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                      "titulo" => "Cladosporium species related hypersensitivity pneu-monitis in household environments"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "S&#46; Chiba"
                            1 => "S&#46; Okada"
                            2 => "Y&#46; Suzuki"
                            3 => "Z&#46; Watanuki"
                            4 => "Y&#46; Mitsuishi"
                            5 => "R&#46; Igusa"
                          ]
                        ]
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                    ]
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                        "tituloSerie" => "Intern Med&#46;"
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                        "volumen" => "48"
                        "paginaInicial" => "363"
                        "paginaFinal" => "367"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19252363"
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                  ]
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                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Presenting features of feather duvet lung"
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                            2 => "T&#46; Renck"
                            3 => "D&#46; M&#252;ller-Wening"
                            4 => "G&#46; H&#246;ffken"
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                        "fecha" => "2010"
                        "volumen" => "152"
                        "paginaInicial" => "264"
                        "paginaFinal" => "270"
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                  "contribucion" => array:1 [
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                            2 => "M&#46; Rolke"
                            3 => "J&#46; Sennekamp"
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                        "fecha" => "2005"
                        "volumen" => "43"
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                        "paginaFinal" => "4910"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16145174"
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                          "autores" => array:3 [
                            0 => "H&#46;V&#46; Olesen"
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                            2 => "J&#46;C&#46; M&#248;ller"
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                      "Revista" => array:6 [
                        "tituloSerie" => "Acta Paediatr&#46;"
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                        "paginaInicial" => "811"
                        "paginaFinal" => "813"
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                            5 => "J&#46;C&#46; Dalphin"
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                        "paginaFinal" => "273"
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                            4 => "M&#46; Ando"
                            5 => "F&#46; Morell"
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                  "host" => array:1 [
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                      "doi" => "10.1164/rccm.200301-137OC"
                      "Revista" => array:6 [
                        "tituloSerie" => "Am J Respir Crit Care Med&#46;"
                        "fecha" => "2003"
                        "volumen" => "168"
                        "paginaInicial" => "952"
                        "paginaFinal" => "958"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12842854"
                            "web" => "Medline"
                          ]
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                      ]
                    ]
                  ]
                ]
              ]
            ]
            6 => array:3 [
              "identificador" => "bib0035"
              "etiqueta" => "&#91;7&#93;"
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                    0 => array:2 [
                      "titulo" => "Factors influencing the devel-opment of serum precipitins to farmer&#39;s lung antigen in Quebec dairy farmers"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "Y&#46; Cormier"
                            1 => "J&#46; B&#233;langer"
                            2 => "P&#46; Durand"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Thorax&#46;"
                        "fecha" => "1985"
                        "volumen" => "40"
                        "paginaInicial" => "138"
                        "paginaFinal" => "142"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/4038823"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            7 => array:3 [
              "identificador" => "bib0040"
              "etiqueta" => "&#91;8&#93;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Clinical survey of pigeon breeders"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "J&#46;N&#46; Fink"
                            1 => "D&#46;P&#46; Schlueter"
                            2 => "A&#46;J&#46; Sosman"
                            3 => "G&#46;F&#46; Unger"
                            4 => "J&#46;J&#46; Barboriak"
                            5 => "A&#46;A&#46; Rimm"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Chest&#46;"
                        "fecha" => "1972"
                        "volumen" => "62"
                        "paginaInicial" => "277"
                        "paginaFinal" => "281"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/4626843"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            8 => array:3 [
              "identificador" => "bib0045"
              "etiqueta" => "&#91;9&#93;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Airway toxicity of house dust and its fungal composition"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "E&#46; Pieckov&#225;"
                            1 => "K&#46; Wilkins"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Ann Agric Environ Med&#46;"
                        "fecha" => "2004"
                        "volumen" => "11"
                        "paginaInicial" => "67"
