Clinical Process and Pulmonary Function of Workers Exposed to Dusts in Manufacturing Industries: Potential Biomarkers of Pneumoconiosis / 대한산업의학회지

Alveolitis is believed to be a primary response after dust inhalation. Activated inflammatory cells by dust and their mediators are major participants in the evolution of pneumoconiosis. Therefore evaluation of degree of alveolitis is useful for assessing disease activity and estimating of prognosis in pneumoconiosis. This study focused on the workers with pneumoconiosis who are working and worked in manufacturing industries because the occupying fraction by them among total pneumoconioses patients in our country is increasing recently. In order to identify and validate biomarkers to early diagnosis and better predict for the suceptible workers, the release of tumor necrosis factor (TNF alpha ), interleukine-8 (IL-8), platelet-derived growth factor-AA(PDGF-AA) and transforming growth factor-beta TGF beta ) from alveolar macrophages and blood monocytes, their concentration in BAL (bronchoalveolar lavage) fluid, pulmonary function test and Gallium index of lung were performed on 25 patients with pneumoconiosis who worked in manufactory industries. The results of this study were as follows ; 1. No significant differences were demonstrated between large opacity group and small opacity group, however pulmonary diffusing capacity in large opacity group was significantly lower than that in small opacity group. 2. (67)Gallium index was significantly correlated with increase of category in pnemoconiosis(r=0.83, p<0.05). 3. Numbers of total cells (r=0.583, p<0.05) and alveolar macrophages (r=0.499, p<0.05) in BAL were significantly correlated with the category of pneumoconiosis. 4. Spontaneous (r=0.474, p<0.05) and LPS (r=0.463, p<0.05) stimulated release of TNF alpha from macrophage, IL-8 (r=0.464, p<0.05) and TGF beta r=0.460, p<0.05) in BAL fluid were significantly correlated with category of pneumoconiosis. 5. Significantly positive correlation was demonstrated between spontaneous (r=0.443, p<0.05) and LPS (r=0.573, p<0.05) stimulated release of TNF alpha with the category of pneumoconiosis. 6. Release of TNF alpha from alveolar macrophages(r=0.61, p<0.05) and blood monocytes (r=0.48, p<0.05), IL-8 concentration in BAL fluid (r=0.52, p<0.05) and (67)Gallium index (r=0.53, p<0.05) were consider to sensitive biomarkers for alveolitis by dust.

The Effect of Hydroxyl Radical Generation on the Cytotoxicity of Alveolar Macrophage and Lipid Peroxidation of Erythrocyte Membrane by Mineral Fibers / 대한산업의학회지

No abstract available.

Relationship Between Mineral Fiber-Induced Pulmonary Tissue Reaction and MIP-2 / 대한산업의학회지

The pulmonary recruitment and activation of inflammatory cells, in particular, neutrophils is thought to contribute to lung injury resulting from dust exposure. MIP-2 (macrophage inflammatory protein-2) which is a member of C-X-C chemokine plays a key role in neutrophil recruitment to sites of tissue injury. Especially, mineral fiber induced pulmonary response is as a model for the neutrophil recruitment. Therefore, we evaluated the distribution of MIP-2 expression in lung tissue of mineral fiber exposed rat using immunohistochemical study and the relationship between degree of inflammation of lower respiratory tract and MIP-2 expression. Total cell counts in bronchoalveolar lavage (BAL) fluid in mineral fiber-exposed group were markedly increased compared with each control group even not in ceramic fiber group. Number of neutrophil in BAL fluid in mineral fiber-exposed group were markedly increased compared with each control group until 4th week but except ceramic fiber group. In chrysotile group, number of neutrophil in BAL fluid were markedly increased compared with control group at 8th week. Lung tissue instilled with all kinds of mineral fibers showed remarkable developments of bronchus associated lymphoid tissue (BALT) and small multiple granulomas but not for ceramic fiber group. In chrysotile group, multiple granuloma and inflammatory change were more profuse response compared with other groups. MIP-2 was predominently expresses in epithelial cells of bronchioles and bronchus and was express also found in macrophages with lung section at 1 week after fiber instillation. Small amount of epithelial cell associated MIP-2 was present in chrysotile at 8 week group. But MIP-2 was not seen in epithelial cells and macrophages in the lung tissue instilled with crocidolite, ceramic fiber and glass fiber at 8 weeks. Our finding suggest that MIP-2 is predominantly expressed in bronchial epithelial cells of lung from mineral fiber-exposed rat and correlated with inflammatory cell, especially neutrophil, recruitment and tissue reaction. And we documented that MIP-2 expression and neutrophil recruitment in man-made vitreous fiber-exposed rat, especially glass fiber, less than chrysotile.

