Immunologic evaluation of patients with polychlorinated biphenyl poisoning: evaluation of delayed-type skin hypersensitive response and its relation to clinical studies

Effect of prenatal exposure to polychlorinated biphenyls on incidence of acute respiratory infections in preschool Inuit children

OBJECTIVE

We set out to assess whether environmental prenatal exposure to polychlorinated biphenyls (PCBs) is associated with incidence of acute respiratory infections in preschool Inuit children.

STUDY DESIGN

We reviewed the medical charts of 343 children from 0 to 5 years of age and evaluated the associations between PCB-153 concentration in umbilical cord plasma and the incidence rates of acute otitis media (AOM) and of upper and lower respiratory tract infections (URTIs and LRTIs, respectively).

RESULTS

The incidence rates of AOM and LRTIs were positively associated with prenatal exposure to PCBs. Compared with children in the first quartile of exposure (least exposed), children in fourth quartile (most exposed) had rate ratios of 1.25 (p<0.001) and 1.40 (p<0.001) for AOM and LRTIs, respectively. There was no association between prenatal PCB exposure and incidence rate of URTIs or hospitalization.

CONCLUSION

Prenatal exposure to PCBs could be responsible for a significant portion of respiratory infections in children of this population.

Endocrine disruption induced by organochlorines (OCs): field studies and experimental models

Long-range transport of persistent organic compounds by air and ocean currents from industrialized areas resulted in high levels of these pollutants in food webs in the Svalbard area. With the aim to test if organochlorine (OC) exposure in free-living polar bears from Svalbard affected their plasma steroid hormone concentrations, it was found that polychlorinated biphenyls (PCBs) were associated with increased progesterone levels in females. The sum of pesticides (sigma pesticides) and sigma PCBs contributed significantly negative to the variation of the plasma testosterone in males, and the overall contribution of the OCs to the plasma cortisol variation was negative. A second objective was to study the effects of selected OCs (i.e., PCB 153 and PCB 126) on animal health as a consequence of effects on endocrine-regulated functions such as reproduction and immunity in a goat model focusing on long-term and low-level exposure during the periods of fetal development and in the neonatal period. Additionally, acute exposure was studied in adult mice. The results indicated that exposure to low doses of PCB 153 in utero and in the suckling period influenced reproductive functions and both PCB 153 and PCB 126 exerted immunomodulatory effects on the offspring, whereas acute exposure of adult mice had minor effects on male reproductive function.

Acute infections and environmental exposure to organochlorines in Inuit infants from Nunavik

The Inuit population of Nunavik (Canada) is exposed to immunotoxic organochlorines (OCs) mainly through the consumption of fish and marine mammal fat. We investigated the effect of perinatal exposure to polychlorinated biphenyls (PCBs) and dichlorodiphenyldichloroethylene (DDE) on the incidence of acute infections in Inuit infants. We reviewed the medical charts of a cohort of 199 Inuit infants during the first 12 months of life and evaluated the incidence rates of upper and lower respiratory tract infections (URTI and LRTIs, respectively), otitis media, and gastrointestinal (GI) infections. Maternal plasma during delivery and infant plasma at 7 months of age were sampled and assayed for PCBs and DDE. Compared to rates for infants in the first quartile of exposure to PCBs (least exposed), adjusted rate ratios for infants in higher quartiles ranged between 1.09 and 1.32 for URTIs, 0.99 and 1.39 for otitis, 1.52 and 1.89 for GI infections, and 1.16 and 1.68 for LRTIs during the first 6 months of follow-up. For all infections combined, the rate ratios ranged from 1.17 to 1.27. The effect size was similar for DDE exposure but was lower for the full 12-month follow-up. Globally, most rate ratios were > 1.0, but few were statistically significant (p < 0.05). No association was found when postnatal exposure was considered. These results show a possible association between prenatal exposure to OCs and acute infections early in life in this Inuit population.

Effects of perinatal exposure to low doses of PCB 153 and PCB 126 on lymphocyte proliferation and hematology in goat kids

Pregnant does (10 goats/group) were dosed orally with either PCB 153 or PCB 126 dissolved in corn oil or only corn oil (control group) from day 60 of gestation until delivery. Effects on in vitro mitogen-induced lymphocyte proliferation and blood cell counts in their goat kids exposed to low levels of PCB 153 and PCB 126 during gestation and lactation were assessed. The concentrations of PCB 153 and PCB 126 in adipose tissue in the goat kids 9 mo postpartum were 5800 ng/g (fat weight) and 0.49 ng/g (fat weight), respectively. Kids exposed to PCB 153 had a significantly higher number of white blood cells, neutrophils, and lymphocytes at 2 wk of age compared to controls. In the kids exposed to PCB 126 there was a significantly lower concentration of monocytes at 2, 4, and 8 wk of age. The mean lymphocyte response to phytohemagglutinin (PHA) and to concanavalin A (Con A) was significant lower in the PCB 153 compared to the control group at wk 2, 4, and 8 postnatally. The results of the present study support previous reports on immunotoxic effects of PCB exposure in animals. However, this is the first report to demonstrate immunotoxicity in animals by using low doses of PCB 153. The difference in results between PCB 126 and PCB 153 treatment groups may strengthen the hypothesis that PCBs mediate immunotoxic effects through both AhR-dependent and -independent mechanisms.