                        "paginaFinal" => "73"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15236501"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            9 => array:3 [
              "identificador" => "bib0050"
              "etiqueta" => "&#91;10&#93;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Household airborne Penicillium associated with peak expiratory flow variability in asthmatic children"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "K&#46;W&#46; Bundy"
                            1 => "J&#46;F&#46; Gent"
                            2 => "W&#46; Beckett"
                            3 => "M&#46;B&#46; Bracken"
                            4 => "K&#46; Belanger"
                            5 => "E&#46; Triche"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/S1081-1206(10)60139-1"
                      "Revista" => array:6 [
                        "tituloSerie" => "Ann Allergy Asthma Immunol&#46;"
                        "fecha" => "2009"
                        "volumen" => "103"
                        "paginaInicial" => "26"
                        "paginaFinal" => "30"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19663123"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            10 => array:3 [
              "identificador" => "bib0055"
              "etiqueta" => "&#91;11&#93;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Allergenic materials in the house dust of allergy clinic patients"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "C&#46; Barnes"
                            1 => "J&#46; Tuck"
                            2 => "S&#46; Simon"
                            3 => "F&#46; Pacheco"
                            4 => "F&#46; Hu"
                            5 => "J&#46; Portnoy"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/S1081-1206(10)62899-2"
                      "Revista" => array:6 [
                        "tituloSerie" => "Ann Allergy Asthma Immunol&#46;"
                        "fecha" => "2001"
                        "volumen" => "86"
                        "paginaInicial" => "517"
                        "paginaFinal" => "523"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11379802"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            11 => array:3 [
              "identificador" => "bib0060"
              "etiqueta" => "&#91;12&#93;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Characterization of the oral fungal micro-biome &#40;mycobiome&#41; in healthy individuals"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "M&#46;A&#46; Ghannoum"
                            1 => "R&#46;J&#46; Jurevic"
                            2 => "P&#46;K&#46; Mukherjee"
                            3 => "F&#46; Cui"
                            4 => "M&#46; Sikaroodi"
                            5 => "A&#46; Naqvi"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1371/journal.ppat.1000713"
                      "Revista" => array:5 [
                        "tituloSerie" => "PLoS Pathog&#46;"
                        "fecha" => "2010"
                        "volumen" => "6"
                        "paginaInicial" => "e1000713"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/20072605"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            12 => array:3 [
              "identificador" => "bib0065"
              "etiqueta" => "&#91;13&#93;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Role of Candida albicans in chronic hypersensitivity pneumonitis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "M&#46; Ando"
                            1 => "K&#46; Yoshida"
                            2 => "H&#46; Nakashima"
                            3 => "Y&#46; Sugihara"
                            4 => "Y&#46; Kashida"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Chest&#46;"
                        "fecha" => "1994"
                        "volumen" => "105"
                        "paginaInicial" => "317"
                        "paginaFinal" => "318"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/8275767"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            13 => array:3 [
              "identificador" => "bib0070"
              "etiqueta" => "&#91;14&#93;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Interstitial lung disease induced by endogenous Can-dida albicans"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "J&#46; Schreiber"
                            1 => "H&#46;D&#46; G&#246;ring"
                            2 => "W&#46; Rosahl"
                            3 => "C&#46; Str&#252;ben"
                            4 => "W&#46; Lakotta"
                            5 => "M&#46; Amthor"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Eur J Med Res&#46;"
                        "fecha" => "2001"
                        "volumen" => "6"
                        "paginaInicial" => "71"
                        "paginaFinal" => "74"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11313193"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            14 => array:3 [
              "identificador" => "bib0075"
              "etiqueta" => "&#91;15&#93;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Circulating IgG antibodies against fungal and actinomycete antigens in the sera of farmer&#39;s lung patients from different countries"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "V&#46;P&#46; Kurup"
                            1 => "R&#46;A&#46; M&#228;ntyj&#228;rvi"
                            2 => "E&#46;O&#46; Terho"
                            3 => "T&#46;H&#46; Ojanen"
                            4 => "J&#46;H&#46; Kalbfleisch"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Mycopathologia&#46;"
                        "fecha" => "1987"
                        "volumen" => "98"
                        "paginaInicial" => "91"
                        "paginaFinal" => "99"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/3299100"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            15 => array:3 [
              "identificador" => "bib0080"
              "etiqueta" => "&#91;16&#93;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Diagnostic value of serum precipitins to mould antigens in active hypersensitivity pneumonitis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "C&#46;M&#46; Fenoglio"
