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Lassandro G, Picchi SG, Corvino A, Massimo C, Tamburrini S, Vanore L, Urraro G, Russo G, Lassandro F. Noninfectious Granulomatous Lung Disease: Radiological Findings and Differential Diagnosis. J Pers Med 2024; 14:134. [PMID: 38392568 PMCID: PMC10890318 DOI: 10.3390/jpm14020134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2023] [Revised: 01/17/2024] [Accepted: 01/21/2024] [Indexed: 02/24/2024] Open
Abstract
Granulomatous lung diseases (GLDs) are a heterogeneous group of pathological entities that can have different clinical presentations and outcomes. Granulomas are histologically defined as focal aggregations of activated macrophages, Langerhans cells, and lymphocytes, and may form in the lungs when the immune system cannot eliminate a foreign antigen and attempts to barricade it. The diagnosis includes clinical evaluation, laboratory testing, and radiological imaging, which especially consists of high-resolution computed tomography. bronchoalveolar lavage, transbronchial needle aspiration or cryobiopsy, positron emission tomography, while genetic evaluation can improve the diagnostic accuracy. Differential diagnosis is challenging due to the numerous different imaging appearances with which GLDs may manifest. Indeed, GLDs include both infectious and noninfectious, and necrotizing and non-necrotizing granulomatous diseases and the imaging appearance of some GLDs may mimic malignancy, leading to confirmatory biopsy. The purposes of our review are to report the different noninfectious granulomatous entities and to show their various imaging features to help radiologists recognize them properly and make an accurate differential diagnosis.
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Affiliation(s)
- Giulia Lassandro
- Department of Radiology, Ospedale del Mare-ASL NA1 Centro, Via Enrico Russo 11, I-80147 Naples, Italy
| | - Stefano Giusto Picchi
- Department of Radiology, Ospedale del Mare-ASL NA1 Centro, Via Enrico Russo 11, I-80147 Naples, Italy
| | - Antonio Corvino
- Medical, Movement and Wellbeing Sciences Department, University of Naples "Parthenope", Via Medina 40, I-80133 Naples, Italy
| | - Candida Massimo
- Department of Radiology, Monaldi Hospital, A.O. Ospedali dei Colli, Via Leonardo Bianchi, I-80131 Naples, Italy
| | - Stefania Tamburrini
- Department of Radiology, Ospedale del Mare-ASL NA1 Centro, Via Enrico Russo 11, I-80147 Naples, Italy
| | - Laura Vanore
- Department of Radiology, Ospedale S. Anna e SS. Madonna della Neve, ASL NA3 Sud, Via Lenze, Boscotrecase, I-80042 Naples, Italy
| | - Giovanna Urraro
- Department of Radiology, Ospedale S. Anna e SS. Madonna della Neve, ASL NA3 Sud, Via Lenze, Boscotrecase, I-80042 Naples, Italy
| | - Giuseppe Russo
- General Direction for Health Management, ASL Napoli 3 Sud, Via Marconi, Torre del Greco, I-80059 Naples, Italy
| | - Francesco Lassandro
- Department of Radiology, Ospedale S. Anna e SS. Madonna della Neve, ASL NA3 Sud, Via Lenze, Boscotrecase, I-80042 Naples, Italy
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Spagnolo P, Ryerson CJ, Guler S, Feary J, Churg A, Fontenot AP, Piciucchi S, Udwadia Z, Corte TJ, Wuyts WA, Johannson KA, Cottin V. Occupational interstitial lung diseases. J Intern Med 2023; 294:798-815. [PMID: 37535448 DOI: 10.1111/joim.13707] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/05/2023]
Abstract
Millions of workers are exposed to substances known to cause occupational interstitial lung diseases (ILDs), particularly in developing countries. However, the burden of the disease is likely to be underestimated due to under-recognition, under-reporting or both. The diagnosis of occupational ILD requires a high level of suspicion and a thorough occupational history, as occupational and non-occupational ILDs may be clinically, functionally and radiologically indistinguishable, leading to delayed diagnosis and inappropriate management. A potential occupational aetiology should always be considered in the differential diagnosis of ILD, as removal from the workplace exposure, with or without treatment, is a key therapeutic intervention and may lead to significant improvement. In this article, we provide an overview of the 'traditional' inorganic dust-related ILDs but also address idiopathic pulmonary fibrosis and the immunologically mediated chronic beryllium disease, sarcoidosis and hypersensitivity pneumonitis, with emphasis on the importance of surveillance and prevention for reducing the burden of these conditions. To this end, health-care professionals should be specifically trained about the importance of occupational exposures as a potential cause of ILD.
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Affiliation(s)
- Paolo Spagnolo
- Respiratory, Disease Unit, Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, Padova, Italy
| | - Christopher J Ryerson
- Department of Medicine, St. Paul's Hospital, University of British Columbia and Centre for Heart Lung Innovation, Vancouver, Canada
| | - Sabina Guler
- Department of Pulmonary Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Johanna Feary
- Department of Occupational and Environmental Medicine, Royal Brompton Hospital, London, UK
- National Heart and Lung Institute, Imperial College London, London, UK
| | - Andrew Churg
- Department of Pathology, University of British Columbia, Vancouver, British Columbia, Canada
| | - Andrew P Fontenot
- Department of Medicine, University of Colorado Anschutz Medical Campus Aurora, Aurora, Colorado, USA
- Department of Immunology and Microbiology, University of Colorado Anschutz Medical Campus Aurora, Aurora, Colorado, USA
| | - Sara Piciucchi
- Department of Radiology, G.B. Morgagni Hospital/University of Bologna, Forlì, Italy
| | - Zarir Udwadia
- Hinduja Hospital and Research Center, Breach Candy Hospital, Mumbai, Maharashtra, India
| | - Tamera J Corte
- NHMRC Centre of Research Excellence in Pulmonary Fibrosis, Camperdown, New South Wales, Australia
- Department of Respiratory Medicine, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia
| | - Wim A Wuyts
- Unit for Interstitial Lung Diseases, University of Leuven, Leuven, Belgium
| | - Kerri A Johannson
- Department of Medicine, University of Calgary, Calgary, Alberta, Canada
- Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada
| | - Vincent Cottin
- Department of Respiratory Medicine, National Reference Coordinating Centre for Rare Pulmonary Diseases, Louis Pradel Hospital, Hospices Civils de Lyon, Lyon, France
- Université de Lyon, Université Claude Bernard Lyon 1, UMR754, IVPC, Lyon, France
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Ganesan N, Ronsmans S, Hoet P. Comparing [ 3H] thymidine LPT and CFSE assay to assess lymphocyte proliferation in beryllium-exposed sarcoidosis patients. Heliyon 2023; 9:e19242. [PMID: 37662805 PMCID: PMC10471999 DOI: 10.1016/j.heliyon.2023.e19242] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Revised: 06/27/2023] [Accepted: 08/16/2023] [Indexed: 09/05/2023] Open
Abstract
The detection of antigen specific lymphocyte responses plays a vital role in the diagnosis of various diseases. Beryllium-specific [3H] thymidine lymphocyte proliferation test (LPT) is regarded as a gold standard in identifying chronic beryllium disease (CBD) cases. Alternatively, flow cytometric based carboxyfluorescein succinimidyl ester (CFSE) assay, has several benefits as opposed to LPT, since it further permits both phenotypical characterization and functional analysis of proliferating lymphocyte subsets. The suitability of both LPT and CFSE assay to therefore detect beryllium sensitivity in a group of Be-exposed sarcoidosis patients with suspected beryllium exposure, was evaluated in this study. The clinical relevance of the test responses, expressed as stimulation indices (SI), were additionally compared on a group and individual level. Agreement in clinical interpretation of the test responses between both methods was observed in 4 out of 5 recruited patients, when considering total lymphocyte population i.e., CD3+ and CD19+-cells combined, on day 7 and with CFSE-SI >1.5, when compared with LPT-SI >2.5. Variability in responses to beryllium was additionally evaluated in Be-exposed sarcoidosis patients and compared with healthy controls. To conclude, both LPT and CFSE assay are suitable assays to detect Be sensitivity in Be-exposed sarcoidosis patients. At the same time, flow cytometric based CFSE assay has the edge over LPT in identifying the relevant proliferating lymphocyte populations. As such, when comparing two or more methods, factors that contribute to assay variability such as timepoints, lymphocyte subsets and number of replicates should always be accounted for.
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Affiliation(s)
- Nirosha Ganesan
- Laboratory of Toxicology, Unit of Environment & Health, Department of Public Health and Primary Care, KU Leuven, Leuven, Belgium
- Laboratory of Respiratory Diseases and Thoracic Surgery (BREATHE), KU Leuven, Leuven, Belgium
| | - Steven Ronsmans
- Laboratory of Toxicology, Unit of Environment & Health, Department of Public Health and Primary Care, KU Leuven, Leuven, Belgium
- Clinic for Occupational and Environmental Medicine, Department of Respiratory Diseases, University Hospitals Leuven, Leuven, Belgium
| | - Peter Hoet
- Laboratory of Toxicology, Unit of Environment & Health, Department of Public Health and Primary Care, KU Leuven, Leuven, Belgium
- Laboratory of Respiratory Diseases and Thoracic Surgery (BREATHE), KU Leuven, Leuven, Belgium
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Feary J, Lindstrom I, Huntley CC, Suojalehto H, de la Hoz RE. Occupational lung disease: when should I think of it and why is it important? Breathe (Sheff) 2023; 19:230002. [PMID: 37377854 PMCID: PMC10292794 DOI: 10.1183/20734735.0002-2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Accepted: 04/05/2023] [Indexed: 06/29/2023] Open
Abstract
Exposure to toxic inhalants in the workplace has the potential to cause (in susceptible individuals) almost any major type of lung disease, such as asthma, COPD and interstitial lung diseases. Patients with occupational lung disease will often present to or will be managed by respiratory specialists without training in occupational respiratory medicine, and patients (or their clinicians) may not identify a link between their disease and their current or a past job. Without an awareness of the range of different occupational lung diseases that exist, their similarity to their non-occupational counterparts, and without directed questioning, these conditions may go unidentified. Patients with occupational lung diseases are often in lower paid work and are disproportionally affected by health inequality. Both clinical and socioeconomic outcomes generally improve if cases are identified early. This allows appropriate advice to be given about the risks of ongoing exposure, clinical management, occupational mobility and, in some cases, eligibility for legal compensation. As respiratory professionals, it is important that these cases are not missed, and if needed, are discussed with a physician with specialised expertise. Here we describe some of the most common occupational lung diseases and outline the diagnostic and treatment approach.
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Affiliation(s)
- Johanna Feary
- National Heart and Lung Institute, Imperial College London, London, UK
- Royal Brompton Hospital, London, UK
| | - Irmeli Lindstrom
- Finnish Institute of Occupational Health, Occupational Health Department, Helsinki, Finland
| | - Christopher C. Huntley
- Occupational and Interstitial Lung Disease Services, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - Hille Suojalehto
- Finnish Institute of Occupational Health, Occupational Health Department, Helsinki, Finland
| | - Rafael E. de la Hoz
- Division of Occupational and Environmental Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA
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5
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Valeyre D, Brauner M, Bernaudin JF, Carbonnelle E, Duchemann B, Rotenberg C, Berger I, Martin A, Nunes H, Naccache JM, Jeny F. Differential diagnosis of pulmonary sarcoidosis: a review. Front Med (Lausanne) 2023; 10:1150751. [PMID: 37250639 PMCID: PMC10213276 DOI: 10.3389/fmed.2023.1150751] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Accepted: 04/24/2023] [Indexed: 05/31/2023] Open
Abstract
Diagnosing pulmonary sarcoidosis raises challenges due to both the absence of a specific diagnostic criterion and the varied presentations capable of mimicking many other conditions. The aim of this review is to help non-sarcoidosis experts establish optimal differential-diagnosis strategies tailored to each situation. Alternative granulomatous diseases that must be ruled out include infections (notably tuberculosis, nontuberculous mycobacterial infections, and histoplasmosis), chronic beryllium disease, hypersensitivity pneumonitis, granulomatous talcosis, drug-induced granulomatosis (notably due to TNF-a antagonists, immune checkpoint inhibitors, targeted therapies, and interferons), immune deficiencies, genetic disorders (Blau syndrome), Crohn's disease, granulomatosis with polyangiitis, eosinophilic granulomatosis with polyangiitis, and malignancy-associated granulomatosis. Ruling out lymphoproliferative disorders may also be very challenging before obtaining typical biopsy specimen. The first step is an assessment of epidemiological factors, notably the incidence of sarcoidosis and of alternative diagnoses; exposure to risk factors (e.g., infectious, occupational, and environmental agents); and exposure to drugs taken for therapeutic or recreational purposes. The clinical history, physical examination and, above all, chest computed tomography indicate which differential diagnoses are most likely, thereby guiding the choice of subsequent investigations (e.g., microbiological investigations, lymphocyte proliferation tests with metals, autoantibody assays, and genetic tests). The goal is to rule out all diagnoses other than sarcoidosis that are consistent with the clinical situation. Chest computed tomography findings, from common to rare and from typical to atypical, are described for sarcoidosis and the alternatives. The pathology of granulomas and associated lesions is discussed and diagnostically helpful stains specified. In some patients, the definite diagnosis may require the continuous gathering of information during follow-up. Diseases that often closely mimic sarcoidosis include chronic beryllium disease and drug-induced granulomatosis. Tuberculosis rarely resembles sarcoidosis but is a leading differential diagnosis in regions of high tuberculosis endemicity.
