pulmoПульмонологияPULMONOLOGIYA0869-01892541-9617Scientific and Practical Journal “PULMONOLOGIYA” LLC10.18093/0869-0189-2021-31-1-88-99pulmo-2271Research ArticleОБЗОРЫREVIEWГиперчувствительный пневмонитHypersensitivity pneumonitishttps://orcid.org/0000-0002-5999-2150АвдеевС. Н.AvdeevS. N.

Авдеев Сергей Николаевич - доктор медицинских наук, член-корреспондент Российской академии наук, профессор, заведующий кафедрой пульмонологии Первого МГМУ им. И.М. Сеченова МЗ РФ (Сеченовский Университет); руководитель клинического отдела НИИ ФМБА России.119991, Москва, ул. Трубецкая, 8, стр. 2; 115682, Москва, Ореховый бульвар, 28.тел.: (495) 708-35-76

Sergey N. Avdeev - Doctor of Medicine, Professor, Corresponding Member of Russian Academy of Sciences, Head of Department of Pulmonology, I.M.Sechenov Federal First Moscow State Medical University, Healthcare Ministry of Russia, Deputy Director for Science, Federal Pulmonology Research Institute, Federal Medical and Biological Agency of Russia; Chief Pulmonologist, Healthcare Ministry of Russia.ul. Trubetskaya 8, build. 2; Orekhovyy bul'var 28, Moscow, 115682.tel.: (495) 708-35-76

serg_avdeev@list.ruПервый Московский государственный медицинский университет имени И.М. Сеченова Министерства здравоохранения Российской Федерации (Сеченовский Университет); Научно-исследовательский институт пульмонологии Федерального медико-биологического агентстваРоссияI.M. Sechenov Federal First Moscow State Medical University, Healthcare Ministry of Russia (Sechenov University); Federal Pulmonology Research Institute, Federal Medical and Biological Agency of RussiaRussian Federation2021190220213118899Copyright © Авдеев С.Н., 20212021Авдеев С.Н.Avdeev S.N.This work is licensed under a Creative Commons Attribution 4.0 License.https://journal.pulmonology.ru/pulm/article/view/2271

Гиперчувствительный пневмонит (ГП) является воспалительным заболеванием легких и дыхательных путей, которое развивается в ответ на повторные ингаляции аэрозольных антигенов широкого спектра. Клиническая картина и течение очень вариабельны и зависят от таких факторов, как природа «виновного» антигена, интенсивность и длительность экспозиции с антигеном, а также от особенностей иммунного ответа пациента. Заболеваемость ГП составляет 1,28—1,94 случая на 100 тыс. населения в год. В настоящее время диагноз ГП обычно основан на наличии характерной клинической картины, данных компьютерной томографии высокого разрешения (КТВР), бронхоскопии, биопсии легких и данных о возможном «виновном» антигене. КТВР играет центральную роль в диагностике ГП. Наиболее частой находкой по данным КТВР при ГП является признак «матового стекла», который может сочетаться с центролобулярными узелками и воздушными ловушками. В некоторых случаях картина при фибротическом ГП очень сильно схожа с таковой при идиопатическом легочном фиброзе — изменения преобладают в нижних отделах и субплеврально. Терапия ГП обычно включает в себя исключение контакта с «виновным» антигеном, рассмотрение назначения глюкокортикостероидов и / или иммуносупрессантов, направленного на подавление активного воспалительного / иммунного ответа и лечение сопутствующих заболеваний. Терапия нинтеданибом у пациентов с прогрессирующими фиброзными интерстициальными заболеваниями легких приводит к замедлению скорости снижения легочной функции по сравнению с плацебо.

Hypersensitivity pneumonitis (HP) is an inflammatory disease of the lungs and airways that develops in response to repeated inhalation of a wide range of aerosol antigens. The clinical picture and course of HP are highly variable and depend on such factors as the nature of the antigen, the intensity and duration of exposure to the antigen, as well as on the characteristics of the patient's immune response. The annual incidence of HAP is 1.28 -1.94 cases per 100 000. Currently, the diagnosis of HP is usually based on the characteristic clinical picture, high-resolution computed tomography (HRCT) data, bronchoscopy, lung biopsy, and evidence on the antigen. HRCT plays a central role in the diagnosis of HP. The most common finding on HRCT in HP is ground-glass opacities, which can be associated with centrilobular nodules and air trapping. In some cases, the fibrotic HP signs are very similar to those of idiopathic pulmonary fibrosis (IPF), and most changes are found in the lower regions and subpleurally. Therapy for HP usually includes avoiding exposure to the antigen, considering corticosteroids (CS) and/or immunosuppressive therapy to suppress the active inflammatory/immune response, and treating comorbidities. Nintedanib therapy in patients with progressive fibrotic HP results in a slower decline of lung function compared to placebo.

гиперчувствительный пневмонитинтерстициальные заболевания легкихлегочный фиброзhypersensitivity pneumonitisinterstitial lung diseasespulmonary fibrosisСтатья опубликована при финансовой поддержке ООО Берингер Ингельхайм. ООО Берингер Ингельхайм не несет ответственности за содержание статьи. Мнение ООО Берингер Ингельхайм может отличаться от мнения авторов статьи и редакции.This publication is supported by Boehringer Ingelheim LLC company. The company is not responsible for the content of this article. The author's and the editorial's opinions could differ from the position of the Boehringer Ingelheim LLC company.ReferencesCostabel U., Bonella F., Guzman J. Chronic hypersensitivity pneumonitis. Clin. Chest Med. 2012; 33 (1): 151-163. DOI: 10.1016/j.ccm.2011.12.004.Costabel U., Bonella F., Guzman J. Chronic hypersensitivity pneumonitis. Clin. Chest Med. 2012; 33 (1): 151-163. DOI: 10.1016/j.ccm.2011.12.004.Selman M., Pardo A., King T.E. 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The authors declare that there are no conflicts of interest present.