Lung dendritic cell profile as a potential hypersensitivity Pneumonitis biomarker

Abstract

Hypersensitivity pneumonitis has been highlighted as one of the main causes of interstitial lung disease in Brazil, being mediated by types III and IV hypersensitivity reactions in response to the inhalation of various environmental agents, with the formation of cellular bronchiolitis and/or granulomas and, often progressing to pulmonary fibrosis. Regardless of the reactions that mediate the process, the initial "starting" is given by the uptake of antigens by the antigen-presenting dendritic cells. Our working hypothesis is based on the various immunoexpression phenotypes that pulmonary epithelial and interstitial dendritic cells can express and actively co-participate in determining the microenvironment of pathophysiological pathways related to the type and intensity of hypersensitivity reactions resulting in fibroids. Thus, our focus is to determine the biomarker potential of dendritic cell profile in surgical lung biopsies from patients diagnosed with HP after multidisciplinary discussion. Therefore, we intend to make an immunohistochemical panel of immunomarkers of different types of dendritic cells and their morphometric analysis, together with a thorough histomorphological and histochemical study, in addition to the survey of clinical and radiological data, including spirometry and survival. The results intend to demonstrate whether there is any pattern of clinical-radiological evolution related to the density and/or specific types of dendritic cells that can be used as a diagnostic and/or prognostic biomarker. (AU)