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Affiliation(s)
- Dominique Valeyre
- Pulmonology Department, Groupe Hospitalier Paris Saint Joseph, Paris, France
- INSERM UMR 1272, Sorbonne University Paris-Nord, Paris, France
| | - Michel Brauner
- Radiology Department, Avicenne University Hospital, Bobigny, France
| | - Jean-François Bernaudin
- INSERM UMR 1272, Sorbonne University Paris-Nord, Paris, France
- Faculté de Médecine, Sorbonne University Paris, Paris, France
| | | | - Boris Duchemann
- INSERM UMR 1272, Sorbonne University Paris-Nord, Paris, France
- Thoracic and Oncology Department, Avicenne University Hospital, Bobigny, France
| | - Cécile Rotenberg
- INSERM UMR 1272, Sorbonne University Paris-Nord, Paris, France
- Pulmonology Department, Avicenne University Hospital, Bobigny, France
| | - Ingrid Berger
- Pulmonology Department, Groupe Hospitalier Paris Saint Joseph, Paris, France
| | - Antoine Martin
- Pathology Department, Avicenne University Hospital, Bobigny, France
| | - Hilario Nunes
- INSERM UMR 1272, Sorbonne University Paris-Nord, Paris, France
- Pulmonology Department, Avicenne University Hospital, Bobigny, France
| | - Jean-Marc Naccache
- Pulmonology Department, Groupe Hospitalier Paris Saint Joseph, Paris, France
| | - Florence Jeny
- INSERM UMR 1272, Sorbonne University Paris-Nord, Paris, France
- Pulmonology Department, Avicenne University Hospital, Bobigny, France
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6
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Toupal L, Jílek R, Kubásek T, Vála L. Beryllium dust generation caused by HHF tests. Fusion Engineering and Design 2023. [DOI: 10.1016/j.fusengdes.2023.113461] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
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7
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Buchner MR, Müller M. Handling Beryllium, the Safe Way. ACS Chem Health Saf 2023. [DOI: 10.1021/acs.chas.3c00003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/11/2023]
Affiliation(s)
- Magnus R. Buchner
- Fachbereich Chemie, Philipps-Universität Marburg, 35032 Marburg, Germany
| | - Matthias Müller
- Fachbereich Chemie, Philipps-Universität Marburg, 35032 Marburg, Germany
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8
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Hiller J, Naglav-Hansen D, Drexler H, Göen T. Human urinary and blood toxicokinetics of beryllium after accidental exposure. J Trace Elem Med Biol 2023; 76:127125. [PMID: 36623420 DOI: 10.1016/j.jtemb.2023.127125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Revised: 12/02/2022] [Accepted: 01/03/2023] [Indexed: 01/06/2023]
Abstract
PURPOSE Beryllium is known to have adverse health effects and is classified as carcinogenic to humans. However, data on systemic beryllium exposure in humans are rare and especially human toxicokinetics are largely uncharted. As such, the first reported multi-annual course of blood and urine concentrations after a high exposure scenario provides important new insights. METHODS For a medical follow-up biomonitoring samples were collected for 56 months from a male subject after an accidental and multi-faceted high exposure. Sampling started on day 2 post-exposure for urine and day 147 for blood. The samples were analyzed by inductively coupled mass spectrometry (ICP-MS) and plotted longitudinally as a function of time. Terminal half-lives were calculated assuming a first-order elimination process. MAIN FINDINGS Both matrices showed highly increased initial concentrations (about 100-fold), despite the 147-day delay in blood sampling, and a marked decline over time. In urine, a two-phase excretion process was suspected based on the longitudinal data. Calculations gave terminal half-lives of 117.5 days and 666.5 days for phases 1 and 2, respectively. Blood kinetics called for a terminal half-life of 103.5 days. Elimination kinetics in blood and urine were comparable, simultaneously gathered samples showed an excellent correlation (R² = 0.985). PRINCIPAL CONCLUSIONS The long-term follow-up after a high initial exposure to beryllium provides the first detailed insights into the elimination course of systemically available beryllium in humans. Conform kinetics of beryllium in urine and blood and the strong correlation between both parameters indicate high data validity and support the good representation of the current systemically available beryllium by urine and blood concentration in humans. The relatively long terminal half-lives in both matrices suggest a possible accumulation in humans in case of repeated exposures.
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Affiliation(s)
- Julia Hiller
- Institute and Outpatient Clinic of Occupational, Social, and Environmental Medicine, Friedrich-Alexander-Universität Erlangen-Nürnberg, Henkestr. 9-11, Erlangen, Germany.
| | | | - Hans Drexler
- Institute and Outpatient Clinic of Occupational, Social, and Environmental Medicine, Friedrich-Alexander-Universität Erlangen-Nürnberg, Henkestr. 9-11, Erlangen, Germany.
| | - Thomas Göen
- Institute and Outpatient Clinic of Occupational, Social, and Environmental Medicine, Friedrich-Alexander-Universität Erlangen-Nürnberg, Henkestr. 9-11, Erlangen, Germany.
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9
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Liu X, Li G, Chen S, Jin H, Liu X, Zhang L, Zhang Z. Hydrogen sulfide alleviates beryllium sulfate-induced ferroptosis and ferritinophagy in 16HBE cells. J Appl Toxicol 2023. [PMID: 36843388 DOI: 10.1002/jat.4453] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2022] [Revised: 02/14/2023] [Accepted: 02/18/2023] [Indexed: 02/28/2023]
Abstract
Beryllium sulfate (BeSO4 ) can result to lung injuries, such as leading to lipid peroxidation and autophagy, and the treatment of beryllium disease has not been well improved. Ferroptosis is a regulated cell death process driven by iron-dependent and lipid peroxidation, while ferritinophagy is a process mediated by nuclear receptor coactivator 4 (NCOA4), combined with ferritin heavy chain 1 (FTH1) degradation and release Fe2+ , which regulated intracellular iron metabolism and ferroptosis. Hydrogen sulfide (H2 S) has the effects of antioxidant, antiautophagy, and antiferroptosis. This study aimed to investigate the effect of H2 S on BeSO4 -induced ferroptosis and ferritinophagy in 16HBE cells and the underlying mechanism. In this study, BeSO4 -induced 16HBE cell injury model was established based on cellular level and pretreated with deferoxamine (DFO, a ferroptosis inhibitor), sodium hydrosulfide (NaHS, a H2 S donor), or NCOA4 siRNA and, subsequently, performed to detect the levels of lipid peroxidation and Fe2+ and the biomarkers of ferroptosis and ferritinophagy. More importantly, our research found that DFO, NaHS, or NCOA4 siRNA alleviated BeSO4 -induced ferroptosis and ferritinophagy by decreasing the accumulation of Fe2+ and lipid peroxides. Furthermore, the relationship between ferroptosis, ferritinophagy, H2 S, and beryllium disease is not well defined; therefore, our research is innovative. Overall, our results provided a new theoretical basis for the prevention and treatment of beryllium disease and suggested that the application of H2 S, blocking ferroptosis, and ferritinophagy may be a potential therapeutic direction for the prevention and treatment of beryllium disease.
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Affiliation(s)
- Xiuli Liu
- Department of Preventive Medicine, School of public health, Hengyang Medical School, University of South China, Hengyang, Hunan, 421001, China
- Hunan Province Key Laboratory of Typical Environmental Pollution and Health Hazards, Hengyang Medical School, University of South China, Hengyang, Hunan, 421001, China
| | - Guilan Li
- Department of Preventive Medicine, School of public health, Hengyang Medical School, University of South China, Hengyang, Hunan, 421001, China
- Hunan Province Key Laboratory of Typical Environmental Pollution and Health Hazards, Hengyang Medical School, University of South China, Hengyang, Hunan, 421001, China
| | - Shaoxiong Chen
- Department of Preventive Medicine, School of public health, Hengyang Medical School, University of South China, Hengyang, Hunan, 421001, China
- Hunan Province Key Laboratory of Typical Environmental Pollution and Health Hazards, Hengyang Medical School, University of South China, Hengyang, Hunan, 421001, China
| | - Huiyun Jin
- Department of Preventive Medicine, School of public health, Hengyang Medical School, University of South China, Hengyang, Hunan, 421001, China
- Hunan Province Key Laboratory of Typical Environmental Pollution and Health Hazards, Hengyang Medical School, University of South China, Hengyang, Hunan, 421001, China
| | - Xiaodong Liu
- Department of Preventive Medicine, School of public health, Hengyang Medical School, University of South China, Hengyang, Hunan, 421001, China
- Hunan Province Key Laboratory of Typical Environmental Pollution and Health Hazards, Hengyang Medical School, University of South China, Hengyang, Hunan, 421001, China
| | - Linfang Zhang
- Department of Preventive Medicine, School of public health, Hengyang Medical School, University of South China, Hengyang, Hunan, 421001, China
| | - Zhaohui Zhang
- Department of Preventive Medicine, School of public health, Hengyang Medical School, University of South China, Hengyang, Hunan, 421001, China
- Hunan Province Key Laboratory of Typical Environmental Pollution and Health Hazards, Hengyang Medical School, University of South China, Hengyang, Hunan, 421001, China
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Li L, Konigsberg IR, Bhargava M, Liu S, MacPhail K, Mayer A, Davidson EJ, Liao SY, Lei Z, Mroz PM, Fingerlin TE, Yang IV, Maier LA. Multiomic Signatures of Chronic Beryllium Disease Bronchoalveolar Lavage Cells Relate to T-Cell Function and Innate Immunity. Am J Respir Cell Mol Biol 2022; 67:632-640. [PMID: 35972918 PMCID: PMC9743181 DOI: 10.1165/rcmb.2022-0077oc] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Accepted: 08/16/2022] [Indexed: 12/15/2022] Open
Abstract
Chronic beryllium disease (CBD) is a Th1 granulomatous lung disease preceded by sensitization to beryllium (BeS). We profiled the methylome, transcriptome, and selected proteins in the lung to identify molecular signatures and networks associated with BeS and CBD. BAL cell DNA and RNA were profiled using microarrays from CBD (n = 30), BeS (n = 30), and control subjects (n = 12). BAL fluid proteins were measured using Olink Immune Response Panel proteins from CBD (n = 22) and BeS (n = 22) subjects. Linear models identified features associated with CBD, adjusting for covariation and batch effects. Multiomic integration methods identified correlated features between datasets. We identified 1,546 differentially expressed genes in CBD versus control subjects and 204 in CBD versus BeS. Of the 101 shared transcripts, 24 have significant cis relationships between gene expression and DNA methylation, assessed using expression quantitative trait methylation analysis, including genes not previously identified in CBD. A multiomic model of top DNA methylation and gene expression features demonstrated that the first component separated CBD from other samples and the second component separated control subjects from remaining samples. The top features on component one were enriched for T-lymphocyte function, and the top features on component two were enriched for innate immune signaling. We identified six differentially abundant proteins in CBD versus BeS, with two (SIT1 and SH2D1A) selected as important RNA features in the multiomic model. Our integrated analysis of DNA methylation, gene expression, and proteins in the lung identified multiomic signatures of CBD that differentiated it from BeS and control subjects.
