Airway responsiveness after antigen inhalation challenge in hypersensitive pneumonia

We performed pulmonary function tests after antigen inhalation challenge in 6 patients with hypersensitive pneumonia. 2 patients showed a reduction in maximal expiratory flow at 25% vital capacity (V25) within the first 1-3 h (early reaction) followed by a decrease in vital capacity, forced expiratory volume at 1 s and increased respiratory resistance in the next 4-7 h (late reaction). In the other 4 patients, only V25 decreased within the first 1-3 h. Diffusion capacity did not change significantly. It is suggested that the small airway is the most sensitive site of reaction to an antigen inhalation challenge in hypersensitive pneumonia and that the obstructive change of the small airway could occur as the early reaction.