                            1 => "G&#46; Reboux"
                            2 => "B&#46; Sudre"
                            3 => "M&#46; Mercier"
                            4 => "S&#46; Roussel"
                            5 => "J&#46;F&#46; Cordier"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1183/09031936.00001006"
                      "Revista" => array:6 [
                        "tituloSerie" => "Eur Respir J&#46;"
                        "fecha" => "2007"
                        "volumen" => "29"
                        "paginaInicial" => "706"
                        "paginaFinal" => "712"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17182654"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            16 => array:3 [
              "identificador" => "bib0085"
              "etiqueta" => "&#91;17&#93;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Circulating antibodies against ther-mophilic actinomycetes in farmers and mushroom workers"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "Y&#46;E&#46; Shen"
                            1 => "V&#46;P&#46; Kurup"
                            2 => "J&#46;N&#46; Fink"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "J Hyg Epidemiol Microbiol Immunol&#46;"
                        "fecha" => "1991"
                        "volumen" => "35"
                        "paginaInicial" => "309"
                        "paginaFinal" => "316"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/1960394"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            17 => array:3 [
              "identificador" => "bib0090"
              "etiqueta" => "&#91;18&#93;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Grain dust and the lungs"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "M&#46; Chan-Yeung"
                            1 => "M&#46;J&#46; Ashley"
                            2 => "S&#46; Grzybowski"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Can Med Assoc J&#46;"
                        "fecha" => "1978"
                        "volumen" => "118"
                        "paginaInicial" => "1271"
                        "paginaFinal" => "1274"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/348288"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            18 => array:3 [
              "identificador" => "bib0095"
              "etiqueta" => "&#91;19&#93;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Feather mites are potentially an important source of allergens for pigeon and budgerigar keepers"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "M&#46;J&#46; Colloff"
                            1 => "T&#46;G&#46; Merrett"
                            2 => "J&#46; Merrett"
                            3 => "C&#46; McSharry"
                            4 => "G&#46; Boyd"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Clin Exp Allergy&#46;"
                        "fecha" => "1997"
                        "volumen" => "27"
                        "paginaInicial" => "60"
                        "paginaFinal" => "67"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9179447"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            19 => array:3 [
              "identificador" => "bib0100"
              "etiqueta" => "&#91;20&#93;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Mite and pet allergen levels in homes of children born to allergic and nonallergic par-ents&#58; the PIAMA study"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "R&#46;T&#46; Van Strien"
                            1 => "L&#46;P&#46; Koopman"
                            2 => "M&#46; Kerkhof"
                            3 => "J&#46; Spithoven"
                            4 => "J&#46;C&#46; De Jongste"
                            5 => "J&#46; Gerritsen"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Environ Health Perspect&#46;"
                        "fecha" => "2002"
                        "volumen" => "110"
                        "paginaInicial" => "A693"
                        "paginaFinal" => "A698"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12417497"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            20 => array:3 [
              "identificador" => "bib0105"
              "etiqueta" => "&#91;21&#93;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "House dust mite Der p 1 downregulates defenses of the lung by inactivating elastase inhibitors"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "A&#46; Brown"
                            1 => "K&#46; Farmer"
                            2 => "L&#46; MacDonald"
                            3 => "N&#46; Kalsheker"
                            4 => "D&#46; Pritchard"
                            5 => "C&#46; Haslett"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1165/rcmb.2003-0060OC"
                      "Revista" => array:6 [
                        "tituloSerie" => "Am J Respir Cell Mol Biol&#46;"
                        "fecha" => "2003"
                        "volumen" => "29"
                        "paginaInicial" => "381"
                        "paginaFinal" => "389"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12689923"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            21 => array:3 [
              "identificador" => "bib0110"
              "etiqueta" => "&#91;22&#93;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Proteases as Th2 adju-vants"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "M&#46;D&#46; Chapman"
                            1 => "S&#46; W&#252;nschmann"
                            2 => "A&#46; Pom&#233;s"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Curr Allergy Asthma Rep&#46;"
                        "fecha" => "2007"
                        "volumen" => "7"
                        "paginaInicial" => "363"
                        "paginaFinal" => "367"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17697645"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            22 => array:3 [
              "identificador" => "bib0115"
              "etiqueta" => "&#91;23&#93;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Major house dust mite allergens Dermatophagoides pteronyssinus 1 and Der- matophagoides farinae 1 degrade and inactivate lung surfactant proteins A and D"
