{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T00:37:52Z","timestamp":1792024672570,"version":"4.4.0"},"reference-count":15,"publisher":"Public Library of Science (PLoS)","issue":"11","license":[{"start":{"date-parts":[[2024,11,25]],"date-time":"2024-11-25T00:00:00Z","timestamp":1732492800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Introduction<\/jats:title>\n<jats:p>Treatment of hypersensitivity pneumonitis involves removal of the antigen and may include the use of immunosuppression or antifibrotic therapy. It remains unclear whether antifibrotic or immunosuppressive therapy is more beneficial in fibrotic hypersensitivity pneumonitis or if clinical markers can predict a patient\u2019s response to therapy.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Methods<\/jats:title>\n<jats:p>We evaluated a retrospective cohort in order to determine if certain clinical characteristics can predict physiologic improvement with immunosuppressive treatment in patients with chronic hypersensitivity pneumonitis. Patients with a diagnosis of hypersensitivity pneumonitis with a moderate, high, or definite confidence according to the American Thoracic Society criteria were included in the study.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Results<\/jats:title>\n<jats:p>Overall immunosuppression did not lead to improvement in % predicted forced vital capacity (FVC%) and % predicted diffusion capacity (DLCO%). Patients with fibrotic hypersensitivity pneumonitis and those with familial interstitial lung disease demonstrated a decline in FVC% predicted as well as DLCO% predicted over one year and the use of immunosuppression does not modify that risk. In contrast, patients with extensive ground glass demonstrated improvement in DLCO% predicted but not FVC% predicted over one year with or without the use of immunosuppression.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Conclusion<\/jats:title>\n<jats:p>Our study demonstrates that certain radiographic variables trend toward a significant impact on FVC% predicted as well as DLCO% predicted and suggests that antifibrotic therapy may be a better initial choice of therapy in patients with fibrotic hypersensitivity pneumonitis as decline occurred with or without the use of immunosuppression.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0313540","type":"journal-article","created":{"date-parts":[[2024,11,25]],"date-time":"2024-11-25T18:29:42Z","timestamp":1732559382000},"page":"e0313540","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":2,"title":["Clinical predictors of physiologic change after treatment with immunosuppression in hypersensitivity pneumonitis"],"prefix":"10.1371","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6781-2199","authenticated-orcid":true,"given":"Margaret","family":"Kypreos","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Esther","family":"de Boer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Graham","family":"Ellington","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-2065-9635","authenticated-orcid":true,"given":"Genichiro","family":"Fujioka","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-4638-3838","authenticated-orcid":true,"given":"Jerry","family":"Liu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Craig","family":"Glazer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Traci","family":"Adams","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2024,11,25]]},"reference":[{"issue":"4","key":"pone.0313540.ref001","doi-asserted-by":"crossref","first-page":"261","DOI":"10.1097\/00005382-200210000-00003","article-title":"Clinical and radiologic manifestations of hypersensitivity pneumonitis","volume":"17","author":"C. Glazer","year":"2002","journal-title":"J Thorac Imaging"},{"issue":"2","key":"pone.0313540.ref002","doi-asserted-by":"crossref","first-page":"442","DOI":"10.1111\/all.15017","article-title":"Hypersensitivity pneumonitis: Current concepts in pathogenesis, diagnosis, and treatment","volume":"77","author":"H. Barnes","year":"2021","journal-title":"Allergy"},{"issue":"3","key":"pone.0313540.ref003","doi-asserted-by":"crossref","first-page":"301","DOI":"10.1164\/rccm.201903-0541PP","article-title":"Hypersensitivity Pneumonitis: Current Concepts of Pathogenesis and Potential Targets for Treatment","volume":"200","author":"M. Vasakova","year":"2019","journal-title":"American Journal of Respiratory and Critical Care