The Evaluation of IL-8 in the Serum of Pneumoconiotic patients / 결핵

Background: Many acute and chronic lung diseases including pneumoconiosis are characterized by the presence of increased numbers of activated macrophages. These macrophages generate several inflammatory cell chemoattractants, by which neutrophil migrate from vascular compartment to the alveolar space. Recruited neutrophils secrete toxic oxygen radicals or proteolytic enzymes and induce inflamatory response. Continuing inflammatory response results in alteration of the pulmonary structure and irreversible fibrosis. Recently, a polypeptide with specific neutrophil chemotactic activity, inlerleukin-8(IL-8), has been cloned and isolated from a number of cells including: monocytes, macrophages and fibroblasts. IL-1 and/or TNF-alpha preceded for the synthesis of IL-8, and we already observed high level of IL-1 and TNF- alpha in the pneumoconioses. So we hypothesized that IL-8 may be a central role in the pathogenesis of pneumoconiosis. In order to evaluate the clinical utility of IL-8 as a biomarker in the early diagnosis of pneumoconiosis, we investigated the increase of IL-8 in the pneumoconiotic patient and the correlation between IL-8 level and progression of pneumoconiosis Method: We measured IL-8 in the serum of 48 patients with pneumoconiosis and 16 persons without dust exposure history as a control group. Pneumoconiotic cases were divided into 3 groups according to ILO Classification: suspicious group(n=16), small opacity group(n=16) and large opacity group(n=16). IL-8 was measured by a sandwich enzyme immunoassay technique. All data were expressed as the mean +/- standard deviation. Results: 1) The mean value of age was higher in the small opacity and large opacity group than comparison group, but smoking history was even. Duration of dust exposure was not different among 3 pneumoconiosis groups. 2) IL-8 level was 70.50 +/-53.63 pg/ml in the suspicious group, 107.50+/-45.88 pg/ml in the small opacity group, 132.50+/-73.47 pg/ml in the large opacity group and 17.85+/- 33.85 pg/ml in the comparison group. IL-8 concentration in all pneumoconiosis group was significant higher than that in the comparison group(p<0.001). 3) IL-8 level tended to increase with the progression of pneumoconiosis. Multiple comparison test using Anova/Scheffe analysis showed a significant difference between suspicious group and large opacity group(p<0.05). 4) The level of IL-8 was correlated with the progression of pneumoconiosis(r=0.4199, p<0.05). Conclusion: IL-8 is thought to be a good biomarker for the early diagnosis of pneumoconiosis.

The Diagnostic Role of HRCT in Simple Pneumoconiosis / 예방의학회지

Early recognition of coalescence in pneumoconiotic lesions is important because such coalescence is associated with the respiratory symptoms and deterioration of lung function. This complicated form of pneumoconiosis also has worse prognosis than does simple pneumoconiosis. High resolution computerized tomography(HRCT) provides significant additional information on the stage of the pneumoconiosis because it easily detects coalescence of nodules and emphysema that may not be apparent on the simple radiograph. The Purpose of this study is to clarify the role of HRCT in detection of large opacity and the relationship of change between the coalescence of nodules or emphysema and lung function in dust exposed workers. 1. There was good correlation between the HRCT grade of pneumoconiosis and ILO category of profusion. 5(9.09%) in 55 study population had confluent nodule extending over two or more cuts on HRCT. HRCT could identify the pneumoconiotic nodules which was not found by simple radiography in 6 workers with category 0/0. 2. No significant difference was observed coalescence of nodules and emphysema by dust type. 3. There was no significant difference in pulmonary function according to ILO and HRCT classification. 4. HRCT could detect the significant reduction in FEV1, FEV1/FVC, PEER, FEF25, FEF50, and FEF75 and remarkable increase in RV and TLC in study persons with emphysema compared with non-emphysema group. 5. Emphysema was found more often in nodules-coalescence group than small opacity group by HRCT. We found that HRCT could easily detect areas of coalescence and complicated emphysema compared to plain chest X-ray. Also our data suggest that it is primarily the degree of emphysema rather than the degree of pneumoconiosis that determines the level of pulmonary function.