PIE症候群の病態に関する研究　第2編 PIE症候群における Aspergillus 抗原を中心とした免疫学的検討

Various allergic and immunologic mechanisms have been postulated in the pathogenesis of PIE syndrome. In this study, the immune response to Aspergillus antigen was examined in patients with the PIE syndrome of allergic bronchopulmonary aspergillosis (ABPA) and those with aspergilloma to elucidate the immune mechanisms wihch regulate the pulmonary changes in PIE syndrome. The same Aspergillus species causes different clinical disease entities such as Aspergillus pneumonia, aspergilloma, ABPA and even hypersensitivity pneumonitis. The specific IgE against the Aspergillus antigen for the type Ⅰ allergy existed in patients with ABPA but not in those with Aspergilloma. However, the prepicitating antibody for the type Ⅲ allergy and enhanced lymphocyte blastogenesis against Aspergillus antigen for the type Ⅳ allergy were found in both the patients with ABPA and those with aspergilloma while pulmonary infiltration, dyspnea and the grade of peripheral eosinophilia correlated with the level of serum IgE and responsiveness of lymphocyte against Aspergillus antigen. These findings indicate that the characteristics of the immune responses of the host play a crucial role in the pathogenesis of PIE syndrome.