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                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "R&#46; Deb"
                            1 => "F&#46; Shakib"
                            2 => "K&#46; Reid"
                            3 => "H&#46; Clark"
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                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1074/jbc.M702336200"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Biol Chem&#46;"
                        "fecha" => "2007"
                        "volumen" => "282"
                        "paginaInicial" => "36808"
                        "paginaFinal" => "36819"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17848554"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            23 => array:3 [
              "identificador" => "bib0120"
              "etiqueta" => "&#91;24&#93;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Surfactant abnormalities in idiopathic pulmonary fibro-sis&#44; hypersensitivity pneumonitis and sarcoidosis"
                      "autores" => array:1 [
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                          "etal" => true
                          "autores" => array:6 [
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                            1 => "R&#46; Schmidt"
                            2 => "F&#46; Nix"
                            3 => "M&#46; Yabut-Perez"
                            4 => "C&#46; Guth"
                            5 => "S&#46; Rosseau"
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                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Eur Respir J&#46;"
                        "fecha" => "1999"
                        "volumen" => "14"
                        "paginaInicial" => "565"
                        "paginaFinal" => "573"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10543276"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            24 => array:3 [
              "identificador" => "bib0125"
              "etiqueta" => "&#91;25&#93;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Analysis of KL-6 and SP-D as disease markers in bird fancier&#39;s lung"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "R&#46; Janssen"
                            1 => "J&#46;C&#46; Grutters"
                            2 => "H&#46; Sato"
                            3 => "H&#46; van Velzen-Blad"
                            4 => "P&#46; Zanen"
                            5 => "N&#46; Kohno"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Sarcoidosis Vasc Diffuse Lung Dis&#46;"
                        "fecha" => "2005"
                        "volumen" => "22"
                        "paginaInicial" => "51"
                        "paginaFinal" => "57"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15881280"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            25 => array:3 [
              "identificador" => "bib0130"
              "etiqueta" => "&#91;26&#93;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
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                          "autores" => array:1 [
                            0 => "J&#46;C&#46; Pimentel"
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                  "host" => array:1 [
                    0 => array:1 [
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                        "fecha" => "1970"
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                        "paginaInicial" => "387"
                        "paginaFinal" => "398"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/5484998"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            26 => array:3 [
              "identificador" => "bib0135"
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              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Quantifying serum antibody in bird fanciers&#8217; hypersensitivity pneumonitis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "C&#46; McSharry"
                            1 => "G&#46;M&#46; Dye"
                            2 => "T&#46; Ismail"
                            3 => "K&#46; Anderson"
                            4 => "E&#46;M&#46; Spiers"
                            5 => "G&#46; Boyd"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1186/1471-2466-6-16"
                      "Revista" => array:5 [
                        "tituloSerie" => "BMC Pulm Med&#46;"
                        "fecha" => "2006"
                        "volumen" => "6"
                        "paginaInicial" => "16"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16800875"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            27 => array:3 [
              "identificador" => "bib0140"
              "etiqueta" => "&#91;28&#93;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Chronic bird fancier&#39;s lung presenting with acute exacerbation due to use of a feather duvet"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "N&#46; Inase"
                            1 => "H&#46; Sakashita"
                            2 => "Y&#46; Ohtani"
                            3 => "Y&#46; Sogou"
                            4 => "Y&#46; Sumi"
                            5 => "T&#46; Umino"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Intern Med&#46;"
                        "fecha" => "2004"
                        "volumen" => "43"
                        "paginaInicial" => "835"
                        "paginaFinal" => "857"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15497520"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            28 => array:3 [
              "identificador" => "bib0145"
              "etiqueta" => "&#91;29&#93;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Bird-years as well as pack-years"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "M&#46;A&#46; Judson"
                            1 => "S&#46;A&#46; Sahn"
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                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Chest&#46;"
                        "fecha" => "2004"
                        "volumen" => "125"
                        "paginaInicial" => "353"