Polychlorinated biphenyls, dibenzo-p-dioxins, and dibenzofurans and birth weight and immune and thyroid function in children

None of the publications reviewed provide clinical evidence that PCBs (polychlorinated biphenyls) and related chemicals adversely affect weight, immune, or thyroid function in infants or children born to healthy mothers. Birth weights of term infants fell within the normal range in all studies. The greatest difference between comparison groups was reported by G. G. Fein et al. (1984a, Intrauterine Exposure of Humans to PCBs: Newborn Effects, EPA-600/3-84-060, Environmental Protection Agency; 1984b, J. Pediatr. 105, 315-320). P. R. Taylor et al. (1989, Am. J. Epidemiol. 129, 395-406) reported smaller differences in occupationally exposed women and E. Dar et al. (1992, Environ. Res. 59, 189-201) found that women with higher PCB serum levels had larger babies. S. Patandin et al. (1998, Pediatr Res. 44, 538-545) found a negative association of PCB concentrations in maternal or cord plasma and birth weight of breast and formula-fed infants combined but not when breast-fed infants were analyzed separately. L. Rylander et al. (1995, Scand. J. Work Environ. Health 21, 368-375) reported decreased birth weights with higher dietary intake of contaminated fish. Thus, correlations between PCB exposure or polluted fish ingestion and birth weight were inconsistent. Thyroid and immune function were also within the normal range. In none of the papers were normal laboratory reference values provided and overall the statistically significant differences accounted for little of the variance.

Role of protein phosphorylation in activation of phospholipase A2 by the polychlorinated biphenyl mixture Aroclor 1242

Polychlorinated biphenyls (PCBs) activate neutrophils to induce degranulation and undergo superoxide production through a mechanism that involves stimulation of phospholipase A(2) (PLA(2)). Since the biochemical processes leading to the PCB-induced activation of this enzyme are unknown, the objective of this study was to determine whether protein phosphorylation has a role in this mechanism. Isolated rat neutrophils were labeled with [(3)H]-arachidonic acid ([(3)H]-AA), and activation of PLA(2) was determined from release of radioactivity into the medium. Exposure to the PCB mixture Aroclor 1242 induced release of [(3)H]-AA, and pretreatment with bromoenol lactone (BEL), an inhibitor of calcium-independent PLA(2), diminished release by 80%. Genistein, an inhibitor of tyrosine kinases, caused a small but significant decrease in Aroclor 1242-stimulated release of [(3)H]-AA. Daidzein, a genistein analog with no activity to inhibit tyrosine kinases, had no effect on [(3)H]-AA release. An inhibitor of p38 mitogen-activated protein kinase (MAPK), SB203580, did not affect Aroclor 1242-induced PLA(2) activity at concentrations selective for p38 MAPK; however, PD 98059, which inhibits MAPK kinase (MEK), decreased [(3)H]-AA release to about the same extent as genistein. Treatment of neutrophils with Aroclor 1242 induced phosphorylation of p44 MAPK, and this phosphorylation was unaffected by BEL but was inhibited by PD 98059. Staurosporine, a nonselective inhibitor of protein kinase C (PKC), inhibited PCB-induced release of [(3)H]-AA. Ro 32-0432, a selective inhibitor of PKC(alpha) and PKC(beta1), produced the greatest degree of inhibition (40%) among the tested protein kinase inhibitors. These results suggest that tyrosine kinases, PKC, and the MEK/MAPK pathway are involved in a fraction of Aroclor 1242-induced activation of PLA(2).

Use of immunotoxicity data in health risk assessments: uncertainties and research to improve the process

A number of environmental contaminants can suppress immune responses and enhance susceptibility to infectious and/or neoplastic disease. Most of the evidence for immunotoxicity of such contaminants has been obtained from laboratory animal studies and risk assessors must make decisions about risk to the human population based on these studies. Uncertainties associated with this process include determining what level of immune suppression is adverse, extrapolating across species from rodent to human, and across levels of biologic organization from effects on immune function at the cellular level to effects on incidence of disease at the population level, accounting for intra-species variability, and assessing the relationship between effects following acute, subchronic, and chronic exposure. This paper reviews immunotoxicity data that may be applied to the development of risk assessment methods and models designed to reduce some of these uncertainties.

The immunologic evaluation of the Yucheng children

The immunologic effects of in utero exposure to polychlorinated biphenyls (PCBs)/polychlorinated dibenzofurans (PCDFs) were evaluated in the Yucheng children in this study. The study subjects consisted of 105 Yucheng children and 101 control children. The Yucheng children were born, between July 1978 and June 1987, to women who had exposed to high dose of PCBs/PCDFs through consumption of contaminated rice bran oil in 1978-1979. These children had been reported to have higher frequencies of bronchitis than their controls in the first six months of life, and higher frequencies of respiratory tract and ear infection in a 6-year follow-up. The low resistance of the Yucheng children to infection suggested that their immune function was suppressed by the PCBs/PCDFs they had exposed to in utero. In the summer and fall of 1995, a thorough physical examination and blood draw were performed on the study children. The Yucheng children were reported by their parents to have higher frequencies of influenza attacks than the control children during the six months prior to the examination. The frequencies of other symptoms were similar between the two groups. The serum levels of various immunoglobulins were similar between the two groups. Fifty-one serum samples, 29 of Yucheng and 22 of control children, were available for cell-mediated immunologic analysis. The percentages of various T cell markers, CD3, CD4, and CD8, and B cell and NK cell markers were not different between the Yucheng and the control children. No dose-response relationship was found between 27 Yucheng children's serum PCB/PCDF levels and any of their immunologic markers. WE concluded that 16 years after the Yucheng incident, Yucheng children exposed to high dose of PCBs/PCDFs in utero did not show, with the serum immunologic marker analyses, suppressed immunity when compared to their controls. To explain the consistent higher frequencies of upper respiratory tract infection in the Yucheng children, immune functional tests such as delayed hypersensitive skin reaction, in vitro lymphocyte proliferation, and antibody synthesis following immunization may be necessary.