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Affiliation(s)
- Li Li
- Division of Environmental and Occupational Health Sciences, Department of Medicine, and
- Division of Pulmonary and Critical Care Sciences
| | - Iain R. Konigsberg
- Division of Biomedical Informatics and Personalized Medicine, Department of Medicine, School of Medicine
| | - Maneesh Bhargava
- Pulmonary, Allergy, Critical Care and Sleep, Department of Medicine, University of Minnesota Medical School, Minneapolis, Minnesota
| | - Sucai Liu
- Division of Environmental and Occupational Health Sciences, Department of Medicine, and
| | - Kristyn MacPhail
- Division of Environmental and Occupational Health Sciences, Department of Medicine, and
| | - Annyce Mayer
- Division of Environmental and Occupational Health Sciences, Department of Medicine, and
- Department of Environmental and Occupational Health
| | - Elizabeth J. Davidson
- Division of Biomedical Informatics and Personalized Medicine, Department of Medicine, School of Medicine
| | - Shu-Yi Liao
- Division of Environmental and Occupational Health Sciences, Department of Medicine, and
- Division of Pulmonary and Critical Care Sciences
- Department of Environmental and Occupational Health
| | - Zhe Lei
- Division of Environmental and Occupational Health Sciences, Department of Medicine, and
| | - Peggy M. Mroz
- Division of Environmental and Occupational Health Sciences, Department of Medicine, and
| | - Tasha E. Fingerlin
- Department of Immunology and Genomic Medicine, National Jewish Health, Denver, Colorado
- Department of Biostatistics and Bioinformatics, and
| | - Ivana V. Yang
- Division of Pulmonary and Critical Care Sciences
- Division of Biomedical Informatics and Personalized Medicine, Department of Medicine, School of Medicine
- Department of Epidemiology, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, Colorado; and
| | - Lisa A. Maier
- Division of Environmental and Occupational Health Sciences, Department of Medicine, and
- Division of Pulmonary and Critical Care Sciences
- Department of Environmental and Occupational Health
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11
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Burkhardt F, Pieralli S, Bergfeldt T, Wemken G, Wesemann C, Stolz D, Spies BC. Elemental analysis of contemporary dental materials regarding potential beryllium content. Sci Rep 2022; 12:19119. [PMID: 36351929 DOI: 10.1038/s41598-022-21068-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Accepted: 09/22/2022] [Indexed: 11/10/2022] Open
Abstract
Exposure to beryllium (Be) can lead to lung pathologies, such as chronic beryllium disease (CBD). This occupational illness has been more prevalent among dental technicians compared to the non-exposed population. Although most manufacturers state that dental materials are Be-free, this prevalence raises the question of whether the materials are completely devoid of Be-traces. Thus, the objective of the present study was to analyze the elemental composition, with emphasis on Be, of a wide range of commercially available dental materials frequently used by dental laboratories. Samples of 32 different materials were collected and analyzed using inductively coupled plasma-optical emission spectrometry (ICP-OES) and X-ray fluorescence spectroscopy. The results showed that the Be content was below the limit of quantification in all included samples (< 0.00005 mass-%). Therefore, it can be concluded that possible traces of Be were below clinical relevance in dental materials. Exposure of dental technicians to alternative Be sources should be further evaluated.
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Ganz M, Gross C, Gehringer F, Wiech T, Ambach A, Mertens PR, Schiefer J. „Stein‑, Bein- und Magenpein“. Nephrologie 2022. [PMCID: PMC9223257 DOI: 10.1007/s11560-022-00586-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Affiliation(s)
- M. Ganz
- Universitätsklinik für Nieren- und Hochdruckkrankheiten, Diabetologie und Endokrinologie, Otto-von-Guericke-Universität Magdeburg, Leipziger Str. 44, 39120 Magdeburg, Deutschland
| | - C. Gross
- Universitätsklinik für Nieren- und Hochdruckkrankheiten, Diabetologie und Endokrinologie, Otto-von-Guericke-Universität Magdeburg, Leipziger Str. 44, 39120 Magdeburg, Deutschland
| | - F. Gehringer
- Universitätsklinik für Nieren- und Hochdruckkrankheiten, Diabetologie und Endokrinologie, Otto-von-Guericke-Universität Magdeburg, Leipziger Str. 44, 39120 Magdeburg, Deutschland
| | - T. Wiech
- Institut für Pathologie, Universitätsklinikum Hamburg-Eppendorf, Hamburg, Deutschland
| | - A. Ambach
- Universitätshautklinik, Otto-von-Guericke-Universität Magdeburg, Magdeburg, Deutschland
| | - P. R. Mertens
- Universitätsklinik für Nieren- und Hochdruckkrankheiten, Diabetologie und Endokrinologie, Otto-von-Guericke-Universität Magdeburg, Leipziger Str. 44, 39120 Magdeburg, Deutschland
| | - J. Schiefer
- Universitätsklinik für Nieren- und Hochdruckkrankheiten, Diabetologie und Endokrinologie, Otto-von-Guericke-Universität Magdeburg, Leipziger Str. 44, 39120 Magdeburg, Deutschland
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Ryan SM, Mroz MM, Herzog EL, Ryu C, Fingerlin TE, Maier LA, Gulati M. Occupational and environmental exposures in the Genomic Research in Alpha-1 Antitrypsin Deficiency and Sarcoidosis (GRADS) study. Respir Med 2022; 200:106923. [PMID: 35932543 DOI: 10.1016/j.rmed.2022.106923] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Revised: 05/25/2022] [Accepted: 06/19/2022] [Indexed: 11/17/2022]
Abstract
INTRODUCTION Sarcoidosis is a granulomatous disorder thought to be caused by exposures in genetically susceptible individuals. This study investigated whether specific exposures were associated with different sarcoidosis phenotypes. METHODS Extensive demographic, occupational and environmental exposure data was analyzed from subjects enrolled in the NHLBI Genomic Research in Alpha-1 Antitrypsin Deficiency and Sarcoidosis (GRADS) study. RESULTS In patients with sarcoidosis, radiation exposure was significantly associated with an increased risk of cardiac sarcoidosis versus non-cardiac sarcoidosis. No exposures were significantly associated with pulmonary only disease versus extrapulmonary disease with or without pulmonary involvement, Scadding Stage II/III/IV versus Scadding Stage 0/I, acute or remitting disease versus non-acute or non-remitting disease, nor chronic versus non-chronic disease. Although not reaching statistically significance after adjustment for multiple comparisons, there were a number of exposures associated with specific disease phenotypes, including exposures where relationships to sarcoidosis have previously been described such as rural exposures and pesticide exposures. CONCLUSIONS Radiation exposure may be a risk factor for cardiac sarcoidosis. Other exposures may also be associated with specific phenotypes and should be further explored. The study was limited by small groups of exposed subjects for individual exposures and multiple comparisons. The development of novel and innovative exposure assessment tools is needed.
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Affiliation(s)
- Sarah M Ryan
- Colorado School of Public Health, Department of Biostatistics and Informatics, USA
| | - Margaret M Mroz
- National Jewish Health, Department of Medicine (Division of Environmental and Occupational Health Sciences), USA
| | - Erica L Herzog
- Yale University School of Medicine, Department of Medicine (Pulmonary, Critical Care and Sleep), USA
| | - Changwan Ryu
- Yale University School of Medicine, Department of Medicine (Pulmonary, Critical Care and Sleep), USA
| | - Tasha E Fingerlin
- National Jewish Health, Department of Immunology and Genomic Medicine, USA
| | - Lisa A Maier
- National Jewish Health, Department of Medicine (Division of Environmental and Occupational Health Sciences), USA; University of Colorado, Department of Medicine, USA
| | - Mridu Gulati
- Yale University School of Medicine, Department of Medicine (Pulmonary, Critical Care and Sleep), USA.
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Cloeren M, Dement J, Gaitens J, Hines S, Diaz L, Tembunde Y, Cranford K, Shorter J, Mosier T, Ringen K. Beryllium disease among construction trade workers at Department of Energy nuclear sites: A follow-up. Am J Ind Med 2022; 65:708-720. [PMID: 35833586 DOI: 10.1002/ajim.23411] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Revised: 06/08/2022] [Accepted: 06/15/2022] [Indexed: 11/11/2022]
Abstract
BACKGROUND Construction workers at U.S. Department of Energy (DOE) nuclear weapons facilities are screened to identify DOE-related occupational illnesses, including beryllium sensitization (BeS) and chronic beryllium disease (CBD). The study objectives were to estimate beryllium disease risks and the CBD claims acceptance rate in the energy workers' benefits program. METHODS Workers diagnosed with BeS via beryllium lymphocyte proliferation test (BeLPT) included in screening examinations were interviewed about subsequent diagnosis of CBD. We estimated the proportion who developed CBD based on the ratio of CBD cases, based on self-reported compensation claim status, to all workers with BeS interviewed. We used stratified analyses to explore trends in disease frequency by age, race, sex, DOE employment duration, site, trade group, and cigarette smoking history. RESULTS Between 1998 and 2020, 21,854 workers received a BeLPT; 262 (1.20%) had BeS (two abnormals or one abnormal plus one borderline test); 212 (0.97%) had a single abnormal BeLPT. Of 177 BeS workers interviewed, 35 (19.8%) reported an accepted CBD compensation claim. The claims acceptance rate among BeS workers increased with years of DOE employment, from 8.4% with <5 years to 33.3% for >25 or more years. Five of 68 interviewed workers with a single positive BeLPT reported CBD claim acceptance; an additional CBD case was confirmed by chart review (8.8%). CONCLUSIONS Years of DOE work predict the risk of developing CBD among those sensitized and getting a claim for CBD accepted. Ongoing surveillance and increased awareness of the risk of beryllium exposure and CBD as an occupational disease among construction workers are needed.
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Affiliation(s)
- Marianne Cloeren
- Division of Occupational and Environmental Medicine, University of Maryland School of Medicine, Baltimore, Maryland, USA
| | - John Dement
- Division of Occupational and Environmental Medicine, Duke University Medical Center, Durham, North Carolina, USA
| | - Joanna Gaitens
- Division of Occupational and Environmental Medicine, University of Maryland School of Medicine, Baltimore, Maryland, USA
| | - Stella Hines
- Division of Occupational and Environmental Medicine, University of Maryland School of Medicine, Baltimore, Maryland, USA
| | - Liliana Diaz
- Division of Occupational and Environmental Medicine, University of Maryland School of Medicine, Baltimore, Maryland, USA
| | - Yazmeen Tembunde
- Division of Occupational and Environmental Medicine, University of Maryland School of Medicine, Baltimore, Maryland, USA
| | - Kim Cranford
- Zenith American Solutions, Covina, California, USA
| | | | - Terry Mosier
- Zenith American Solutions, Covina, California, USA
| | - Knut Ringen
- Center for Construction Research and Training, Silver Spring, Maryland, USA
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15
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Atif SM, Mack DG, Martin AK, Fontenot AP. Protective role of tissue-resident regulatory T cells in a murine model of beryllium-induced disease. JCI Insight 2022; 7:156098. [PMID: 35819849 PMCID: PMC9462505 DOI: 10.1172/jci.insight.156098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Accepted: 07/07/2022] [Indexed: 11/17/2022] Open
Abstract
CD4+ T cells drive the immunopathogenesis of chronic beryllium disease (CBD), and their recruitment to the lung heralds the onset of granulomatous inflammation. We have shown that regulatory CD4+ T cells (Tregs) control granuloma formation in an HLA-DP2 transgenic (Tg) model of CBD. In these mice, Be oxide (BeO) exposure resulted in the accumulation of three distinct CD4+ T cell subsets in the lung with the majority of tissue-resident memory cells expressing FoxP3. The amount of Be regulated the number of total and antigen-specific CD4+ T cells and Tregs in the lungs of HLA-DP2 Tg mice. Depletion of Tregs increased the number of IFN-γ-producing CD4+ T cells and enhanced lung injury while mice treated with IL2/αIL-2 complexes had increased Tregs and reduced inflammation and Be-responsive T cells in the lung. BeO-experienced resident Tregs suppressed anti-CD3-induced proliferation of CD4+ T cells in a contact-dependent manner. CLTLA-4 and ICOS blockade as well as addition of LPS to BeO-exposed mice increased the Teff/Treg ratio and enhanced lung injury. Collectively, these data show that the protective role of tissue-resident Tregs is dependent on quantity of Be exposure and is overcome by blocking immune regulatory molecules or additional environmental insults.
