过敏性肺炎的研究进展

Advancement of Hypersensitivity Pneumonitis

摘要: 过敏性肺炎(HP)是一种由吸入性抗原引起的炎症性和/或纤维性疾病。过去被认为是罕见疾病，但现在被认为是一种普遍存在的呼吸疾病，在全球范围内造成重大疾病负担。最新的HP诊断指南将其分类为非纤维化HP (纯炎症性)和纤维化HP (混合性炎症性和纤维化或纯纤维化)。非纤维化HP的病因包括微生物、动物蛋白、植物蛋白和无机颗粒物等，发病机制主要涉及异常免疫反应。其病理学特征以细支气管为中心的慢性间质性炎症为主，临床表现为咳嗽、胸闷、呼吸困难等。治疗关键在于及时脱离变应原，必要时采用激素治疗。纤维化HP的病因和发病机制与非纤维化HP相似，但会导致永久性损害和纤维化。这篇综述旨在提高对HP新分类及其最新研究进展的认识。

Abstract: Hypersensitivity pneumonitis (HP) is an inflammatory and/or fibrous disease caused by inhaled antigens. It used to be considered a rare disease but is now recognized as a prevalent respiratory disease that causes a significant disease burden worldwide. The latest guidelines for the diagnosis of HP classify it as non-fibrotic HP (purely inflammatory) and fibrotic HP (mixed inflammatory and fibrotic or purely fibrotic). The etiology of non-fibrotic HP includes microorganisms, animal proteins, plant proteins, and inorganic particulate matter, and the pathogenesis mainly involves an abnormal immune response. Its pathology is characterized by chronic interstitial inflammation centered on the fine bronchi, with clinical manifestations such as cough, chest tightness, and dyspnea. The key to treatment is timely detachment from allergens, and hormone therapy is used when necessary. The etiology and pathogenesis of fibrotic HP is similar to that of non-fibrotic HP, but leads to permanent damage and fibrosis. This review aims to raise awareness of the new classification of HP and its latest research advances.