Experimental studies on immunosuppression: how do they predict for man?

The ultimate goal of any animal model in immunotoxicity testing is that it be a sensitive predictor of xenobiotic-induced immune dysfunction in humans. Such models should be capable of identifying the target(s) within the immune system affected by the xenobiotic. In particular the tier testing models have been successfully used to identify and characterize a variety of different immunotoxicants in animals as it pertains to immunosuppression and reduced resistance to infectious diseases. These tier models in mice and rats have been validated in interlaboratory studies. Although these protocols were designed for studies of rats and mice, some have been applied successfully for studying immunotoxicity in other animal species, including non-human primates. A great amount of data has been generated by the application of these models, which demonstrate that xenobiotics alter the immune system of animals. In man, the database on chemical-induced immunosuppression is limited, as the use of markers of immunotoxicity has received little attention in clinical and epidemiological studies. Such studies have not been performed frequently, and their interpretation often does not permit unequivocal conclusions to be drawn, due for instance to the presence of confounding factors and the uncontrolled nature of exposure. Also, testing possibilities in humans are limited and immune function changes by chemical exposure are often subtle. In humans, a number of agents have been shown to have immunosuppressive properties (including PCBs, PCDDs, PCDFs, oxidant gases, and ultraviolet radiation), but the strongest evidence stems from the clinical use of immunosuppressant drugs in transplant patients. These human data do in general terms confirm the data gained with experimental animals. Immunotoxicity assessment in rodents therefore adequately forms the basis for human risk assessment. Knowledge on the predictability of these animal models and immune assays can be further improved by comparison of the human and animal data obtained in the development of drugs.

Lack of effects of some individual polybrominated diphenyl ether (PBDE) and polychlorinated biphenyl (PCB) congeners on human lymphocyte functions in vitro

The structural similarities between polybrominated diphenyl ethers and immunotoxic halogenated aromatic compounds suggest that the polybrominated diphenyl ethers might affect the immune system. The present study was undertaken to investigate the immunological effects of some purified PBDE-congeners on human lymphocyte function in vitro. Polychlorinated biphenyl congeners were also included in the study. Mitogen-induced DNA synthesis and immunoglobulin synthesis by lymphocytes from blood donors were examined following polybrominated diphenyl ether or polychlorinated biphenyl exposure in vitro in order to determine the immunotoxic potential of these substances. No effects on mitogen-induced proliferation or immunoglobulin synthesis were observed after exposure of cells to concentrations up to 10(-5) M. The negative findings in this study indicate that certain functions of human peripheral lymphocytes, i.e. proliferation and immunoglobulin synthesis, are insensitive to the direct action of polybrominated diphenyl ethers and polychlorinated biphenyls. Our results are in accordance with other recent studies in which no effects on immunological parameters were demonstrated by exposure of lymphocytes to polyhalogenated aromatic hydrocarbons in vitro.

Markers for immunotoxic effects in rodents and man

There is growing interest and concern in society about the capacity of chemicals to impair immune responses and trigger autoimmune disease. Methods to investigate chemical-induced immunosuppression have been developed and validated in the mouse and rat. Animal models that are suitable to investigate the ability of chemicals to induce autoimmune disease are virtually lacking. From the plethora of tests to assess immunity in man, panels of biomarkers to study immunotoxicity in humans have been proposed. Such studies in humans are considerably more complex than in animals as non-invasive tests are limited, responses in the population are heterogeneous, and exposure levels are often low. Human risk assessment is therefore mostly based on animal studies. As examples of compounds affecting biomarkers in animals and man, 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD) and hexachlorobenzene are discussed.

Immunotoxicity of PCBs (Aroclors) in relation to Great Lakes

Polychlorinated biphenyls (PCBs) are among the most widespread environmental pollutants and a prominent contaminant of the Great Lakes basin. Due to their resistance to biodegradation and lipophilic properties, PCBs bioaccumulate in fish tissues and in fish-eating humans. PCBs are also known to cross the placenta and to be excreted into the mother's milk, thus predisposing the infant to potentially adverse health effects. For example, a higher incidence of bacterial infections was reported for breast-fed infants born to mothers who consumed large amounts of Great Lakes fish compared to the incidence in control infants whose mothers ingested low amounts of fish. While data regarding the PCB-induced immunotoxic effects in humans are scarce, data derived from the use of experimental animals, including nonhuman primates, indicate that the immune system is a potential target for the immunotoxic effects of PCBs. Such studies have used the commercially available PCB mixtures alone. However, PCBs have the potential of partially antagonizing the effects of other structurally related compounds including the highly toxic dioxins, which are also present in small amounts in the Great Lakes. Thus, to fully evaluate the magnitude of the immunotoxic risk PCBs pose to humans, consideration should be given to investigations in which the interactive effects of PCBs are combined with other contaminants present in the Great Lakes.