                        "paginaFinal" => "354"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/14718473"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            29 => array:3 [
              "identificador" => "bib0150"
              "etiqueta" => "&#91;30&#93;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Detection of specific antibodies to pigeon serum and bloom antigens by enzyme linked immunosorbent assay in pigeon breeder&#39;s disease"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "M&#46;J&#46; Rodrigo"
                            1 => "M&#46;I&#46; Benavent"
                            2 => "M&#46;J&#46; Cruz"
                            3 => "M&#46; Rosell"
                            4 => "C&#46; Murio"
                            5 => "C&#46; Pascual"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Occup Environ Med&#46;"
                        "fecha" => "2000"
                        "volumen" => "57"
                        "paginaInicial" => "159"
                        "paginaFinal" => "164"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10810097"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            30 => array:3 [
              "identificador" => "bib0155"
              "etiqueta" => "&#91;31&#93;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Quantification of IgG antibodies to Aspergillus fumigatus and pigeon antigens by ImmunoCAP technology&#58; an alternative to the precipitation technique&#63;"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "E&#46; Van Hoeyveld"
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                            2 => "X&#46; Bossuyt"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1373/clinchem.2006.067546"
                      "Revista" => array:6 [
                        "tituloSerie" => "Clin Chem&#46;"
                        "fecha" => "2006"
                        "volumen" => "52"
                        "paginaInicial" => "1785"
                        "paginaFinal" => "1793"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16858079"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            31 => array:3 [
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                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Immune responsiveness to inhaled antigens&#58; local antibody pro-duction in the respiratory tract in health and lung diseases"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "Y&#46; Yoshizawa"
                            1 => "Y&#46; Ohtani"
                            2 => "T&#46; Inoue"
                            3 => "S&#46; Miyake"
                            4 => "A&#46; Ikeda"
                            5 => "M&#46; Tanba"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
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                        "tituloSerie" => "Clin Exp Immunol&#46;"
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                        "paginaFinal" => "400"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/7774048"
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Vol. 17. Issue 6.
Pages 253-259 (November - December 2011)
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Vol. 17. Issue 6.
Pages 253-259 (November - December 2011)
Original article
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Significance of specific IgG against sensitizing antigens in extrinsic allergic alveolitis: Serological methods in EAA
A importância da IgG específica contra antigénios sensibilizantes na alveolite alérgica extrínseca: Métodos serológicos na AAE
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M. Sterclovaa,
Corresponding author
martina.sterclova@ftn.cz

Corresponding author.
, M. Vasakovab, M. Metlickab
a Department of Respiratory Diseases, Thomayer's University Hospital, Videnska, Prague, Czech Republic
b Department of Immunology, Thomayer's University Hospital, Videnska, Prague, Czech Republic
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Abstract

The aim of our study is to find differences in IgG in sera of potentially exposed and nonexposed individuals and to detect differences in concentrations of specific serum IgG among subjects with and without EAA. Seventy-two patients being followed for suspected interstitial lung disease were included. Specific IgG in sera were established by ImmunoCAP. Serum concentrations of Aspergillus fumigatus, Candida albicans IgG and mixture of moulds IgG were higher in subjects with exposure to relevant inhalation antigens (p < 0.05). Patients exposed to parrot and mammal hair mixture had higher serum concentration of specific IgG (p < 0.05). Subjects without exposure to mites had lower serum IgG to Dermatophagoides pteronyssinus, Dermatophagoides farinae, Dermatophagoides microceras and Glycophagus domesticus (p < 0.05). Higher concentration of serum specific IgG may show previous exposure to this antigen. Even though mite specific IgG are not commonly tested in EAA patients, we suggest their immunomodulatory activity may influence susceptibility to other inhalation antigens.

Keywords:
Aeroallergen
Hypersensitivity pneumonitis
Immunoglobulins
Indoor environment
Resumo

O objetivo do nosso estudo é descobrir diferenças da IgG no soro de possíveis indi-víduos expostos e não-expostos, bem como detetar diferenças de concentrações da IgG sérica específico entre indivíduos com e sem AAE. Foram incluídos setenta e dois pacientes com suspeita de doença pulmonar intersticial. A IgG sérica específica foi definida pelo ImmunoCAP. As concentrações séricas de IgG para o Aspergillus fumigatus, Candida albicans e mistura de fungos foram superiores em sujeitos expostos a inalação de antigénios relevantes (p < 0,05). Os pacientes expostos a uma mistura de penas de papagaio e pelos de mamíferos apresentaram uma maior concentração sérica da IgG específica (p < 0,05). Os indivíduos sem exposição a ácaros apresentaram menor IgG sérica para Dermatophagoides pteronyssinus, D. farinae, D. microceras e Glycophagus domesticus (p < 0,05). Uma elevada concentração de IgG sérica específica pode indicar uma exposição prévia a este antigénio. Embora a IgG específica para os ácaros não seja normalmente testada em pacientes com AAE, referimos que a sua atividade imunomoduladora pode influenciar a suscetibilidade de outras inalações de antigénios.

