免疫生物学杂志

The Cause of Idiopathic Pulmonary Fibrosis: A Hypothesis

Abstract

Ian M Rogers

Idiopathic pulmonary fibrosis (IPF) is a rapidly fatal condition of unknown cause. The alveolar membrane becomes thickened with collagen and inflammatory and immune cells, which accumulate in the sub-alveolar tissues. The reduction in the ability of oxygen to diffuse across the membrane leads inevitably to progressive anoxia. There is no satisfactory treatment.

It is proposed that the histological changes observed in the alveolar membrane are due to an immunological reaction to foreign antigens delivered to the alveoli in the form of an aerosol. It is further proposed that repeated exposure to the same foreign antigen leads to an intense immunological reaction. It is argued that expired antigens from the patient’s partner may be the source of the antigens.

Further investigations of this hypothesis are likely to involve Polymer chain reaction (PCR) of the expressed breath condensate (EBC) of the relevant partner.

What is the key question?

Is there evidence that repetitive exposure of the alveolar epithelium to the same antigen would be consistent with the pathogenesis?

What is the bottom line?

Expressed breath condensate (EBC) of the partner should be investigated as the suspected antigen for the immunological reaction of the alveolar membrane in IPF.

Why read on?

Idiopathic pulmonary fibrosis quickly kills; it is incurable and progressive and the cause is presently unknown. This hypothesis is consistent with the known pathology and lends itself to further analysis.