Lack of direct immunosuppressive effects of 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD) on human peripheral blood lymphocyte subsets in vitro

A wide variety of immunosuppressive effects of 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD) in experimental animals has been documented. In contrast, the impact of dioxin on the human immune system remains controversial, although adverse health effects have been reported in humans after occupational or accidental exposure to dioxin. Recently, Neubert et al. (1991) found that a dose-dependent decrease of peripheral blood lymphocyte (PBL) subpopulations in humans and non-human primates, including helper-inducer/memory cells (CD4+CD29+) and B cells (CD20+) occurred in pokeweed mitogen (PWM) stimulated cultures at concentrations as low as 10(-12)-10(-14) M TCDD. Therefore, the direct effects of dioxin on human PBL subpopulations have been studied, in order to determine their usefulness as sensitive biomarkers for human dioxin exposure. Lymphocyte cultures from healthy individuals were treated with 10(-7) M-10(-14) M TCDD in the absence and presence of stimulation with pokeweed mitogen (PWM) or anti-CD3 monoclonal antibody (moAb; OKT3) for 3 days. Cytochrome P450 (CYP1A1) enzyme induction, one of the best studied direct biological effects of TCDD on numerous cell types, was assayed in parallel by ethoxyresorufin-O-deethylase (EROD) activity. Percentages of the different lymphocytes subsets, including CD2 (T cells); CD4; CD45 RA (suppressor-inducer/virgin T cells); CD4 CD29; CD8; CD19 (B cells) as well as interleukin 2 (IL-2) receptor (CD25) and class II antigen (HLA-DR) expression, were analyzed by flow cytometry. DNA synthesis was determined by 3H-thymidine uptake after 3 days of culture.(ABSTRACT TRUNCATED AT 250 WORDS)

Aryl hydrocarbon or dioxin receptor: biologic and toxic responses

1. The AhR represents a ligand-activated transcription factor. Receptor agonists include planar aromatic compounds, a variety of heterocyclic plant constituents, and PCDD/PCDF. The latter lead to persistent activation of the receptor due to their strong binding affinity and long biologic half-life of over 10 years in human blood and fat. Practically every person on earth is exposed to these compounds via the diet (> 90%) and by high concentrations in mother's milk. PCDD/PCDF produced toxic responses in exposed people (primarily chloracne and immunosuppression) in the past. However, the present PCDD/PCDF levels (basal levels) in the general population are below those warranting toxicologic concern. 2. The AhR has been characterized as a helix-loop-helix transcription factor related to the Drosophila developmental genes sim and per. The cytosolic form of the receptor is present as an inactive complex with two subunits of HSP90. After ligand binding HSP90 is released and the receptor enters the nucleus as a heterodimer together with a related protein ARNT. It binds with high affinity to certain enhancer elements in the upstream region of several genes such as cytochrome P4501A1 (CYP1A1). The AhR transcriptionally activates several drug-metabolizing enzymes and proteins involved in growth/differentiation, such as the plasminogen activator inhibitor PAI-2 and IL-1 beta. In addition, it modulates the action of a number of other nuclear transcription factors such as receptors of the steroid hormone receptor superfamily and of cell surface receptors such as EGF. With the exception of CYP1A1 induction, little is known about the mechanism of transcriptional activation of the AhR-controlled genes. Many AhR-modulated biologic responses (such as modulation of the estrogen and EGF receptor) appear to be indirect. 3. Persistent activation of the AhR is probably responsible for toxic responses in experimental animals and humans. They are markedly tissue and species specific. In rodents a wasting syndrome, immunosuppression, teratogenicity, chloracne, and carcinogenicity/tumor promotion have been well studied. There is good evidence for an involvement for the AhR in these responses. However, the chain of events from receptor activation to the diverse toxic endpoints is largely unknown. Alteration of growth and differentiation of epithelial tissues may underlie most of the toxic responses. A lot has already been achieved, mostly by characterizing the AhR and transcriptional activation of CYP1A1. Still more work lies ahead of us, for example, elucidation of the physiologic roles of the AhR and of the chains of events from receptor activation to the various biologic and toxic endpoints.

Detection and characterization of Ah receptor in tissue and cells from human tonsils

Ah receptor was identified and characterized in cytosol and nuclear extracts from human tonsils obtained at surgery from children 2 to 6 years of age. Ah receptor was found in cytosol prepared from whole-tonsil homogenates as well as in cytosol and nuclear fractions prepared from tonsil lymphocytes or tonsil fibroblasts grown in primary culture. Cytosolic Ah receptor was detectable in tonsillar tissue with either halogenated (2,3,7,8-[3H]tetrachlorodibenzo-p-dioxin (TCDD)) or nonhalogenated (3-[3H]methylcholanthrene and [3H]benzo[a]pyrene) aromatic hydrocarbons and sedimented at approximately 9 S after velocity sedimentation on sucrose gradients. The apparent binding affinity (Kd) of [3H]TCDD for Ah receptor ranged from 3 to 12 nM in cytosols from seven different donors. The same analyses indicated a concentration of Ah receptor in human tonsils of approximately 100-300 fmol/mg cytosolic protein. Incubation of either tonsil lymphocytes or tonsil fibroblasts with [3H]TCDD resulted in transformation of cytosolic Ah receptor to a nuclear binding form which could be detected as a specifically labeled peak sedimenting at approximately 6 S on sucrose gradients. These data demonstrate the existence of Ah receptor in human tonsils and suggest that this immune organ may be an appropriate model for further studies on the mechanism and manifestation of aromatic hydrocarbon-induced immunotoxicity in man.