Palavras chave:
Aeroalergénio
Pneumonite de hipersensibilidade
Imunoglobulinas
Ambiente interior
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References
[1]
S. Chiba, S. Okada, Y. Suzuki, Z. Watanuki, Y. Mitsuishi, R. Igusa, et al.
Cladosporium species related hypersensitivity pneu-monitis in household environments.
Intern Med., 48 (2009), pp. 363-367
[2]
D. Koschel, H. Wittstruck, T. Renck, D. Müller-Wening, G. Höffken.
Presenting features of feather duvet lung.
Int Arch Allergy Immunol., 152 (2010), pp. 264-270
[3]
P. Kämpfer, S. Engelhart, M. Rolke, J. Sennekamp.
Extrinsic allergic alveolitis (hypersensitivity pneumonitis) caused by Sphingobacterium spiritivorum from the water reservoir of a steam iron.
J Clin Microbiol., 43 (2005), pp. 4908-4910
[4]
H.V. Olesen, T. Thelle, J.C. Møller.
Childhood hypersensitiv-ity pneumonitis probably caused by cat hair.
Acta Paediatr., 87 (1998), pp. 811-813
[5]
G. Reboux, M. Reiman, S. Roussel, K. Taattola, L. Millon, J.C. Dalphin, et al.
Impact of agricultural practices on micro-biology of hay, silage and flour on Finnish and French farms.
Ann Agric Environ Med., 13 (2006), pp. 267-273
[6]
Y. Lacasse, M. Selman, U. Costabel, J.C. Dalphin, M. Ando, F. Morell, et al.
Clinical diagnosis of hypersensitivity pneumonitis.
Am J Respir Crit Care Med., 168 (2003), pp. 952-958
[7]
Y. Cormier, J. Bélanger, P. Durand.
Factors influencing the devel-opment of serum precipitins to farmer's lung antigen in Quebec dairy farmers.
Thorax., 40 (1985), pp. 138-142
[8]
J.N. Fink, D.P. Schlueter, A.J. Sosman, G.F. Unger, J.J. Barboriak, A.A. Rimm, et al.
Clinical survey of pigeon breeders.
Chest., 62 (1972), pp. 277-281
[9]
E. Piecková, K. Wilkins.
Airway toxicity of house dust and its fungal composition.
Ann Agric Environ Med., 11 (2004), pp. 67-73
[10]
K.W. Bundy, J.F. Gent, W. Beckett, M.B. Bracken, K. Belanger, E. Triche, et al.
Household airborne Penicillium associated with peak expiratory flow variability in asthmatic children.
Ann Allergy Asthma Immunol., 103 (2009), pp. 26-30
[11]
C. Barnes, J. Tuck, S. Simon, F. Pacheco, F. Hu, J. Portnoy.
Allergenic materials in the house dust of allergy clinic patients.
Ann Allergy Asthma Immunol., 86 (2001), pp. 517-523
[12]
M.A. Ghannoum, R.J. Jurevic, P.K. Mukherjee, F. Cui, M. Sikaroodi, A. Naqvi, et al.
Characterization of the oral fungal micro-biome (mycobiome) in healthy individuals.
PLoS Pathog., 6 (2010), pp. e1000713
[13]
M. Ando, K. Yoshida, H. Nakashima, Y. Sugihara, Y. Kashida.
Role of Candida albicans in chronic hypersensitivity pneumonitis.
Chest., 105 (1994), pp. 317-318
[14]
J. Schreiber, H.D. Göring, W. Rosahl, C. Strüben, W. Lakotta, M. Amthor.
Interstitial lung disease induced by endogenous Can-dida albicans.
Eur J Med Res., 6 (2001), pp. 71-74
[15]
V.P. Kurup, R.A. Mäntyjärvi, E.O. Terho, T.H. Ojanen, J.H. Kalbfleisch.
Circulating IgG antibodies against fungal and actinomycete antigens in the sera of farmer's lung patients from different countries.
Mycopathologia., 98 (1987), pp. 91-99
[16]
C.M. Fenoglio, G. Reboux, B. Sudre, M. Mercier, S. Roussel, J.F. Cordier, et al.