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Affiliation(s)
- Shaikh M Atif
- Department of Medicine, University of Colorado Anschutz Medical Campus, Auroroa, United States of America
| | - Douglas G Mack
- Department of Medicine, University of Colorado Anschutz Medical Campus, Auroroa, United States of America
| | - Allison K Martin
- Department of Medicine, University of Colorado Anschutz Medical Campus, Auroroa, United States of America
| | - Andrew P Fontenot
- Department of Medicine, University of Colorado Anschutz Medical Campus, Auroroa, United States of America
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Chen S, Sun Z, Deng W, Li G, Liu X, Zhang Z. Whole transcriptome analysis of long noncoding RNA in beryllium sulfate-treated 16HBE cells. Toxicol Appl Pharmacol 2022. [DOI: 10.1016/j.taap.2022.116097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Revised: 05/28/2022] [Accepted: 05/30/2022] [Indexed: 11/18/2022]
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17
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Soriano D, Quartucci C, Agarwal P, Müller-Quernheim J, Frye BC. Sarkoidose und Berylliose. Internist (Berl) 2022; 63:557-565. [DOI: 10.1007/s00108-022-01323-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/09/2022] [Indexed: 11/29/2022]
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Abstract
BACKGROUND Sarcoidosis is a non-caseating granulomatous disease, mostly affecting previously healthy persons in their fourth and fifth decade. In Belgium, there is a paucity of epidemiological data concerning sarcoidosis and it is unknown to what respect national data on sarcoidosis relates to the global epidemiology of the disease. OBJECTIVES In this cohort study we describe the patient population in an academic center of reference, serving both as a regional care center and a center for a tertiary referral. METHODS We collected epidemiological data among 234 consecutive patients consulting the outpatient sarcoidosis clinic during a two-year time period. We manually explored the electronic patient file for data retrieval. RESULTS Out of the 234 patients, 140 are male (60%) and 94 are female (40%) patients. Forced vital capacity showed a median decline of 2% during follow-up, whereas median diffusion capacity increased with 4% over the same period of time. Within our study cohort, we observed a preponderance in employment as construction workers (14%), the chemical industry (6%) and in the metal processing industry (6%). CONCLUSION The current study reports on epidemiological findings among the largest cohort of sarcoidosis patients in Belgium published to date. Graphical abstract [Figure: see text].
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Affiliation(s)
- Jolien De Ridder
- Department of Respiratory Diseases, University Hospitals Leuven, Leuven, Belgium
| | - Steven Ronsmans
- Department of Respiratory Diseases, University Hospitals Leuven, Leuven, Belgium
- Laboratory of Respiratory Diseases and Thoracic Surgery (BREATHE), Department CHROMETA, KU Leuven, Leuven, Belgium
| | - Steven Vanderschueren
- Clinical Department of General Internal Medicine, Research Department of Microbiology, Immunology and Transplantation, Laboratory of Clinical Infectious and Inflammatory Disorders, KU Leuven, Leuven, Belgium
| | - Wim Wuyts
- Department of Respiratory Diseases, University Hospitals Leuven, Leuven, Belgium
- Laboratory of Respiratory Diseases and Thoracic Surgery (BREATHE), Department CHROMETA, KU Leuven, Leuven, Belgium
| | - Jonas Yserbyt
- Department of Respiratory Diseases, University Hospitals Leuven, Leuven, Belgium
- Laboratory of Respiratory Diseases and Thoracic Surgery (BREATHE), Department CHROMETA, KU Leuven, Leuven, Belgium
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Cauci S, Tavano M, Curcio F, Francescato MP. Biomonitoring of urinary metals in athletes according to particulate matter air pollution before and after exercise. Environ Sci Pollut Res Int 2022; 29:26371-26384. [PMID: 34855175 PMCID: PMC8637506 DOI: 10.1007/s11356-021-17730-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Accepted: 11/20/2021] [Indexed: 06/13/2023]
Abstract
Exposure to air pollution during physical exercise is a health issue because fine particulate matter (dimension < 10 μm; PM10) includes several inhalable toxic metals. Body metal changes in athletes according to air pollution are poorly known. Urinary concentrations of 15 metals: beryllium (Be9), aluminum (Al27), vanadium (V51), chromium (Cr51 + Cr52), manganese (Mn55), cobalt (Co59), nickel (Ni61), copper (Cu63), zinc (Zn61), arsenic (As75), selenium (Se82), cadmium (Cd111 + Cd112), thallium (Tl125), lead (Pb207), and uranium (U238) were measured before and after ten 2-h training sessions in 8 non-professional Italian American-football players (18-28 years old, body mass index 24.2-33.6 kg/m2). Collectively, post-training sessions, urinary concentrations of As, Cd, Co, Cu, Mn, Ni, Pb, Se, Tl, and Zn were higher than pre-training sessions; Al, Be, Cr, and U did not change; conversely, V decreased. Subdividing training sessions according to air PM10 levels: low (< 20 μg/m3), medium (20-40 μg/m3), and high (> 40 μg/m3), pre-session and post-session urinary concentrations of Be, Cd, Cu, and Tl were significantly higher (p < 0.05) in more polluted days, whereas V concentrations were lower (p < 0.001). All the remaining metals were unaffected. We first showed that PM10 levels modulate urinary excretion of some toxic metals suggesting an effect of air pollution. The effects of toxic metals inhaled by athletes exercising in polluted air need further studies.
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Affiliation(s)
- Sabina Cauci
- Department of Medicine, School of Medicine, University of Udine, Piazzale Kolbe 4, 33100, Udine, Italy.
| | - Michael Tavano
- Department of Medicine, School of Medicine, University of Udine, Piazzale Kolbe 4, 33100, Udine, Italy
| | - Francesco Curcio
- Department of Medicine, School of Medicine, University of Udine, Piazzale Kolbe 4, 33100, Udine, Italy
- Clinical Analysis Laboratory, Department of Laboratory Medicine, Institute of Clinical Pathology, Santa Maria della Misericordia University-Hospital, 33100, Udine, Italy
| | - Maria Pia Francescato
- Department of Medicine, School of Medicine, University of Udine, Piazzale Kolbe 4, 33100, Udine, Italy
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Özdemir VT, Tuğaç HM, Arar Ö. Two-pot Oxidative Preparation of Dicarboxylic Acid Containing Cellulose
for the Removal of Beryllium (Be2+) from Aqueous Solution. CURR ANAL CHEM 2022. [DOI: 10.2174/1573411016999200719232310] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Background:
Cellulose is one of the most abundant, non-toxic, and renewable natural biopolymers. The presence
of hydroxyl groups in cellulose leads to further modification of it. Preparation and modification of cellulose-based sorbents
and their applications on water treatment gained traction in recent years.
Objective:
A low-cost and eco-friendly biosorbent was designed and fabricated by introducing the acetate functional groups
into cellulose for removing Beryllium (Be2+) from an aqueous solution. The so
rption of Be2+ on acetate containing cellulose
was evaluated for varying sorbent doses and initial solution pH values.
Method:
The sorbent was prepared by a two-step oxidation process. In the initial step, cellulose reacted with NaIO4 and
aldehyde groups were introduced to cellulose. In the second step, newly obtained aldehyde groups were oxidized to create
acetate groups.
Results:
The kinetics of the sorption process showed that Be2+ uptake reached equilibrium in 3 minutes. The sorption
isotherm was well fitted in the Langmuir model, and maximum sorption capacity was 4.54 mg/g. Moreover, the
thermodynamic studies demonstrated that Be2+ sorption is spontaneous and exothermic. Furthermore, the prepared sorbent
can be regenerated by using 0.1 M HCl or H2SO4 solutions.
Conclusion:
Removal of Be2+ is pH dependent and it is favorable at high solution pH. The kinetics of the prepared sorbent
is rapid and equilibrium attained in 3 minutes. The prepared sorbent can be regenerated with 0.1 M acid solution with >
99% efficiency.
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Affiliation(s)
- Vedat Tolga Özdemir
- Department of Chemistry, Faculty of Science, Ege University, Izmir 35040,Turkey
| | - Himmet Mert Tuğaç
- Department of Chemistry, Faculty of Science, Ege University, Izmir 35040,Turkey
| | - Özgür Arar
- Department of Chemistry, Faculty of Science, Ege University, Izmir 35040,Turkey
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Radenković S, Đorđević S. Spatial and electronic structures of BeB8 and MgB8. How far the analogy goes? Chemphyschem 2022; 23:e202200070. [PMID: 35188320 DOI: 10.1002/cphc.202200070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Revised: 02/18/2022] [Indexed: 11/09/2022]
Abstract
Doping of boron clusters with Be and its heavier alkaline-earth congener, Mg usually leads to complexes of different geometry and electronic structure. In this work we showed that both neutral BeB 8 and MgB 8 exhibit a singlet ground state umbrella-like form. In addition, the stability, electronic structure, and aromaticity of the target molecules were compared. The magnetically induced current densities showed that BeB 8 and MgB 8 are double aromatic systems: π and σ electrons induce strong diatropic currents. The current densities induced in the studied complexes are of very similar intensity, but with a different spatial distribution. The found differences between the current density patterns in BeB 8 and MgB 8 arise from the very nature of the bonding interactions between the M atom and B 8 fragment, as demonstrated through the energy decomposition analysis (EDA).
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Affiliation(s)
- Slavko Radenković
- University of Kragujevac: Univerzitet u Kragujevcu, Department of Chemistry, 12 Radoja Domanovića, P.O. Box 60, 34000, Kragujevac, SERBIA
| | - Slađana Đorđević
- University of Kragujevac: Univerzitet u Kragujevcu, Department of Chemistry, SERBIA
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Crooks J, Mroz MM, VanDyke M, McGrath A, Schuler C, McCanlies EC, Virji MA, Rosenman KD, Rossman M, Rice C, Monos D, Fingerlin TE, Maier LA. HLA-DPB1 E69 genotype and exposure in beryllium sensitisation and disease. Occup Environ Med 2022; 79:120-126. [PMID: 34535537 PMCID: PMC8760148 DOI: 10.1136/oemed-2021-107736] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Accepted: 08/09/2021] [Indexed: 02/03/2023]
Abstract
OBJECTIVES Human leukocyte antigen-DP beta 1 (HLA-DPB1) with a glutamic acid at the 69th position of the ß chain (E69) genotype and inhalational beryllium exposure individually contribute to risk of chronic beryllium disease (CBD) and beryllium sensitisation (BeS) in exposed individuals. This retrospective nested case-control study assessed the contribution of genetics and exposure in the development of BeS and CBD. METHODS Workers with BeS (n=444), CBD (n=449) and beryllium-exposed controls (n=890) were enrolled from studies conducted at nuclear weapons and primary beryllium manufacturing facilities. Lifetime-average beryllium exposure estimates were based on workers' job questionnaires and historical and industrial hygienist exposure estimates, blinded to genotype and case status. Genotyping was performed using sequence-specific primer-PCR. Logistic regression models were developed allowing for over-dispersion, adjusting for workforce, race, sex and ethnicity. RESULTS Having no E69 alleles was associated with lower odds of both CBD and BeS; every additional E69 allele increased odds for CBD and BeS. Increasing exposure was associated with lower odds of BeS. CBD was not associated with exposure as compared to controls, yet the per cent of individuals with CBD versus BeS increased with increasing exposure. No evidence of a gene-by-exposure interaction was found for CBD or BeS. CONCLUSIONS Risk of CBD increases with E69 allele frequency and increasing exposure, although no gene by environment interaction was found. A decreased risk of BeS with increasing exposure and lack of exposure response in CBD cases may be due to the limitations of reconstructed exposure estimates. Although reducing exposure may not prevent BeS, it may reduce CBD and the associated health effects, especially in those carrying E69 alleles.