Human lymphocyte reactivity after in vitro exposure to technical and analytical grade pentachlorophenol

To investigate the potential effects of technical pentachlorophenol (PCP-T, contaminated with polychlorinated dioxins and furans) and of analytical grade pentachlorophenol (PCP-A) on the human immune system, in vitro assays with freshly prepared human peripheral blood lymphocytes were used as an alternative to experimental animals. Both cell-mediated and humoral immune functions were examined after direct lymphocyte exposure to PCP-T or PCP-A at concentrations ranging from 0-200 microM. In each case the viability of the treated cells remained within the control value range. T lymphocyte blastogenesis after 3 days incubation with PCP was measured using both optimal and suboptimal mitogen (PHA) concentration. Interleukin-2 activity of 24.5-h supernatants of lymphocytes in response to PHA, pretreated with PCP for 20-24 h, was examined in a bioassay using the mouse IL-2-dependent CTLL-6 cell line. The synthesis of immunoglobulins was determined after stimulation with T-dependent (PWM) and T-independent (KlebsM) polyclonal B cell activators. In the proliferation assay the effects of PCP-T became more evident after suboptimal mitogen stimulation. Whereas after optimal mitogen stimulation blastogenesis was affected only at the highest concentration of 200 microM PCP-T, cell reactivity after suboptimal PHA stimulation was altered by all PCP-T doses. In the lower concentration range PCP-T caused enhanced proliferative responses, but at the two highest PCP-T concentrations cell reactivity was significantly suppressed as compared to the medium controls. Significant differences between the effects of PCP-T and PCP-A could be demonstrated only after optimal mitogen stimulation at the highest PCP concentration (200 microM). In contrast, lymphokine production as well as Ig secretion showed severe dose-dependent suppression after exposure to both PCP-T and PCP-A. The humoral immune response appeared to be more suppressed when cultures were stimulated with T-dependent rather than T-independent mitogens. The two different PCP preparations caused immunosuppression of both lymphocyte functions to the same extent. To summarize, the results of our studies indicate that PCP itself is directly immunotoxic to human immunocompetent cells and the T helper cell subset appears to be especially sensitive to PCP exposure. Furthermore, the observation of a direct effect on humoral immunity is similar to previous results showing considerable alterations of antigen specific antibody production in experimental animals after in vivo exposure.

Effects of PCB (Aroclor 1254) on non-specific immune parameters in rhesus (Macaca mulatta) monkeys

The effects of low level, chronic polychlorinated biphenyl--Aroclor 1254--(PCB) exposure were investigated on non-specific immune parameters in female rhesus (Macaca mulatta) monkeys. Five groups of monkeys were orally administered with PCB at concentrations of 0, 5, 20, 40 or 80 micrograms/kg bw/day. Immunotoxicity testing was initiated after 55 months of exposure. The serum hemolytic complement activity in all PCB treated groups was significantly higher (P less than 0.05) than that in the control group. A statistically significant dose-related increase in natural killer cell activity was evident at the 75:1 effector to target cell ratio. Similarly, a statistically significant dose-related increase was noted for thymosin alpha-1 levels but not for thymosin beta-4 levels. Statistically significant increased interferon levels were noted in the 20 and 80 micrograms/kg groups compared with the control group while the levels in the 40 micrograms/kg group were decreased significantly compared with the control group. The production of tumor necrosis factor by monocytes in the PCB treated groups was not different to that in the control group. The results indicated that long term exposure to PCB modulate several non-specific immune parameters.

Immunotoxicology: suppressive and stimulatory effects of drugs and environmental chemicals on the immune system. A discussion

The fundamental characteristic of the adaptive immune system which has evolved in the vertebrates is the ability to recognise, and subsequently destroy, "foreign", and potentially harmful, antigens. The selective advantage which the immune system confers is the capacity to resist infectious, and possibly malignant, disease. It has been apparent for many years that individuals in whom immune function is impaired, due either to a congenital defect or to other factors such as treatment with certain immunosuppressive drugs, exhibit an increased susceptibility to infection and, in some cases, an elevated risk of developing at least some forms of malignancy. There is an increasing awareness from rodent studies that a variety of drugs and environmental chemicals have the potential to unintentionally impair components of the immune system. Risk assessment, based upon data from chemically induced changes in one or more parameters of immune function, is, however, dependent upon a knowledge of the functional reserve of the immune system. One of the objectives of the meeting from which this report derives was to examine what sources of information are available, and what experimental protocols can be employed, to permit accurate evaluation of immunological reserve. Although, under normal circumstances, the immune system selectively and specifically recognises foreign antigen, it is clear that the potential to recognise "self" is present and that in certain circumstances this potential is realised. Antibodies directed against normal tissue antigens have been shown to be associated with, and in some instances the presumptive cause of, "autoimmune" disease. There is a growing list of drugs and chemicals which are capable of eliciting autoantibodies and pathological autoimmune reactions. A second purpose of this meeting and of this report was to review the current state of knowledge regarding drug- and chemical-induced autoimmunity.

Toxic effects of environmental chemicals on the immune system

The main focus of the discipline of immunotoxicology is the study of alterations in immunological mechanisms caused by chemicals and drugs. These alterations may result in increased incidence of infections or the development of tumors. The major interest of immunotoxicology lies in the evaluation of the results of toxicity testing in rodents for the purpose of risk assessment for humans. As J. G. Vos and colleagues explain, such immunotoxicity testing is preferably carried out as a tiered system consisting of screening followed by functional studies of selected chemicals. This approach has been successful in identifying notorious environmental pollutants as immunotoxic chemicals. Evidence that the non-mammalian immune system can also be damaged by toxic environmental pollutants emphasizes the importance of ecotoxicology.

