Abstract
Background: Feather duvet lung (FDL) is an underestimated form of acute
and chronic hypersensitivity pneumonitis. Serological tests for FDL need
to be validated. We investigated the ability of recombinant pigeon
Proproteinase E (r-PROE) and Immunoglobulin-lambda-like-polypeptide-1
(r-IGLL1) proteins to support the serological diagnosis of FDL, and
propose them as a serological tool for clinicians to differentiate cases
from FDL and Bird fancier’s lung (BFL). Methods: Specific IgG antibodies
against r-PROE and r-IGLL1, analyzed with ELISA, were measured in
patients diagnosed with FDL (n=31), BFL (n=15) controls exposed (n=15)
and unexposed to feathers (n=15). Results: The sensitivity and
specificity of the r-PROE ELISA for the serological diagnosis of FDL
cases versus exposed and unexposed controls were 74.2% and 86.7%
respectively, with an index threshold of 0.5. (AUC: 0.9). In addition,
this serological test was effective to support the serological diagnosis
of FDL and BFL cases with significantly different thresholds. The
r-IGLL1 ELISA was only effective for the serological diagnosis of BFL.
Also, these two serological tests were useful for the diagnosis of both
chronic and acute forms. Conclusions: The new diagnostic test for FDL
using r-PROE protein should help to detect overt and hidden cases of
FDL. The combination of both test will help the clinician in distinguish
between the etiology of birds or feathers duvet.