Gavin Boyd

Quantifying serum antibody in bird fanciers' hypersensitivity pneumonitis

BackgroundDetecting serum antibody against inhaled antigens is an important diagnostic adjunct for hypersensitivity pneumonitis (HP). We sought to validate a quantitative fluorimetric assay testing serum from bird fanciers.MethodsAntibody activity was assessed in bird fanciers and control subjects using various avian antigens and serological methods, and the titer was compared with symptoms of HP.ResultsIgG antibody against pigeon serum antigens, quantified by fluorimetry, provided a good discriminator of disease. Levels below 10 mg/L were insignificant, and increasing titers were associated with disease. The assay was unaffected by total IgG, autoantibodies and antibody to dietary hens egg antigens. Antigens from pigeon serum seem sufficient to recognize immune sensitivity to most common pet avian species. Decreasing antibody titers confirmed antigen avoidance.ConclusionIncreasing antibody titer reflected the likelihood of HP, and decreasing titers confirmed antigen avoidance. Quantifying antibody was rapid and the increased sensitivity will improve the rate of false-negative reporting and obviate the need for invasive diagnostic procedures. Automated fluorimetry provides a method for the international standardization of HP serology thereby improving quality control and improving its suitability as a diagnostic adjunct.

Pigeon fancier's lung.

Pigeon racing is based on the remarkable homing instinct of pigeons, which enables them to return to their loft over distances of many hundreds of miles. British pigeon fanciers are particularly proud of their role in the second world war, when highly trained pigeons were used for communication.1 Pigeons were parachuted in small containers into occupied Europe with instructions for the finder to attach espionage messages to the birds, which were then released to fly silently and undetected back to lofts in Britain. There are now about 83 000 registered pigeon fanciers in Britain. When racing, the birds are transported to a liberation point; a ring is placed on one leg; and, when released, the bird returns to its loft, where the ring is removed and placed in a special clock which registers the exact “timing in” of the bird. The location of each loft has been registered so that the distance travelled by each pigeon can be calculated. Racing pigeons have been bred and trained for speed and endurance. The official British duration record is 1173 miles in 15 days, and the highest race speed is 110.07 miles per hour.2 Although a typical pigeon fancier keeps pigeons as a hobby, pigeon fancying is a multimillion pound business, and top class birds have been sold for as much as £110 800.2 Pigeon fanciers lung …

Discriminant analysis of symptom pattern and serum antibody titres in humidifier related disease.

BACKGROUND--The heterogeneous patterns of symptoms among factory workers exposed to aerosols from contaminated air humidifiers were analysed to assess the association between specific symptoms and the serum IgG antibody response to the humidifier water contaminants, and to test the ability of specific symptoms to predict this antibody response. METHODS--Symptoms from 88 factory workers were surveyed by a doctor administered questionnaire and compared with their serum IgG antibody titres to humidifier water contaminants quantified by enzyme immunoassay. RESULTS--The strength of association between individual symptoms and antibody showed that fever, shivering or chills, influenza-like symptoms, or headache were individually significantly associated with the presence and higher titres of antibody. This was also true for those subjects whose symptoms were most pronounced during the first day of the working week. Within each subjects full symptom profile there were significant associations between the description of chest tightness, breathlessness, and wheeze; between headache and influenza like symptoms; between fever and shivering or chills; and between intermittent onset and general tiredness. Discriminant analysis of the full symptom profiles showed that there was maximum information content in five independent parameters, namely, the descriptions of fever, headache, and chest tightness, the timing of their onset, and the readiness to describe miscellaneous symptoms in addition to those in the questionnaire. On the basis of these criteria 72% of subjects could be classified according to their antibody state. Cluster analysis with these five independent parameters described four symptom clusters: one associated with high median antibody levels, one with low, and two with zero median levels. These were, respectively: (1) fever with headache and chest tightness; (2) either no or few symptoms; (3) chest tightness and headache with intermittent onset; (4) headache and miscellaneous symptoms with intermittent onset. CONCLUSIONS--The association between serum antibody titres and specific symptom patterns may identify different categories of disease which constitute the spectrum known as humidifier related disease, and strengthens the hypothesis that antibody may be involved in the pathogenesis of some components of the disease.

Pigeon fancier's lung: Antigen avoidance and respiratory protection are the mainstays of management

Pigeon racing is based on the remarkable homing instinct of pigeons, which enables them to return to their loft over distances of many hundreds of miles. British pigeon fanciers are particularly proud of their role in the second world war, when highly trained pigeons were used for communication.1 Pigeons were parachuted in small containers into occupied Europe with instructions for the finder to attach espionage messages to the birds, which were then released to fly silently and undetected back to lofts in Britain. There are now about 83 000 registered pigeon fanciers in Britain. When racing, the birds are transported to a liberation point; a ring is placed on one leg; and, when released, the bird returns to its loft, where the ring is removed and placed in a special clock which registers the exact “timing in” of the bird. The location of each loft has been registered so that the distance travelled by each pigeon can be calculated. Racing pigeons have been bred and trained for speed and endurance. The official British duration record is 1173 miles in 15 days, and the highest race speed is 110.07 miles per hour.2 Although a typical pigeon fancier keeps pigeons as a hobby, pigeon fancying is a multimillion pound business, and top class birds have been sold for as much as £110 800.2 Pigeon fanciers lung …

Pigeon fancier9s lung

Pigeon racing is based on the remarkable homing instinct of pigeons, which enables them to return to their loft over distances of many hundreds of miles. British pigeon fanciers are particularly proud of their role in the second world war, when highly trained pigeons were used for communication.1 Pigeons were parachuted in small containers into occupied Europe with instructions for the finder to attach espionage messages to the birds, which were then released to fly silently and undetected back to lofts in Britain. There are now about 83 000 registered pigeon fanciers in Britain. When racing, the birds are transported to a liberation point; a ring is placed on one leg; and, when released, the bird returns to its loft, where the ring is removed and placed in a special clock which registers the exact “timing in” of the bird. The location of each loft has been registered so that the distance travelled by each pigeon can be calculated. Racing pigeons have been bred and trained for speed and endurance. The official British duration record is 1173 miles in 15 days, and the highest race speed is 110.07 miles per hour.2 Although a typical pigeon fancier keeps pigeons as a hobby, pigeon fancying is a multimillion pound business, and top class birds have been sold for as much as £110 800.2 Pigeon fanciers lung …

Salmeterol and oral steroid treatment

Current international guidelines for asthma management recommend the introduction of supportive long acting bronchodilator therapy to be used in conjunction with maximal levels of inhaled corticosteroids, particularly before the introduction of long term oral corticosteroid therapy. A study in severe asthmatics, who were under consideration for the introduction of oral corticosteroid treatment, demonstrated that the addition of Salmeterol to maximal doses of inhaled corticosteroids significantly improved the overall level of asthma control so that in some patients the need to employ long term oral corticosteroid therapy was delayed or prevented.