显示HLA-DQW3在患者中的频率增加，提示宿主因素在本病发生中的重要性。

We studied the etiologic agent and pathogenesis of summer-type hypersensitivity pneumonitis (HP). Our results were as follows.i. Studies on the etiologic agent of summer-type HP When the incidence of fungi in patients' homes were compared with that in homes of control subjects, extensive distribution of trichosporon cutaneum, an arthro-spore forming yeast, war observed in home environments of patients with summer-type HP but not in homes of normal control subjects. The isolated t. cutaneum demonstrated high reactivity to the patients' sera. almost all patients responded to the inhalation challenge with the culture filtrate antigen of t. cutaneum. These results clearly indicate that T. cutaneum is an etiologic agent of summer type HP. HP induced by T. cutaneum is a new disease of HP groups.ii. Studies on the pathogenesis of summer-type HP. Environmental study revealed that summer-type HP tended to occur in the resident of old wooded houses, and that T. cutaneum grew on old damp wood, floor mats, bed clothes, or budgeriger droppings in their houses during muggy summer season following the rainy season. In other words, summer-type HP in Japan is a sick-house syn-drome. The phenotype of the major histocompatibility complex, loci A, B, C, DR, and DQ, was studied in 66 patients with Japanese summer-type HP induced by T. cutaneum, and the results were compared to those obtained from 472 normal healthy subjects. Our results showed an increase of the frequency of HLA-DQW3 in the patients, suggesting the importance of the host factors for the generation of this disease.