Evaluation of the immunotoxicity of low level PCB exposure in the rat

Weanling male Fischer 344 rats were exposed daily by gastric intubation for up to 15 weeks to the polychlorinated biphenyl (PCB) Aroclor 1254 at 0.1, 1, 10, or 25 mg/kg body weight. At 5, 10 and 15 weeks groups of rats were killed and immune functions were evaluated. The immune parameters examined included the following: body and lymphoid organ weights, mitogen-stimulated lymphoproliferative (LP) responses, natural killer (NK) cell activity, mixed lymphocyte reaction (MLR), and cytotoxic T lymphocyte (CTL) response. After 15 weeks of dosing body weights were reduced in rats receiving 25 mg/kg PCB while thymus weights were decreased in rats receiving 10 and 25 mg/kg. NK cell activity was reduced in rats dosed for 15 weeks at 10 and 25 mg/kg. The LP response to phytohemagglutinin was enhanced in rats dosed for 15 weeks at 25 mg/kg PCB. Exposure of rats to PCB did not affect the MLR or CTL responses. Other groups of rats were exposed to cyclophosphamide (CY) and served as positive controls for the immune assays employed. CY induced alterations in all of the immune parameters measured, indicating that this is an appropriate battery of immune function tests which is capable of detecting immune alterations in the rat. Alterations in immune function induced by daily gastric intubation with PCB were accompanied by reductions in body weight and/or hepatomegaly. These results suggest that the observed immune alterations may be related to the overt toxicity of this PCB in the rat.

Immunotoxicity studies of PCB (Aroclor 1254) in the adult rhesus (Macaca mulatta) monkey--preliminary report

The effects of PCB (Aroclor 1254) on the immune system of adult female rhesus monkeys were investigated in a chronic study wherein five groups of monkeys (16/group) were administered (orally) PCB at levels of 0.0, 5.0, 20.0, 40.0 or 80.0 micrograms/kg body wt daily. Tests for immunotoxicity were initiated at 23 months of exposure to PCB, at which time the monkeys had achieved an apparent pharmacokinetic steady state based on the PCB concentration in fat and/or blood. A statistically significant (P less than 0.05) dose response reduction in antibody levels (IgG and IgM) to sheep red blood cells (SRBC) was observed following i.v. administration of three immunizing doses of SRBC at weekly intervals. A statistically significant decrease in the percent TH and an increase in the percent and absolute TS lymphocyte levels was found in the 80 micrograms/kg body wt group compared to the control. The TH/TS ratio was also significantly lower in the 80 micrograms/kg body wt group compared to the control. Other parameters investigated including percent of B-lymphocytes and total T-lymphocytes, total serum immunoglobulin levels (IgG, IgM and IgA), other serum proteins, glucocorticosteroid levels and lymphocyte transformation results following stimulation with the mitogens PHA-P and Con A were not affected significantly by PCB treatment. Additional immunologic parameters are currently being investigated to further elucidate the mechanism by which PCB induces immunotoxicity.

Congenital poisoning by polychlorinated biphenyls and their contaminants in Taiwan

In 1979, a mass poisoning occurred in Taiwan from cooking oil contaminated by thermally degraded polychlorinated biphenyls. Because these chemicals persist in human tissue, children born to female patients after the outbreak were exposed in utero. In 1985, 117 children born to affected women and 108 unexposed controls were examined and evaluated. The exposed children were shorter and lighter than controls; they had abnormalities of gingiva, skin, nails, teeth, and lungs more frequently than did controls. The exposed children showed delay of developmental milestones, deficits on formal developmental testing, and abnormalities on behavioral assessment. These findings are most consistent with a generalized disorder of ectodermal tissue. This syndrome is one of very few documented to result from transplacental exposure to pollutant chemicals.

Suppression of allograft immunity by 3,4,5,3',4',5'-hexachlorobiphenyl. I. Effects of exposure on tumor rejection and cytotoxic T cell activity in vivo

There are conflicting reports in the literature concerning the immunotoxic effects of polychlorinated biphenyls (PCB) on cell-mediated immune responses. In the studies reported here, we show that the in vivo generation of cytotoxic T lymphocytes (CTL) in response to allogeneic tumor challenge is sensitive to suppression by 3,4,5,3',4',5'-hexachlorobiphenyl[(345)2-HxCB], a poorly metabolized, toxic, Ah receptor-binding PCB isomer. C57B1/6 mice treated with a single oral dose of (345)2-HxCB two days prior to the i.p. injection of allogeneic P815 tumor cells exhibited a dose-dependent reduction in peak CTL activity in the spleen. When examined on a kinetic basis, the CTL response was reduced in magnitude on all days examined with no evidence for a shift in the kinetics of the response induced by (345)2-HxCB exposure. (345)2-HxCB exposure prior to antigen challenge (day -14, -7, or -1 relative to P815 injection on day 0) produced significant suppression of the CTL response. (345)2-HxCB exposure 6 weeks prior to antigen challenge was still significantly suppressive, although the reduced degree of suppression suggested that recovery was in progress. When (345)2-HxCB exposure occurred after antigen challenge, significant suppression was produced only when exposure occurred within the first three days of the response, suggesting that, as the CTL matured, their sensitivity to (345)2-HxCB diminished. Clearance of the allogeneic tumor cells from the peritoneal cavity was delayed in (345)2-HxCB-treated mice and was associated with an altered composition of the white blood cell infiltrate in the peritoneal cavity. Symptoms of overt toxicity as well as immunotoxicity were apparent at lower doses of (345)2-HxCB in male as compared to female mice. In addition, interactive effects of (345)2-HxCB exposure and P815 antigen challenge on body weight and thymic involution were observed in both male and female mice. Possible mechanisms for the altered CTL response in (345)2-HxCB-exposed mice are discussed.