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Affiliation(s)
- James Crooks
- Division of Biostatistics and Bioinformatics, National Jewish Health, Denver, Colorado, USA
| | - Margaret M Mroz
- Department of Medicine, National Jewish Health, Denver, Colorado, USA
| | - Michael VanDyke
- Department of Environmental & Occupational Health, Colorado School of Public Health, Aurora, Colorado, USA
| | - Alison McGrath
- Environmental Health and Safety, University of Colorado, Denver, Colorado, USA
| | - Christine Schuler
- DRDS/Field Studies Branch, U.S. National Institute for Occupational Safety and Health, Morgantown, West Virginia, USA
| | - Erin C McCanlies
- HELD, Health Effects Laboratory, National Institute for Occupational Safety and Health, Morgantown, West Virginia, USA
| | - M Abbas Virji
- DRDS/Field Studies Branch, U.S. National Institute for Occupational Safety and Health, Morgantown, West Virginia, USA
| | - Kenneth D Rosenman
- Department of Medicine, Michigan State University, East Lansing, Michigan, USA
| | - Milton Rossman
- Department of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Carol Rice
- Department of Environmental & Public Health Sciences, University of Cincinnati, Cincinnati, Ohio, USA
| | - Dimitri Monos
- Department of Pathology and Laboratory Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Tasha E Fingerlin
- Center for Genes, Environment & Health, National Jewish Health, Denver, Colorado, USA
| | - Lisa A Maier
- Department of Medicine, National Jewish Health, Denver, Colorado, USA
- Department of Medicine, University of Colorado, Denver, Colorado, USA
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Dhanaliwala AH, Sood S, Olivias C, Simpson S, Galperin-Aisenberg M, Torigian D, Zigmund B, Johnson CR, Patterson K, Miller WT. A CT Algorithm Can Elevate the Differential Diagnosis of Interstitial Lung Disease by Non-specialists to Equal That of Specialist Thoracic Radiologists. Acad Radiol 2022; 29 Suppl 2:S181-S190. [PMID: 34429261 DOI: 10.1016/j.acra.2021.07.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Revised: 07/21/2021] [Accepted: 07/22/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND Diagnosis of diffuse parenchymal lung diseases (DPLD) on high resolution CT (HRCT) is difficult for non-expert radiologists due to varied presentation for any single disease and overlap in presentation between diseases. RATIONALE AND OBJECTIVES To evaluate whether a pattern-based training algorithm can improve the ability of non-experts to diagnosis of DPLD. MATERIALS AND METHODS Five experts (cardiothoracic-trained radiologists), and 25 non-experts (non-cardiothoracic-trained radiologists, radiology residents, and pulmonologists) were each assigned a semi-random subset of cases from a compiled database of DPLD HRCTs. Each reader was asked to create a top three differential for each case. The non-experts were then given a pattern-based training algorithm for identifying DPLDs. Following training, the non-experts were again asked to create a top three differential for each case that they had previously evaluated. Accuracy between groups was compared using Chi-Square analysis. RESULTS A total of 400 and 1450 studies were read by experts and non-experts, respectively. Experts correctly placed the diagnosis as the first item on the differential versus having the correct diagnosis as one of their top three diagnoses at an overall rate of 48 and 64.3%, respectively. Pre-training, non-experts achieved a correct diagnosis/top three of 32.5 and 49.7%, respectively. Post-training, non-experts demonstrated a correct diagnosis/top three of 41.2 and 65%, a statistically significant increase (p < 0.0001). In addition, post training, there was no difference between non-experts and experts in placing the correct diagnosis within their top three differential. CONCLUSION The diagnosis of DPLDs by HRCT imaging alone is relatively poor. However, use of a pattern-based teaching algorithm can improve non-expert interpretation and enable non-experts to include the correct diagnosis within their differential diagnoses at a rate comparable to expert cardiothoracic trained radiologists.
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Affiliation(s)
- Ali H Dhanaliwala
- University of Pennsylvania Health System, Department of Radiology, Perelman School of Medicine at the University of Pennsylvania, Silverstein 1, 3400 Spruce St, Philadelphia, PA 19104
| | - Shweta Sood
- University of Pennsylvania Health System, Department of Radiology, Perelman School of Medicine at the University of Pennsylvania, Silverstein 1, 3400 Spruce St, Philadelphia, PA 19104
| | - Christina Olivias
- Department of Radiology, Mercy Catholic Medical Center, Darby, Pennsylvania
| | - Scott Simpson
- University of Pennsylvania Health System, Department of Radiology, Perelman School of Medicine at the University of Pennsylvania, Silverstein 1, 3400 Spruce St, Philadelphia, PA 19104
| | - Maya Galperin-Aisenberg
- University of Pennsylvania Health System, Department of Radiology, Perelman School of Medicine at the University of Pennsylvania, Silverstein 1, 3400 Spruce St, Philadelphia, PA 19104
| | - Drew Torigian
- University of Pennsylvania Health System, Department of Radiology, Perelman School of Medicine at the University of Pennsylvania, Silverstein 1, 3400 Spruce St, Philadelphia, PA 19104
| | - Beth Zigmund
- Department of Radiology, University of Vermont, Burlington, Vermont
| | - Cheilonda R Johnson
- University of Pennsylvania Health System, Department of Radiology, Perelman School of Medicine at the University of Pennsylvania, Silverstein 1, 3400 Spruce St, Philadelphia, PA 19104
| | - Karen Patterson
- University of Pennsylvania Health System, Department of Radiology, Perelman School of Medicine at the University of Pennsylvania, Silverstein 1, 3400 Spruce St, Philadelphia, PA 19104; Brighton and Sussex Medical School, Falmer, Brighton, United Kingdom
| | - Wallace T Miller
- University of Pennsylvania Health System, Department of Radiology, Perelman School of Medicine at the University of Pennsylvania, Silverstein 1, 3400 Spruce St, Philadelphia, PA 19104.
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Zheng K, Cai Y, Lei Y, Liu Y, Sun Z, Wang Y, Xu X, Zhang Z. Proteomic characteristics of beryllium sulfate-induced differentially expressed proteins in rats. Toxicol Res (Camb) 2021; 10:962-974. [PMID: 34733481 DOI: 10.1093/toxres/tfab051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Revised: 04/06/2021] [Accepted: 05/10/2021] [Indexed: 11/12/2022] Open
Abstract
Sprague Dawley rats were exposed to beryllium sulfate (BeSO4), and proteomic and bioinformatic techniques were applied to screen for differentially expressed proteins in their lung tissue and serum. A total of 12 coexpression modules were constructed for 18 samples with 2333 proteins. Four modules were found to have significant differences in the regulation of protein coexpression modules in the serum following exposure to BeSO4. A further three modules had significant differences in the regulation of protein coexpression modules in the lung tissues. Five modules with good correlation were obtained by calculating the gene significance and module membership values, whereas these module Hub proteins included: Hspbp1, Rps15a, Srsf2, Hadhb, Elmo3, Armt1, Rpl18, Afap1L1, Eif3d, Eif3c, and Rps3. The five proteins correlating highest with the Hub proteins in the lung tissue and serum samples were obtained using string analysis. KEGG and GO enrichment analyses showed that these proteins are mainly involved in ribosome formation, apoptosis, cell cycle regulation, and tumor necrosis factor regulation. By analyzing the biological functions of these proteins, proteins that can be used as biomarkers, such as Akt1, Prpf19, Cct2, and Rpl18, are finally obtained.
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Affiliation(s)
- Kai Zheng
- School of public health, University of South China, Hengyang, Hunan 421001, China
| | - Ying Cai
- School of public health, University of South China, Hengyang, Hunan 421001, China
| | - Yuandi Lei
- School of public health, University of South China, Hengyang, Hunan 421001, China
| | - Yanping Liu
- School of public health, University of South China, Hengyang, Hunan 421001, China
| | - Zhanbing Sun
- School of public health, University of South China, Hengyang, Hunan 421001, China
| | - Ye Wang
- School of public health, University of South China, Hengyang, Hunan 421001, China
| | - Xinyun Xu
- Institute of Environment and Health, Shenzhen Center for Disease Control and Prevention, Shenzhen, Guangdong 518055, China
| | - Zhaohui Zhang
- School of public health, University of South China, Hengyang, Hunan 421001, China
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25
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Ronsmans S, De Ridder J, Vandebroek E, Keirsbilck S, Nemery B, Hoet PHM, Vanderschueren S, Wuyts WA, Yserbyt J. Associations between occupational and environmental exposures and organ involvement in sarcoidosis: a retrospective case-case analysis. Respir Res 2021; 22:224. [PMID: 34372845 PMCID: PMC8351152 DOI: 10.1186/s12931-021-01818-5] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Accepted: 08/01/2021] [Indexed: 11/23/2022] Open
Abstract
Background Sarcoidosis most commonly affects lungs and intrathoracic lymph nodes, but any other organ can be involved. In epidemiological studies, many occupational and environmental exposures have been linked to sarcoidosis but their relationship with the disease phenotype has barely been studied.
Objective To investigate how occupational and environmental exposures prior to diagnosis relate to organ involvement in patients with sarcoidosis Methods We retrospectively studied patients seen at a sarcoidosis clinic between 2017 and 2020. Patients were included if they had a clinical presentation consistent with sarcoidosis and histologically confirmed epithelioid granulomas or had Löfgren syndrome. In a case–case analysis using multivariable logistic regression we calculated odds ratios (OR) of prespecified exposure categories (based on expert ascertainment) for cases with a given organ involvement versus cases without this organ involvement. Results We included 238 sarcoidosis patients. Sarcoidosis limited to pulmonary involvement was associated with exposure to inorganic dust prior to diagnosis (OR 2.11; 95% confidence interval [CI] 1.11–4.17). Patients with liver involvement had higher odds of contact with livestock (OR 3.68; 95% CI 0.91–12.7) or having jobs with close human contact (OR 4.33; 95% CI 1.57–11.3) than patients without liver involvement. Similar associations were found for splenic involvement (livestock: OR 4.94, 95% CI 1.46–16.1; close human contact: OR 3.78; 95% CI 1.47–9.46). Cardiac sarcoidosis was associated with exposure to reactive chemicals (OR 5.08; 95% CI 1.28–19.2) or livestock (OR 9.86; 95% CI 1.95–49.0). Active smokers had more ocular sarcoidosis (OR 3.26; 95% CI 1.33–7.79). Conclusions Our study indicates that, in sarcoidosis patients, different exposures might be related to different organ involvements—hereby providing support for the hypothesis that sarcoidosis has more than one cause, each of which may promote a different disease phenotype.
Supplementary Information The online version contains supplementary material available at 10.1186/s12931-021-01818-5.
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Affiliation(s)
- Steven Ronsmans
- Clinic for Occupational and Environmental Medicine, Department of Respiratory Diseases, University Hospitals Leuven, Leuven, Belgium.,Centre for Environment and Health, Department of Public Health and Primary Care, KU Leuven, Leuven, Belgium
| | - Jolien De Ridder
- Unit for Interstitial Lung Diseases, Department of Respiratory Diseases, University Hospitals Leuven, Herestraat 49, 3000, Leuven, Belgium
| | - Eline Vandebroek
- Clinic for Occupational and Environmental Medicine, Department of Respiratory Diseases, University Hospitals Leuven, Leuven, Belgium.,Premed, External Service for Prevention and Protection at Work, Leuven, Belgium
| | - Stephan Keirsbilck
- Clinic for Occupational and Environmental Medicine, Department of Respiratory Diseases, University Hospitals Leuven, Leuven, Belgium.,IDEWE, External Service for Prevention and Protection at Work, Leuven, Belgium
| | - Benoit Nemery
- Clinic for Occupational and Environmental Medicine, Department of Respiratory Diseases, University Hospitals Leuven, Leuven, Belgium.,Centre for Environment and Health, Department of Public Health and Primary Care, KU Leuven, Leuven, Belgium
| | - Peter H M Hoet
- Centre for Environment and Health, Department of Public Health and Primary Care, KU Leuven, Leuven, Belgium
| | - Steven Vanderschueren
- Department of General Internal Medicine, University Hospitals Leuven, Leuven, Belgium.,Laboratory of Clinical Infectious and Inflammatory Diseases, Department of Microbiology, Immunology, and Transplantation, KU Leuven, Leuven, Belgium
| | - Wim A Wuyts
- Unit for Interstitial Lung Diseases, Department of Respiratory Diseases, University Hospitals Leuven, Herestraat 49, 3000, Leuven, Belgium.,Laboratory of Respiratory Diseases and Thoracic Surgery (BREATHE), Department CHROMETA, KU Leuven, Leuven, Belgium
| | - Jonas Yserbyt
- Unit for Interstitial Lung Diseases, Department of Respiratory Diseases, University Hospitals Leuven, Herestraat 49, 3000, Leuven, Belgium. .,Laboratory of Respiratory Diseases and Thoracic Surgery (BREATHE), Department CHROMETA, KU Leuven, Leuven, Belgium.