Diagnostic value of serum precipitins to mould antigens in active hypersensitivity pneumonitis.
Eur Respir J., 29 (2007), pp. 706-712
[17]
Y.E. Shen, V.P. Kurup, J.N. Fink.
Circulating antibodies against ther-mophilic actinomycetes in farmers and mushroom workers.
J Hyg Epidemiol Microbiol Immunol., 35 (1991), pp. 309-316
[18]
M. Chan-Yeung, M.J. Ashley, S. Grzybowski.
Grain dust and the lungs.
Can Med Assoc J., 118 (1978), pp. 1271-1274
[19]
M.J. Colloff, T.G. Merrett, J. Merrett, C. McSharry, G. Boyd.
Feather mites are potentially an important source of allergens for pigeon and budgerigar keepers.
Clin Exp Allergy., 27 (1997), pp. 60-67
[20]
R.T. Van Strien, L.P. Koopman, M. Kerkhof, J. Spithoven, J.C. De Jongste, J. Gerritsen, et al.
Mite and pet allergen levels in homes of children born to allergic and nonallergic par-ents: the PIAMA study.
Environ Health Perspect., 110 (2002), pp. A693-A698
[21]
A. Brown, K. Farmer, L. MacDonald, N. Kalsheker, D. Pritchard, C. Haslett, et al.
House dust mite Der p 1 downregulates defenses of the lung by inactivating elastase inhibitors.
Am J Respir Cell Mol Biol., 29 (2003), pp. 381-389
[22]
M.D. Chapman, S. Wünschmann, A. Pomés.
Proteases as Th2 adju-vants.
Curr Allergy Asthma Rep., 7 (2007), pp. 363-367
[23]
R. Deb, F. Shakib, K. Reid, H. Clark.
Major house dust mite allergens Dermatophagoides pteronyssinus 1 and Der- matophagoides farinae 1 degrade and inactivate lung surfactant proteins A and D.
J Biol Chem., 282 (2007), pp. 36808-36819
[24]
A. Günther, R. Schmidt, F. Nix, M. Yabut-Perez, C. Guth, S. Rosseau, et al.
Surfactant abnormalities in idiopathic pulmonary fibro-sis, hypersensitivity pneumonitis and sarcoidosis.
Eur Respir J., 14 (1999), pp. 565-573
[25]
R. Janssen, J.C. Grutters, H. Sato, H. van Velzen-Blad, P. Zanen, N. Kohno, et al.
Analysis of KL-6 and SP-D as disease markers in bird fancier's lung.
Sarcoidosis Vasc Diffuse Lung Dis., 22 (2005), pp. 51-57
[26]
J.C. Pimentel.
Furrier's lung.
Thorax., 25 (1970), pp. 387-398
[27]
C. McSharry, G.M. Dye, T. Ismail, K. Anderson, E.M. Spiers, G. Boyd.
Quantifying serum antibody in bird fanciers’ hypersensitivity pneumonitis.
BMC Pulm Med., 6 (2006), pp. 16
[28]
N. Inase, H. Sakashita, Y. Ohtani, Y. Sogou, Y. Sumi, T. Umino, et al.
Chronic bird fancier's lung presenting with acute exacerbation due to use of a feather duvet.
Intern Med., 43 (2004), pp. 835-857
[29]
M.A. Judson, S.A. Sahn.
Bird-years as well as pack-years.
Chest., 125 (2004), pp. 353-354
[30]
M.J. Rodrigo, M.I. Benavent, M.J. Cruz, M. Rosell, C. Murio, C. Pascual, et al.
Detection of specific antibodies to pigeon serum and bloom antigens by enzyme linked immunosorbent assay in pigeon breeder's disease.
Occup Environ Med., 57 (2000), pp. 159-164
[31]
E. Van Hoeyveld, L. Dupont, X. Bossuyt.
Quantification of IgG antibodies to Aspergillus fumigatus and pigeon antigens by ImmunoCAP technology: an alternative to the precipitation technique?.
Clin Chem., 52 (2006), pp. 1785-1793
[32]
Y. Yoshizawa, Y. Ohtani, T. Inoue, S. Miyake, A. Ikeda, M. Tanba, et al.
Immune responsiveness to inhaled antigens: local antibody pro-duction in the respiratory tract in health and lung diseases.
Clin Exp Immunol., 100 (1995), pp. 395-400
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