Chemiluminescence in human whole blood: modulation by the cocarcinogens phorbol diester and polychlorobiphenyls

A human whole blood chemiluminescence (CL) assay was established using zymosan as cell activator. Aroclor 1254 was found to inhibit this CL response in a direct linear relation to its concentration, (50% inhibitory dose, (ID50) equal to 5 x 10(-4)M) in diluted blood samples of 10 normal human subjects. In comparison the ID50 of other inhibitors was 1.3 x 10(-3)M for ethylenediamine tetraacetic acid, 3.3 x 10(-3)M for ascorbic acid, 4 x 10(-3)M for reduced glutathione, 1.2 x 10(-1)M for ethanol, 2.5 x 10(-1)M for methanol and 3.7 x 10(-1)M for dimethyl sulfoxide. Using 12-o-tetradecanoyl-phorbol-13-acetate (TPA) as cell activator the CL response was likewise inhibited by Aroclor 1254 with an ID50 of 4.5 x 10(-4)M. However, it was found that Aroclor 1254 alone has a stimulatory CL effect on otherwise unactivated cells. To compare the mechanisms involved in the CL elicited by the three stimulants zymosan, TPA and Aroclor 1254, the CL signal was measured in the presence of cytochalasin B. Cytochalasin B inhibited zymosan-induced CL, had a smaller inhibitory effect on TPA-induced CL but it could augment the CL response initiated by Aroclor 1254. This pattern of responses implicates Aroclor 1254 in the activation of eicosanoid metabolism as it matches the differential responses reported for arachidonic acid.

An in vitro model for studying the toxicity of 2,3,7,8-tetrachlorodibenzo-p-dioxin to human thymus

A coculture system of human thymic epithelial (HuTE) cells and thymocytes (T lymphocyte precursors) has been established and characterized as an in vitro model for assessing the potential toxicity of 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD) to human thymus. HuTE cells in culture were responsive to TCDD as judged by induction of the cytochrome P1-450 monooxygenase activities, 7-ethoxycoumarin O-deethylase (ECOD) and 7-ethoxyresorufin O-deethylase (EROD). Measurement of the responsiveness of thymocytes cocultured on TCDD-pretreated HuTE monolayers to the mitogens concanavalin A (Con A) and phytohemagglutinin (PHA) indicated that TCDD can act directly on HuTE cells to suppress thymocyte maturation (at a concentration of 10 nM, TCDD produced a 25 to 50% inhibition of thymocyte responsiveness to Con A and PHA). Both the induction of cytochrome P1-450 monooxygenase activity (EC50 values approximately 1 nM) and immunosuppressive responses elicited by TCDD in HuTE cells were concentration-dependent and stereospecific (as judged by the relative activities of chlorinated dibenzo-p-dioxin and dibenzofuran isomers), indicating involvement of the Ah receptor which was detected in all HuTE strains examined. Initial characterization of these Ah receptor-mediated responses in several strains of HuTE cells indicated marked interstrain differences in maximally inducible ECOD and EROD activities which did not appear to directly correlate with measured concentrations of the cytosolic Ah receptor, and in certain strains examined, differences in sensitivity and magnitude were observed for TCDD-evoked immunotoxic responses but not always for the induction response. These data on the actions of TCDD on cultured HuTE cells suggest that human thymus is a target for TCDD and related halogenated aromatic compounds. In HuTE cells, measurement of either the Ah receptor concentration or of marker responses such as the induction of cytochrome P1-450 alone cannot provide an accurate quantitative assessment of susceptibility to TCDD-induced thymus toxicity.

Immunotoxicology: an overview

It is now known that chemicals and drugs may induce selective toxicity which may alter the interactions between immunocompetent cells, especially if the toxicity occurs during proliferation and differentiation. Hence, a flexible panel of sensitive in vivo and in vitro assays has been developed and validated to assess the immunotoxicity or immunopharmacology of suspect agents in rodents. The combined use of such sequential analysis methods with host resistance assays can effectively define immunomodulation following exposure to xenobiotics. Methods development, refinement and validation will be an ongoing requirement because of our rapidly expanding knowledge of the cell biology of the immune system. Classic studies of the comparative preclinical toxicology of several immunosuppressive drugs have substantiated species similarities and have contributed significantly to the development of predictive rodent models for extrapolation to humans. Studies of immunopharmacology and immunotoxicity of cyclosporin A, for example, produced both the desired pharmacology and the undesired toxicity at similar doses in both rodents and humans. When species differences are observed during toxicology studies they are most probably due to differences in absorption, disposition, metabolism, excretion, or delivered dose at the target tissue, rather than major species differences in cellular targets or cell physiology. This assumption is the basis for using rodent species to predict the toxicity of chemicals and drugs under development.(ABSTRACT TRUNCATED AT 250 WORDS)

Cancer mortality of capacitor manufacturing workers

Experimental studies have demonstrated that certain types of commercially produced polychlorinated biphenyls (PCBs) are carcinogenic. Data in humans are still controversial. This study was undertaken in order to determine possible long-term effects, particularly cancer, in workers engaged in the manufacture of capacitors impregnated with PCBs in a plant operating since 1946. All workers employed for at least 1 week between 1946 and 1978 were admitted to the study (544 males and 1,556 females), and their mortality was examined for the period 1946-1982. Data on environmental contamination, workers' PCBs intake, and health effects (chloracne) were available, which documented the general exposure conditions in the plant. Vital status was ascertained for over 99% of the subjects, and death certificates were obtained for all deceased persons. Expected deaths were calculated using two sets of mortality rates, national and local. Among male workers, cancer deaths (14 obs.) were significantly increased as were deaths owing to cancer of the gastrointestinal (GI) tract (6 obs.). Also, mortality from hematologic neoplasms (3 obs.) and lung cancer (3 obs.) was higher than expected; however, the excess was statistically not significant. Female workers exhibited an overall mortality that was significantly increased above expectations. Cancer deaths (12 obs.) and hematologic neoplasms (4 obs.) were significantly higher than expected when compared with the local population. Interpretation of the results is limited by the small number of deaths; however, the point of interest is the consistency of these results with previous experimental and epidemiologic studies, which indicated the GI tract and lymphatic and hemopoietic tissue as the most probable target sites of the PCBs carcinogenic activity.