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26
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Abstract
Many granulomatous diseases can mimic sarcoidosis histologically and in terms of their clinical features. These mimics include infectious granulomatous diseases, granulomatous reactions to occupational and environmental exposures, granulomatous drug reactions, vasculitides and idiopathic granulomatous conditions. It is important to distinguish sarcoidosis from these mimics, as a misdiagnosis of these diseases may have serious consequences. This manuscript reviews numerous sarcoidosis mimics and describes features of these diseases that may allow them to be differentiated from sarcoidosis. Distinguishing features between sarcoidosis and its mimics requires a careful review of the medical history, symptoms, demographics, radiographic findings, histologic features, and additional laboratory data. Understanding the clinical characteristics of sarcoidosis and its mimics should lead to more accurate diagnoses and treatment of granulomatous disorders that should improve the care of these patients. As the diagnostic criteria of sarcoidosis are not standardized, it is possible that some of these sarcoidosis mimics may represent varied clinical presentations of sarcoidosis itself.
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Affiliation(s)
- Marc A Judson
- Division of Pulmonary and Critical Care Medicine MC-91, Department of Medicine, Albany, NY, United States
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27
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Abstract
PURPOSE OF REVIEW Previous studies mainly described a role for organic agents as possible triggers for sarcoidosis. In this review, we address recent studies suggesting a possible role for inorganic elements, such as metals or silica in sarcoidosis pathogenesis. RECENT FINDINGS Several epidemiological papers suggest that inorganic agents, either by environmental exposures or occupational activities, could trigger sarcoidosis. Association between inorganics and sarcoidosis is also described in several recently published case reports and studies demonstrating immunological sensitization to inorganic agents in sarcoidosis patients.Studies comparing chronic beryllium disease (CBD) and sarcoidosis suggest that although antigenic triggers may differ, underlying processes may be comparable.Besides the fact that a growing number of studies show a possible role for inorganic triggers, it is also suggested that inorganic triggered sarcoidosis may result in a more severe phenotype, including pulmonary fibrosis. SUMMARY We can use the knowledge already gained on CBD pathogenesis to conduct further research into role of inorganics, such as metals and silica as antigens in sarcoidosis. Given the importance of a lymphocyte proliferation test (LPT) in diagnosing CBD, it seems obvious to also implement this test in the diagnostic work-up of sarcoidosis to identify patients with an inorganic antigenic trigger of their disease.
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Liao SY, Atif SM, Mould K, Konigsberg IR, Fu R, Davidson E, Li L, Fontenot AP, Maier LA, Yang IV. Single-cell RNA sequencing identifies macrophage transcriptional heterogeneities in granulomatous diseases. Eur Respir J 2021; 57:13993003.03794-2020. [PMID: 33602861 DOI: 10.1183/13993003.03794-2020] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2020] [Accepted: 02/08/2021] [Indexed: 12/25/2022]
Affiliation(s)
- Shu-Yi Liao
- Dept of Medicine, National Jewish Health, Denver, CO, USA
| | - Shaikh M Atif
- Dept of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Kara Mould
- Dept of Medicine, National Jewish Health, Denver, CO, USA
| | - Iain R Konigsberg
- Dept of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Rui Fu
- RNA Biosciences Initiative, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Elizabeth Davidson
- Dept of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Li Li
- Dept of Medicine, National Jewish Health, Denver, CO, USA.,Dept of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Andrew P Fontenot
- Dept of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, USA.,Dept of Immunology and Microbiology, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Lisa A Maier
- Dept of Medicine, National Jewish Health, Denver, CO, USA.,Dept of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, USA.,Dept of Environmental and Occupational Health, Colorado School of Public Health, Aurora, CO, USA
| | - Ivana V Yang
- Dept of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, USA .,Dept of Epidemiology, Colorado School of Public Health, Aurora, CO, USA
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29
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Liu YP, Yuan XY, Li XY, Wang Y, Sun ZB, Deng WH, Lei YD, Huang L, Jiang TY, Zhang ZH. Hydrogen sulfide alleviates apoptosis and autophagy induced by beryllium sulfate in 16HBE cells. J Appl Toxicol 2021; 42:230-243. [PMID: 34091916 DOI: 10.1002/jat.4205] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Revised: 05/06/2021] [Accepted: 05/19/2021] [Indexed: 12/21/2022]
Abstract
Beryllium and its compounds are systemic toxicants that are widely applied in many industries. Hydrogen sulfide has been found to protect cells. The present study aimed to determine the protective mechanisms involved in hydrogen sulfide treatment of 16HBE cells following beryllium sulfate-induced injury. 16HBE cells were treated with beryllium sulfate doses ranging between 0 and 300 μM BeSO4 . Additionally, 16HBE cells were subjected to pretreatment with either a 300 μM dose of sodium hydrosulfide (a hydrogen sulfide donor) or 10 mM DL-propargylglycine (a cystathionine-γ-lyase inhibitor) for 6 hr before then being treated with 150 μM beryllium sulfate for 48 hr. This study illustrates that beryllium sulfate induces a reduction in cell viability, increases lactate dehydrogenase (LDH) release, and increases cellular apoptosis and autophagy in 16HBE cells. Interestingly, pretreating 16HBE cells with sodium hydrosulfide significantly reduced the beryllium sulfate-induced apoptosis and autophagy. Moreover, it increased the mitochondrial membrane potential and alleviated the G2/M-phase cell cycle arrest. However, pretreatment with 10 mM DL-propargylglycine promoted the opposite effects. PI3K/Akt/mTOR and Nrf2/ARE signaling pathways are also activated following pretreatment with sodium hydrosulfide. These results indicate the protection provided by hydrogen sulfide in 16HBE cells against beryllium sulfate-induced injury is associated with the inhibition of apoptosis and autophagy through the activation of the PI3K/Akt/mTOR and Nrf2/ARE signaling pathways. Therefore, hydrogen sulfide has the potential to be a promising candidate in the treatment against beryllium disease.
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Affiliation(s)
- Yan-Ping Liu
- School of public health, University of South China, Hengyang, China.,Hunan Province Key Laboratory of Typical Environmental Pollution and Health Hazards, University of South China, Hengyang, China
| | - Xiao-Yan Yuan
- School of public health, University of South China, Hengyang, China.,Hunan Province Key Laboratory of Typical Environmental Pollution and Health Hazards, University of South China, Hengyang, China
| | - Xun-Ya Li
- School of public health, University of South China, Hengyang, China
| | - Ye Wang
- School of public health, University of South China, Hengyang, China
| | - Zhan-Bing Sun
- School of public health, University of South China, Hengyang, China
| | - Wei-Hua Deng
- School of public health, University of South China, Hengyang, China
| | - Yuan-di Lei
- School of public health, University of South China, Hengyang, China
| | - Lian Huang
- School of public health, University of South China, Hengyang, China
| | - Tian-Yi Jiang
- School of public health, University of South China, Hengyang, China
| | - Zhao-Hui Zhang
- School of public health, University of South China, Hengyang, China.,Hunan Province Key Laboratory of Typical Environmental Pollution and Health Hazards, University of South China, Hengyang, China
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30
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Lee YC, Chang KY, Mirsaeidi M. State-Level Health Disparity Is Associated with Sarcoidosis Mortality. J Clin Med 2021; 10:2366. [PMID: 34072248 DOI: 10.3390/jcm10112366] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Revised: 05/24/2021] [Accepted: 05/26/2021] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND Sarcoidosis is associated with significant morbidity and rising health care utilization, which contribute to the health care burden and disease outcome. In the United States (US), evaluation of sarcoidosis mortality by individual states has not been investigated. METHODS We examined sarcoidosis mortality data for 1999-2018 from the Centers for Disease Control and Prevention (CDC). America's Health Rankings (AHR) assesses the nation's health on a state-by-state basis to determine state health rankings. The numbers of certified Sarcoidosis Clinics within the US were obtained from World Association for Sarcoidosis and Other Granulomatous Disorders (WASOG) and Foundation for Sarcoidosis Research (FSR). The associations between sarcoidosis mortality and state health disparities were calculated by linear regression analyses. RESULTS From 1999 to 2018, the mean age-adjusted mortality rate (AAMR) in all populations, African Americans and European Americans were 2.9, 14.8, and 1.4 per 1,000,000 population, respectively. South Carolina had the highest AAMR for all populations (6.6/1,000,000) and African Americans (20.8/1,000,000). Both Utah and Vermont had the highest AAMR for European Americans (2.6/1,000,000). New York State and South Atlantic had the largest numbers of FSR-WASOG Sarcoidosis Clinics (6 and 13, respectively). States with better health rankings were significantly associated with lower AAMR in all population (R2 = 0.170, p = 0.003) but with higher AAMR in European Americans (R2 = 0.223, p < 0.001). CONCLUSIONS There are significant variations in sarcoidosis mortality within the US. Sarcoidosis mortality was strongly associated with state health disparities. The current study suggests sarcoidosis mortality could be an indicator to reflect the state-level health care disparities in the US.
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31
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Franquet T, Franks TJ, Galvin JR, Marchiori E, Giménez A, Mazzini S, Johkoh T, Lee KS. Non-Infectious Granulomatous Lung Disease: Imaging Findings with Pathologic Correlation. Korean J Radiol 2021; 22:1416-1435. [PMID: 34132073 PMCID: PMC8316771 DOI: 10.3348/kjr.2020.1082] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Revised: 10/26/2020] [Accepted: 11/01/2020] [Indexed: 12/14/2022] Open
Abstract
Non-infectious granulomatous lung disease represents a diverse group of disorders characterized by pulmonary opacities associated with granulomatous inflammation, a relatively nonspecific finding commonly encountered by pathologists. Some lesions may present a diagnostic challenge because of nonspecific imaging features; however, recognition of the various imaging manifestations of these disorders in conjunction with patients' clinical history, such as age, symptom onset and duration, immune status, and presence of asthma or cutaneous lesions, is imperative for narrowing the differential diagnosis and determining appropriate management of this rare group of disorders. In this pictorial review, we describe the pathologic findings of various non-infectious granulomatous lung diseases as well as the radiologic features and high-resolution computed tomography imaging features.
