Innate immunity in hypersensitivity pneumonitis
Research type
Research Study
Full title
Innate immune responses to fungal stimulation in hypersensitivity pneumonitis of unknown cause
IRAS ID
241029
Contact name
John Simpson
Contact email
Sponsor organisation
Newcastle upon Tyne Hospitals NHS Foundation Trust
Duration of Study in the UK
1 years, 5 months, 31 days
Research summary
"Pigeon fancier's lung" and "farmer's lung" are diseases caused by inhalation of dusts (from pigeons and mouldy hay respectively), where inflammation of the lung, if untreated, may progresses to permanent scarring of the lungs, with permanent breathlessness and sometimes death. The pattern of pathology and x-ray changes for these diseases is remarkably similar, and the best treatment is removing patients from exposure to the relevant dust before scarring occurs.
Many patients present with the same clinical, x-ray and pathological features but without exposure to birds or mouldy hay. While some other "dust" is sometimes identified (e.g. mushroom worker's lung or humidifier fever), in the majority of cases no cause is found. These patients may respond to steroids or other aggressive treatments, but progressive disease is common. Remarkably little is known about this disease (here called "hypersensitivity pneumonitis of unknown cause (HP-UC))" except that it is an immune reaction to unidentified inhaled sources.
As we spend more than half our lives indoors, we postulate that invisible spores from indoor fungus/yeast may be the source, in susceptible individuals. We shall therefore leave microbiology laboratory "plates" around the homes of patients with HP-UC, and around the homes of people without HP-UC from similar postcodes, of similar age, sex and smoking history. This will determine if yeast spores are more common in HP-UC households. We shall invite the patients and controls to provide a single blood sample, which we shall use to determine how white blood cells respond to common yeast molecules, to determine if patients have a more "aggressive" immune response to yeast exposure.
We hope these studies will provide clues into the processes driving HP-UC, so we can design larger, more detailed studies with a view to developing rational treatments for this currently untreatable chronic lung condition.
REC name
South Central - Berkshire Research Ethics Committee
REC reference
18/SC/0530
Date of REC Opinion
21 Sep 2018
REC opinion
Favourable Opinion