Humoral and cellular immunity in extrinsic pulmonary granulomatoses.

In the present study the AA. analyse the immunological behaviour of patients taken from a group of 309 cases of Extrinsic Pulmonary Granulomatoses (E.P.G.). Humoral immunological changes were studied by assessing serum immunoglobulins, various complement fractions and, when possible, circulating precipitating antibodies. Immunoglobulins A and G values were significantly higher than control values. On the contrary there was no significant difference between IgM values, in patients and controls. The complement fractions (C3c, C4 and C3 activator) showed values within normal limits. Specific circulating antibodies were detected both in bird fanciers and in cork workers. Cellular immunity was evaluated by comparing the results of various tests. Eighty percent of all cases of E.P.G. had negative tuberculin tests, while eighty percent of the general population, in Portugal, has positive tuberculin tests. The Kveim-Siltzbach test was positive in one of 19 cases of E.P.G., and this was considered a false positive result. In vitro lymphocyte blastic transformation in presence of pigeon antigen showed a significant increase in pigeon breeders as compared with controls. The migration of leucocytes from affected and non-affected corkworkers, affected and non-affected pigeon fanciers and controls, in the presence of the specific antigens, showed significant results. Finally, similarities and differences in immunological behaviour of these patients are discussed.