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Affiliation(s)
- Tomás Franquet
- Department of Diagnostic Radiology, Hospital de Sant Pau, Universitat Autónoma de Barcelona, Barcelona, Spain.
| | - Teri J Franks
- Department of Defense, Pulmonary & Mediastinal Pathology, The Joint Pathology Center, Silver Spring, MD, USA
| | - Jeffrey R Galvin
- Department of Diagnostic Radiology, Chest Imaging, & Pulmonary Critical Care Medicine, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Edson Marchiori
- Department of Radiology, Hospital Universitário Clementino Fraga Filho-Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brasil
| | - Ana Giménez
- Department of Diagnostic Radiology, Hospital de Sant Pau, Universitat Autónoma de Barcelona, Barcelona, Spain
| | - Sandra Mazzini
- Department of Diagnostic Radiology, Hospital de Sant Pau, Universitat Autónoma de Barcelona, Barcelona, Spain
| | - Takeshi Johkoh
- Department of Radiology, Kansai Rosai Hospital, Hyogo, Japan
| | - Kyung Soo Lee
- Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine (SKKU-SOM), Seoul, Korea
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32
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KleinJan A, van Nimwegen M, Leman K, Wen KX, Boon L, Hendriks RW. Involvement of Dendritic Cells and Th17 Cells in Induced Tertiary Lymphoid Structures in a Chronic Beryllium Disease Mouse Model. Mediators Inflamm 2021; 2021:8845966. [PMID: 34054347 DOI: 10.1155/2021/8845966] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2020] [Revised: 03/27/2021] [Accepted: 04/20/2021] [Indexed: 11/18/2022] Open
Abstract
Objective To study airway pathophysiology and the role of dendritic cells (DCs) and IL-17 receptor (IL-17R) signals in a mouse model for CBD. Methods Here, we present a CBD mouse model in which mice were exposed to beryllium during three weeks. We also exposed IL-17R-deficient mice and mice in which DCs were depleted. Results Eight weeks after the initial beryllium exposure, an inflammatory response was detected in the lungs. Mice displayed inflammation of the lower airways that included focal dense infiltrates, granuloma-like foci, and tertiary lymphoid structure (TLS) containing T cells, B cells, and germinal centers. Alveolar cell analysis showed significantly increased numbers of CD4+ T cells expressing IFNγ, IL-17, or both cytokines. The pathogenic role of IL-17R signals was demonstrated in IL-17R-deficient mice, which had strongly reduced lung inflammation and TLS development following beryllium exposure. In CBD mice, pulmonary DC subsets including CD103+ conventional DCs (cDCs), CD11b+ cDCs, and monocyte-derived DCs (moDCs) were also prominently increased. We used diphtheria toxin receptor-mediated targeted cell ablation to conditionally deplete DCs and found that DCs are essential for the maintenance of TLS in CBD. Furthermore, the presence of antinuclear autoantibodies in the serum of CBD mice showed that CBD had characteristics of autoimmune disease. Conclusions We generated a translational model of sarcoidosis driven by beryllium and show that DCs and IL-17R signals play a pathophysiological role in CBD development as well as in established CBD in vivo.
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33
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Falta MT, Crawford JC, Tinega AN, Landry LG, Crawford F, Mack DG, Martin AK, Atif SM, Li L, Santos RG, Nakayama M, Kappler JW, Maier LA, Thomas PG, Pinilla C, Fontenot AP. Beryllium-specific CD4+ T cells induced by chemokine neoantigens perpetuate inflammation. J Clin Invest 2021; 131:144864. [PMID: 33630763 DOI: 10.1172/jci144864] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2020] [Accepted: 02/23/2021] [Indexed: 12/12/2022] Open
Abstract
Discovering dominant epitopes for T cells, particularly CD4+ T cells, in human immune-mediated diseases remains a significant challenge. Here, we used bronchoalveolar lavage (BAL) cells from HLA-DP2-expressing patients with chronic beryllium disease (CBD), a debilitating granulomatous lung disorder characterized by accumulations of beryllium-specific (Be-specific) CD4+ T cells in the lung. We discovered lung-resident CD4+ T cells that expressed a disease-specific public CDR3β T cell receptor motif and were specific to Be-modified self-peptides derived from C-C motif ligand 4 (CCL4) and CCL3. HLA-DP2-CCL/Be tetramer staining confirmed that these chemokine-derived peptides represented major antigenic targets in CBD. Furthermore, Be induced CCL3 and CCL4 secretion in the lungs of mice and humans. In a murine model of CBD, the addition of LPS to Be oxide exposure enhanced CCL4 and CCL3 secretion in the lung and significantly increased the number and percentage of CD4+ T cells specific for the HLA-DP2-CCL/Be epitope. Thus, we demonstrate a direct link between Be-induced innate production of chemokines and the development of a robust adaptive immune response to those same chemokines presented as Be-modified self-peptides, creating a cycle of innate and adaptive immune activation.
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Affiliation(s)
- Michael T Falta
- Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - Jeremy C Crawford
- Department of Immunology, St. Jude Children's Research Hospital, Memphis, Tennessee, USA
| | - Alex N Tinega
- Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - Laurie G Landry
- Barbara Davis Center for Childhood Diabetes, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | | | - Douglas G Mack
- Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - Allison K Martin
- Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - Shaikh M Atif
- Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - Li Li
- Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA.,Department of Medicine, National Jewish Health, Denver, Colorado, USA
| | - Radleigh G Santos
- Department of Mathematics, Nova Southeastern University, Ft. Lauderdale, Florida, USA
| | - Maki Nakayama
- Barbara Davis Center for Childhood Diabetes, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA.,Department of Immunology and Microbiology, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - John W Kappler
- Department of Biomedical Research and.,Department of Immunology and Microbiology, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - Lisa A Maier
- Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA.,Department of Medicine, National Jewish Health, Denver, Colorado, USA
| | - Paul G Thomas
- Department of Immunology, St. Jude Children's Research Hospital, Memphis, Tennessee, USA
| | | | - Andrew P Fontenot
- Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA.,Department of Immunology and Microbiology, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
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Bode SFN, Rohr J, Müller Quernheim J, Seidl M, Speckmann C, Heinzmann A. Pulmonary granulomatosis of genetic origin. Eur Respir Rev 2021; 30:30/160/200152. [PMID: 33927005 PMCID: PMC9488645 DOI: 10.1183/16000617.0152-2020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Accepted: 08/27/2020] [Indexed: 11/30/2022] Open
Abstract
Granulomatous inflammation of the lung can be a manifestation of different conditions and can be caused by endogenous inflammation or external triggers. A multitude of different genetic mutations can either predispose patients to infections with granuloma-forming pathogens or cause autoinflammatory disorders, both leading to the phenotype of pulmonary granulomatosis. Based on a detailed patient history, physical examination and a diagnostic approach including laboratory workup, pulmonary function tests (PFTs), computed tomography (CT) scans, bronchoscopy with bronchoalveolar lavage (BAL), lung biopsies and specialised microbiological and immunological diagnostics, a correct diagnosis of an underlying cause of pulmonary granulomatosis of genetic origin can be made and appropriate therapy can be initiated. Depending on the underlying disorder, treatment approaches can include antimicrobial therapy, immunosuppression and even haematopoietic stem cell transplantation (HSCT). Patients with immunodeficiencies and autoinflammatory conditions are at the highest risk of developing pulmonary granulomatosis of genetic origin. Here we provide a review on these disorders and discuss pathogenesis, clinical presentation, diagnostic approach and treatment. Pulmonary granulomatosis of genetic origin mostly occurs in immunodeficiency disorders and autoinflammatory conditions. In addition to specific approaches in this regard, the diagnostic workup needs to cover environmental and occupational aspects.https://bit.ly/31SqdHW
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Affiliation(s)
- Sebastian F N Bode
- Dept of General Paediatrics, Adolescent Medicine and Neonatology, Medical Centre - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Jan Rohr
- Dept of General Paediatrics, Adolescent Medicine and Neonatology, Medical Centre - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Joachim Müller Quernheim
- Dept of Pneumology, Medical Centre - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Maximilan Seidl
- Institute for Surgical Pathology, Medical Centre - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany.,Institute of Pathology, Heinrich-Heine University and University Hospital Düsseldorf, Düsseldorf, Germany
| | - Carsten Speckmann
- Centre for Paediatrics and Adolescent Medicine, Medical Centre - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany.,Institute for Immunodeficiency, Centre for Chronic Immunodeficiency (CCI), Medical Centre - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Andrea Heinzmann
- Dept of General Paediatrics, Adolescent Medicine and Neonatology, Medical Centre - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
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Frye BC, Gaede KI, Saltini C, Rossman MD, Monos DS, Rosenman KD, Schuler CR, Weston A, Wegner R, Noth R, Zissel G, Schreiber S, Nothnagel M, Müller-Quernheim J. Analysis of single nucleotide polymorphisms in chronic beryllium disease. Respir Res 2021; 22:107. [PMID: 33863318 PMCID: PMC8051053 DOI: 10.1186/s12931-021-01691-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Accepted: 03/22/2021] [Indexed: 11/17/2022] Open
Abstract
Sarcoidosis and chronic beryllium disease (CBD) are phenocopies, however the latter one has a clear trigger factor that is beryllium exposure. This study analyses single nucleotide polymorphisms (SNPs) in a large cohort for beryllium-exposed persons. SNPs were chosen for their relevance in sarcoidosis. Even though one of largest cohorts of beryllium-exposed persons was analysed, no statistically relevant association between any SNP and CBD could be verified. Notably, some SNPs exhibit inverse OR for beryllium sensitization and CBD with nominally statistical significance, which allows hypothesizing about pathophysiological role of genes for the disease triggering and development.
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Affiliation(s)
- Björn C Frye
- Department of Pneumology, Faculty of Medicine, Medical Center-University of Freiburg, University of Freiburg, Killianstrasse 5, 79106, Freiburg, Germany
| | - Karoline I Gaede
- BioMaterial Bank Nord, Research Center Borstel, Leibniz Lung Center, 23845 Borstel, Parkallee 35, Germany.,Airway Research Center North, German Center for Lung Research (DZL), Wöhrendamm 80, 22927, Großhansdorf, Germany
| | - Cesare Saltini
- Department of Medicine, University of Florida, 1600 Archer Rd, Gainesville, 32610, FL, USA
| | - Milton D Rossman
- Pulmonary, Allergy, and Critical Care Division, University of Pennsylvania Medical Center, Philadelphia, USA
| | - Dimitri S Monos
- Pulmonary, Allergy, and Critical Care Division, University of Pennsylvania Medical Center, Philadelphia, USA
| | - Ken D Rosenman
- Division of Occupational and Environmental Medicine, Department of Medicine, Michigan State University, East Lansing, MI, USA
| | - Christine R Schuler
- Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health, Morgantown, WV, USA
| | - Ainsley Weston
- Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health, Morgantown, WV, USA
| | - Ralf Wegner
- Institute for Occupational and Maritime Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Rainer Noth
- Institute for Clinical Molecular Biology, Christian-Albrechts University, Kiel, Germany
| | - Gernot Zissel
- Department of Pneumology, Faculty of Medicine, Medical Center-University of Freiburg, University of Freiburg, Killianstrasse 5, 79106, Freiburg, Germany
| | - Stefan Schreiber
- Institute for Clinical Molecular Biology, Christian-Albrechts University, Kiel, Germany
| | - Michael Nothnagel
- Department of Statistical Genetics and Bioinformatics, Cologne Center for Genomics (CCG), University of Cologne, Cologne, Germany.,University Hospital Cologne, Cologne, Germany
| | - Joachim Müller-Quernheim
- Department of Pneumology, Faculty of Medicine, Medical Center-University of Freiburg, University of Freiburg, Killianstrasse 5, 79106, Freiburg, Germany.
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Lin NW, Maier LA, Mroz MM, Jacobson S, MacPhail K, Liu S, Lei Z, Barkes BQ, Fingerlin TE, Hamzeh N, Mayer AS, Restrepo CI, Chhabra D, Yang IV, Li L. Genomic biomarkers in chronic beryllium disease and sarcoidosis. Respir Med 2021; 187:106390. [PMID: 34399367 DOI: 10.1016/j.rmed.2021.106390] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Revised: 03/29/2021] [Accepted: 03/30/2021] [Indexed: 11/20/2022]
Abstract
Background Previous gene expression studies have identified genes IFNγ, TNFα, RNase 3, CXCL9, and CD55 as potential biomarkers for sarcoidosis and/or chronic beryllium disease (CBD). We hypothesized that differential expression of these genes could function as diagnostic biomarkers for sarcoidosis and CBD, and prognostic biomarkers for sarcoidosis. Study Design/Methods We performed RT-qPCR on whole blood samples from CBD (n = 132), beryllium sensitized (BeS) (n = 109), and sarcoidosis (n = 99) cases and non-diseased controls (n = 97) to determine differential expression of target genes. We then performed logistic regression modeling and generated ROC curves to determine which genes could most accurately differentiate: 1) CBD versus sarcoidosis 2) CBD versus BeS 3) sarcoidosis versus controls 4) non-progressive versus progressive sarcoidosis. Results CD55 and TNFα were significantly upregulated, while CXCL9 was significantly downregulated in CBD compared to sarcoidosis (p < 0.05). The ROC curve from the logistic regression model demonstrated high discriminatory ability of the combination of CD55, TNFα, and CXCL9 to distinguish between CBD and sarcoidosis with an AUC of 0.98. CD55 and TNFα were significantly downregulated in sarcoidosis compared to controls (p < 0.05). The ROC curve from the model showed a reasonable discriminatory ability of CD55 and TNFα to distinguish between sarcoidosis and controls with an AUC of 0.86. There was no combination of genes that could accurately differentiate between CBD and BeS or sarcoidosis phenotypes. Interpretation CD55, TNFα and CXCL9 expression levels can accurately differentiate between CBD and sarcoidosis, while CD55 and TNFα expression levels can accurately differentiate sarcoidosis and controls.
