Interstitial lung diseases cause damage to the lung tissue through inflammatory cellular reactions which leads to scarring (fibrosis). A very practical classification of interstitial lung disease is presented in the first chapter of a textbook edited by Dr. Marvin I. Schwarz and Dr. Talmadge E. King entitled "Interstitial Lung Disease" Third Edition. 1998, published by B.C. Decker, Inc. Many cases of interstitial lung disease have recognized causes or fit a specific pattern based upon clinical presentation, exposure histories, blood testing , and lung biopsies. When exposure histories, blood testing and lung biopsies fail to reveal a probable cause, the interstitial lung disease is then termed idiopathic (unknown cause).
Types of Interstitial Lung Disease Drug-induced, Autoimmune, Hypersensitivity Pneumonitis, Asbestosis, Sarcoidosis, Coal Worker's Disease, Others, and Idiopathic (Unknown) Type
Idiopathic Interstitial Lung Disease It is the idiopathic group of interstitial lung diseases that has been the focus of Dr. Jacobs over the past 25 years with a philosophy that Hypersensitivity Pneumonia (HP) was being under-diagnosed and that it was hidden in the large group of disorders termed Idiopathic Interstitial Pneumonia (IIP),chronic coughs, asthmatic bronchitis, COPD with a restrictive component, and others. The decision was made to investigate sequential cases of idiopathic interstitial pneumonias, fibrosis of the lung, and restrictive patterns on pulmonary functions at the time of referral with an immunological laboratory evaluation and detailed environmental histories and investigations. Peer review publications that have resulted from this approach are listed below.
Jacobs RL, Thorner RE, Holcomb JR, Schwietz LA, Jacobs FO: Hypersensitivity pneumonitis caused by Cladosporium in an enclosed hot-tub area. Ann Int Med. 1986;105:204-6.
Jacobs RL, Andrews CP, Jacobs FO: Hypersensitivity pneumonitis treated with an electrostatic dust filter. Ann Int Med. 1989;110:115-8.
These cases, upon applying current histopathological criteria, are consistent with nonspecific interstitial pneumonia, fibrotic type (NSIP, fibrotic)
Jacobs RL, Andrews CP, Coalson J: Organic antigen-induced interstitial lung disease: Diagnosis and management. Ann Allergy Asthma Immunol. 2002;88:30-41.
Jacobs RL, Andrews CP: Hypersensitivity pneumonia: NSIP histopathological presentation - A study in diagnosis and long-term management. Ann Allergy Asthma Immunol. 2003;90:265-270.
Jacobs RL, Andrews CP, Coalson JJ. Hypersensitivity pneumonitis: Beyond classic occupational disease - changing concepts of diagnosis and management. Ann Allergy Asthma Immunol. 2005;95:115-128.
In the above publications, we have taken the position that most cases of idiopathic interstitial pneumonia/fibrosis are the result of organic antigen exposure with >95% of the cases occurring in the home, not the workplace, in the South Texas area. This Web site is being constructed to help patients and physicians begin to determine the causation of the disorders that are environmentally-induced and learn how to manage the problem for the remainder of their lives. We are continuing to evaluate patients with these techniques This is a dynamic web site that is continually being upgraded with new information as it is gathered. We initiate this unique approach to management of causative environments rather than treatment of deadly diseases with deadly drugs.
Example of Mold Contamination
Example of specific challenges in Hypersensitivity Pneumonia: Non-Specific Type.
QUESTIONS & ANSWERS
Q: How can I expect this web site to be helpful to me and my physician to diagnose and manage my interstitial disease?
A: The web site will discuss the diagnostic criteria from the viewpoint of a clinical immunologist concerning laboratory tests and challenge techniques to determine a causative environment and effective remediation (cleaning up) of the environment.
Q: How can I determine if there is a contamination in my home or workplace?
A: Every case has had some differences and many similarities. We walk you through the techniques necessary to determine if there is a contamination causing your symptoms. Significant data has been accumulated on the proven causes of contamination and are being posted.
Q: How can I identify what specifically is causing my disease?
A: Only an inhalational challenge to the specific organic antigen can clearly diagnose the cause. This type of challenge is not indicated in the clinical setting. A natural, or environmental challenge is the technique that is used to determine the causative environment and to determine if remediation has been effective.
Q: How can I remain in a non-progressive state with this problem?
A: Only by practicing lifelong anti-microbial techniques in the home and workplace and by avoiding other environments that may have similar contaminations.