Medicine"},{"issue":"5","key":"pone.0313540.ref004","doi-asserted-by":"crossref","first-page":"1644","DOI":"10.1378\/chest.12-2685","article-title":"Identifying an Inciting Antigen Is Associated with Improved Survival in Patients with Chronic Hypersensitivity Pneumonitis","volume":"144","author":"E. Fernandez Perez","year":"2013","journal-title":"Chest"},{"issue":"3","key":"pone.0313540.ref005","first-page":"555","article-title":"Bird breeder\u2019s hypersensitivity pneumonitis: Progress studies of lung function after cessation of exposure to the provoking antigen","volume":"114","author":"D.H. Allen","year":"1976","journal-title":"American Review of Respiratory Disease"},{"issue":"1","key":"pone.0313540.ref006","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1164\/ajrccm\/145.1.3","article-title":"Effect of Corticosteroid Treatment on the Recovery of Pulmonary Function in Farmer\u2019s Lung","volume":"145","author":"J. Kokkarinen","year":"1992","journal-title":"American Review of Respiratory Disease"},{"issue":"3","key":"pone.0313540.ref007","doi-asserted-by":"crossref","first-page":"619","DOI":"10.1016\/j.chest.2016.10.029","article-title":"Use of Mycophenolate Mofetil or Azathioprine for the Management of Chronic Hypersensitivity Pneumonitis","volume":"151","author":"J. Morriset","year":"2016","journal-title":"Chest"},{"issue":"18","key":"pone.0313540.ref008","doi-asserted-by":"crossref","first-page":"1718","DOI":"10.1056\/NEJMoa1908681","article-title":"Nintendanib in Progressive Fibrosing Interstitial Lung Diseases","volume":"381","author":"K. Flaherty","year":"2019","journal-title":"The New England Journal of Medicine"},{"issue":"3","key":"pone.0313540.ref009","doi-asserted-by":"crossref","first-page":"36","DOI":"10.1164\/rccm.202005-2032ST","article-title":"Diagnosis of Hypersensitivity Pneumonitis in Adults: An Official ATS\/JRS\/ALAT Clinical Practice Guideline","volume":"202","author":"G. Raghu","year":"2020","journal-title":"American Journal of Respiratory and Critical Care Medicine"},{"issue":"6","key":"pone.0313540.ref010","doi-asserted-by":"crossref","first-page":"483","DOI":"10.1016\/S2213-2600(15)00096-X","article-title":"CT staging and monitoring of fibrotic interstitial lung disease in clinical practice and treatment trials: a Position Paper from the Fleischner society","volume":"3","author":"D.M. Hansell","year":"2015","journal-title":"Lancet Respiratory Medicine"},{"issue":"163","key":"pone.0313540.ref011","doi-asserted-by":"crossref","DOI":"10.1183\/16000617.0169-2021","article-title":"Diagnosis, course and management of hypersensitivity pneumonitis","volume":"31","author":"M. Hamblin","year":"2022","journal-title":"European Respiratory Review"},{"issue":"3","key":"pone.0313540.ref012","doi-asserted-by":"crossref","DOI":"10.1183\/23120541.00016-2017","article-title":"Outcomes of immunosuppressive therapy in chronic hypersensitivity pneumonitis","volume":"3","author":"A. Adegunsoye","year":"2017","journal-title":"ERJ Open Res"},{"issue":"84","key":"pone.0313540.ref013","article-title":"Nintendanib and immunomodulatory therapies in progressive fibrosing interstitial lung diseases","volume":"22","author":"V. Cottin","year":"2021","journal-title":"Respir Res"},{"issue":"6","key":"pone.0313540.ref014","doi-asserted-by":"crossref","first-page":"1710","DOI":"10.1183\/13993003.00308-2016","article-title":"Telomere-related lung fibrosis is diagnostically heterogeneous but uniformly progressive","volume":"48","author":"C. Newton","year":"2016","journal-title":"Eur Respir J"},{"issue":"5","key":"pone.0313540.ref015","doi-asserted-by":"crossref","first-page":"2300441","DOI":"10.1183\/13993003.00441-2023","article-title":"Telomere length and immunosuppression in non-idiopathic pulmonary fibrosis interstitial lung disease","volume":"62","author":"D. Zhang","year":"2023","journal-title":"Eur Respir J"}],"container-title":["PLOS ONE"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0313540","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,11,25]],"date-time":"2024-11-25T18:29:47Z","timestamp":1732559387000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0313540"}},"subtitle":[],"editor":[{"given":"Bharat Bhushan","family":"Sharma","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2024,11,25]]},"references-count":15,"journal-issue":{"issue":"11","published-online":{"date-parts":[[2024,11,25]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0313540","relation":{},"ISSN":["1932-6203"],"issn-type":[{"value":"1932-6203","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,11,25]]}}}