Respiratory involvement and immune status in yusho patients

Clinical and experimental studies on respiratory involvement and alterations in immune status were carried out. Respiratory distress occurring in these patients has improved gradually for 14 years but still remains. Copious expectoration at an early stage of the disease may be related to the fact that a number of discrete polychlorinated biphenyls (PCBs) are distributed throughout the lung parenchyma. For accumulation in the bronchial mucosa, structural requirements and specific dose dependence of PCBs have been clearly shown; however, pathological and physiological studies have indicated that respiratory involvement in yusho is mainly small airway disease that may be caused by involvement of cellular component (Clara cells) in bronchioles and/or associated infection. Respiratory distress is often exacerbated by viral or bacterial infection. Changes in the immune status in PCB and polychlorinated dibenzofuran (PCDF) poisoning are as follows: IgA and IgM in the serum are decreased at an early stage of the disease and then return to normal; suppression of cellular immunity was reported in Taiwanese patients and some may remain in the later stages of the disease, as shown in our patients. PCDFs now appear to be the main causal agents in yusho. Rats given PCDFs showed necrosis of the Clara cells in bronchioles and marked thymus atrophy, while few such changes were noted in rats given PCBs. Therefore, further examination is needed for the difference of the toxic effects between two compounds.

Accumulation of a commercial polychlorinated biphenyl mixture (Aroclor 1016) in adult rhesus monkeys and their nursing infants

Female rhesus monkeys (24) were divided into 3 groups and fed diets calculated to contain 1.0, 0.25 or 0 parts per million (ppm) of a commercial mixture of polychlorinated biphenyls (PCBs), Aroclor 1016. The animals consumed a calculated total of 18.1 +/- 3.1, 4.5 +/- 0.6 and 0 mg Aroclor 1016/kg of body weight over the 87 +/- 9 week experimental period. All animals were bred, conceived and experienced uncomplicated pregnancies. The birth weights of the infants born to females receiving the 1.0 ppm PCB diets were significantly less than those of the control infants. There was a positive relationship between the levels of Aroclor 1016 in the tissues and the dose administered in the diets. Aroclor 1016 content of infant tissues was consistent with maternal adipose tissue PCB levels. The content of Aroclor 1016 in the milk fat of the animals more closely approximated that in the individual's adipose tissue than in the serum. At weaning, the mesenteric fat of the experimental infants contained concentrations of Aroclor 1016 which were 4-7 times that found in the mothers. Analyses of the tissues and fluids of the experimental animals demonstrated accumulation of PCB isomerides. The number of isomerides present and the ratio of those detected differed between adult and infants as well as between milk and serum. After weaning, the pattern of Aroclor 1016 isomerides present in the infants' adipose was similar to that observed at weaning although the concentrations had decreased.

Polychlorinated biphenyl (PCB) toxicity in adult cynomolgus monkeys (M. fascicularis): a pilot study

Aroclor 1254 and Aroclor 1248, at doses of 11.7 and 4.7 mg/kg body weight (equivalent to 5 and 2 mg/kg/day), were given 3 days per week to groups of cynomolgus monkeys, and caused weight loss, fingernail loss, facial edema, epiphora, and death. Blood and adipose tissue PCB concentrations rose with the length of treatment. Tissue concentrations in blood, adipose tissue, liver and kidneys were highest in monkeys treated with Aroclor 1254, reflecting dose differences. There was considerable variation, both within and between groups, in hematologic responses to PCB treatment. Aroclor 1254-treated monkeys had depressed and weakly responsive erythropoiesis. Aroclor 1248-treated monkeys had active but ineffective or depressed erythropoiesis with severe macrocytic or moderate normocytic anemia. Biochemical determination of blood serum constituents revealed treatment and time-related trends towards hypoalbuminemia and increased alkaline phosphatase, serum glutamic oxaloacetic transaminase, serum glutamic pyruvic transaminase, lactic dehydrogenase, cholesterol, triglycerides, total bilirubin and direct bilirubin values. Pathologic lesions common in both Aroclor groups were dilatation of meibomian glands duct; mucinous hyperplasia of the gastric mucosa; atrophy and loss of germinal centers in the splenic and other lymphoid follicles; enlargement, fatty degeneration, and necrosis of hepatocytes; bile duct and gall bladder epithelial cell hypertrophy and hyperplasia; and thyroid aberrations in follicular cell size and number of intracytoplasmic lysosomes. Lesions seen exclusively in an Aroclor 1254-treated monkey were widespread mucinous metaplasia and hyperplasia of the fundic mucosa. The results suggest that in general, cynomolgus monkeys may be more refractory or less susceptible to PCB toxicity than rhesus monkeys and, that Aroclor 1248 may be more toxic than Aroclor 1254.