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MacMurdo MG, Dweik RA. Cluster of Beryllium-Sensitized Individuals May Be Related to Environmental Exposure to Beryllium-Containing Concrete Dust. Chest 2021; 159:900-901. [PMID: 33678270 DOI: 10.1016/j.chest.2020.09.242] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Accepted: 09/21/2020] [Indexed: 11/26/2022] Open
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Affiliation(s)
- Jenna K. Buchanan
- School of Fundamental Sciences, Massey University, Private Bag 11 222, Palmerston North, New Zealand
| | - Paul G. Plieger
- School of Fundamental Sciences, Massey University, Private Bag 11 222, Palmerston North, New Zealand
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39
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Abstract
Sarcoidosis, a systemic granulomatous disease of unknown etiology, may mimic other conditions at presentation often resulting in delayed diagnosis. These conditions include infections, neoplasms, autoimmune, cardiovascular, and drug-induced diseases. This review highlights the most common sarcoidosis mimics that often lead to pitfalls in diagnosis and delay in appropriate treatment. Prior to invasive testing and initiating immunosuppressants (commonly corticosteroids), it is important to exclude sarcoid mimickers.
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Affiliation(s)
- Naureen Narula
- Staten Island University Hospital, New York, NY, United States
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Vethanayagam D, Peters J, Saad E, Mulchey K, Gillson AM, McNab B, Farr-Jones M, Hruczkowski T, Blevins G, Coulden R, Oudit G, Beach J. Sarcoidosis: a prospective observational cohort from Northern Alberta. Sarcoidosis Vasc Diffuse Lung Dis 2020; 37:e2020014. [PMID: 33597801 PMCID: PMC7883513 DOI: 10.36141/svdld.v37i4.8522] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/23/2020] [Accepted: 11/15/2020] [Indexed: 11/25/2022]
Abstract
INTRODUCTION Sarcoidosis is a multi-system disease reported to occur with a higher incidence in Alberta than many other health jurisdictions within and outside of Canada. The reasons for this higher incidence are currently not known. Exposure to beryllium can result in a clinically and radiologically identical disease to sarcoidosis. The purpose of our study was to identify patterns with potential occupational or environmental exposures to beryllium amongst individuals with sarcoidosis in Alberta through a tertiary referral center. METHODS A prospective observational study was carried out at the University of Alberta Hospital. Patients with confirmed sarcoidosis (stages 0-4) were recruited from subspecialty clinics (Respirology, Cardiology, Neurology and Occupational Health). A predetermined list of industries thought to involve potentially relevant exposures for the development of sarcoidosis was used to capture current and previous exposure history. Results were entered into a database and where possible verified by comparing with existing electronic medical records (including histories, physical examination, diagnostic imaging and physiology). RESULTS A total of 45 patients were recruited, 25 men and 20 women. Of these, 84% of participants reported working in or being exposed to an industry/environment suspected of contributing to development of sarcoidosis over their lifetime. The most frequently reported exposures were within farming and agriculture (27%), oil and gas (20%), metalworking and handling animals (18%). CONCLUSIONS Amongst this cohort, a high proportion reported working with a potentially relevant exposure. Individuals being assessed for sarcoidosis should have their most responsible physician elicit a detailed work and environmental history. (Sarcoidosis Vasc Diffuse Lung Dis 2020; 37 (4): e2020014).
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Affiliation(s)
| | | | - Emad Saad
- Division of Pulmonary Medicine, University of Alberta
| | | | | | - Brian McNab
- Division of Pulmonary Medicine, University of Alberta
| | | | | | | | - Richard Coulden
- Department of Radiology and Diagnostic Imaging, University of Alberta
| | - Gavin Oudit
- Division of Cardiology, University of Alberta
| | - Jeremy Beach
- Emeritus, Division of Preventive Medicine, University of Alberta
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Hayashi F, Kido T, Sakamoto N, Zaizen Y, Ozasa M, Yokoyama M, Yura H, Hara A, Ishimoto H, Yamaguchi H, Miyazaki T, Obase Y, Ishimatsu Y, Eishi Y, Fukuoka J, Mukae H. Pneumoconiosis with a Sarcoid-Like Reaction Other than Beryllium Exposure: A Case Report and Literature Review. ACTA ACUST UNITED AC 2020; 56:medicina56110630. [PMID: 33266389 PMCID: PMC7700418 DOI: 10.3390/medicina56110630] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2020] [Revised: 11/16/2020] [Accepted: 11/20/2020] [Indexed: 01/18/2023]
Abstract
Background: Chronic beryllium disease (CBD) is a granulomatous disease that resembles sarcoidosis but is caused by beryllium. Clinical manifestations similar to those observed in CBD have occasionally been reported in exposure to dusts of other metals. However, reports describing the clinical, radiographic, and pathological findings in conditions other than beryllium-induced granulomatous lung diseases, and detailed information on mineralogical analyses of metal dusts, are limited. Case presentation: A 51-year-old Japanese man with rapidly progressing nodular shadows on chest radiography, and a 10-year occupation history of underground construction without beryllium exposure, was referred to our hospital. High-resolution computed tomography showed well-defined multiple centrilobular and perilobular nodules, and thickening of the intralobular septa in the middle and lower zones of both lungs. No extrathoracic manifestations were observed. Pathologically, the lung specimens showed 5–12 mm nodules with dust deposition and several non-necrotizing granulomas along the lymphatic routes. X-ray analytical electron microscopy of the same specimens revealed aluminum, iron, titanium, and silica deposition in the lung tissues. The patient stopped smoking and changed his occupation to avoid further dust exposure; the chest radiography shadows decreased 5 years later. Conclusion: The radiological appearances of CBD and sarcoidosis are similar, although mediastinal or hilar lymphadenopathy is less common in CBD and is usually seen in the presence of parenchymal opacities. Extrathoracic manifestations are also rare. Despite limited evidence, these findings are similar to those observed in pneumoconiosis with a sarcoid-like reaction due to exposure to dust other than of beryllium. Aluminum is frequently detected in patients with pneumoconiosis with a sarcoid-like reaction and is listed as an inorganic agent in the etiology of sarcoidosis. It was also detected in our patient and may have contributed to the etiology. Additionally, our case suggests that cessation of dust exposure may contribute to improvement under the aforementioned conditions.
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Affiliation(s)
- Fumiko Hayashi
- Department of Respiratory Medicine, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki 852-8501, Japan; (F.H.); (N.S.); (M.O.); (H.Y.); (A.H.); (H.I.); (H.Y.); (Y.O.); (H.M.)
| | - Takashi Kido
- Department of Respiratory Medicine, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki 852-8501, Japan; (F.H.); (N.S.); (M.O.); (H.Y.); (A.H.); (H.I.); (H.Y.); (Y.O.); (H.M.)
- Correspondence: ; Tel.: +81-95-819-7273; Fax: +81-95-849-7285
| | - Noriho Sakamoto
- Department of Respiratory Medicine, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki 852-8501, Japan; (F.H.); (N.S.); (M.O.); (H.Y.); (A.H.); (H.I.); (H.Y.); (Y.O.); (H.M.)
| | - Yoshiaki Zaizen
- Department of Pathology, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki 852-8520, Japan; (Y.Z.); (J.F.)
| | - Mutsumi Ozasa
- Department of Respiratory Medicine, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki 852-8501, Japan; (F.H.); (N.S.); (M.O.); (H.Y.); (A.H.); (H.I.); (H.Y.); (Y.O.); (H.M.)
- Department of Pathology, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki 852-8520, Japan; (Y.Z.); (J.F.)
| | - Mitsuru Yokoyama
- Department of Anatomy, University of Occupational and Environmental Health, 1-1, Iseigaoka, Yahatanishiku, Kitakyushu City, Fukuoka 807-8555, Japan;
| | - Hirokazu Yura
- Department of Respiratory Medicine, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki 852-8501, Japan; (F.H.); (N.S.); (M.O.); (H.Y.); (A.H.); (H.I.); (H.Y.); (Y.O.); (H.M.)
| | - Atsuko Hara
- Department of Respiratory Medicine, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki 852-8501, Japan; (F.H.); (N.S.); (M.O.); (H.Y.); (A.H.); (H.I.); (H.Y.); (Y.O.); (H.M.)
| | - Hiroshi Ishimoto
- Department of Respiratory Medicine, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki 852-8501, Japan; (F.H.); (N.S.); (M.O.); (H.Y.); (A.H.); (H.I.); (H.Y.); (Y.O.); (H.M.)
| | - Hiroyuki Yamaguchi
- Department of Respiratory Medicine, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki 852-8501, Japan; (F.H.); (N.S.); (M.O.); (H.Y.); (A.H.); (H.I.); (H.Y.); (Y.O.); (H.M.)
| | - Taiga Miyazaki
- Department of Infectious Diseases, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki 852-8501, Japan;
| | - Yasushi Obase
- Department of Respiratory Medicine, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki 852-8501, Japan; (F.H.); (N.S.); (M.O.); (H.Y.); (A.H.); (H.I.); (H.Y.); (Y.O.); (H.M.)
| | - Yuji Ishimatsu
- Department of Nursing, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki 852-8520, Japan;
| | - Yoshinobu Eishi
- Department of Human Pathology, Tokyo Medical and Dental University, Yushima, Bunkyo-ku, Tokyo 113-8519, Japan;
| | - Junya Fukuoka
- Department of Pathology, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki 852-8520, Japan; (Y.Z.); (J.F.)
| | - Hiroshi Mukae
- Department of Respiratory Medicine, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki 852-8501, Japan; (F.H.); (N.S.); (M.O.); (H.Y.); (A.H.); (H.I.); (H.Y.); (Y.O.); (H.M.)
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Phalke S, Aviszus K, Rubtsova K, Rubtsov A, Barkes B, Powers L, Warner B, Crooks JL, Kappler JW, Fernández-Pérez ER, Maier LA, Hamzeh N, Marrack P. Age-associated B Cells Appear in Patients with Granulomatous Lung Diseases. Am J Respir Crit Care Med 2020; 202:1013-1023. [PMID: 32501729 DOI: 10.1164/rccm.201911-2151oc] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
Rationale: A subpopulation of B cells (age-associated B cells [ABCs]) is increased in mice and humans with infections or autoimmune diseases. Because depletion of these cells might be valuable in patients with certain lung diseases, the goal was to find out if ABC-like cells were at elevated levels in such patients.Objectives: To measure ABC-like cell percentages in patients with lung granulomatous diseases.Methods: Peripheral blood and BAL cells from patients with sarcoidosis, beryllium sensitivity, or hypersensitivity pneumonitis and healthy subjects were analyzed for the percentage of B cells that were ABC-like, defined by expression of CD11c, low levels of CD21, FcRL 1-5 (Fc receptor-like protein 1-5) expression, and, in some cases, T-bet.Measurements and Main Results: ABC-like cells in blood were at low percentages in healthy subjects and higher percentages in patients with sarcoidosis as well as at high percentages among BAL cells of patients with sarcoidosis, beryllium disease, and hypersensitivity pneumonitis. Treatment of patients with sarcoidosis led to reduced percentages of ABC-like cells in blood.Conclusions: Increased levels of ABC-like cells in patients with sarcoidosis may be useful in diagnosis. The increase in percentage of ABC-like cells in patients with lung granulomatous diseases and decrease in treated patients suggests that depletion of these cells may be valuable.
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Affiliation(s)
| | | | | | | | | | - Linda Powers
- Department of Medicine, Roy J. and Lucille A. Carver College of Medicine, University of Iowa, Iowa City, Iowa
| | - Brenda Warner
- Department of Medicine, Roy J. and Lucille A. Carver College of Medicine, University of Iowa, Iowa City, Iowa
| | - James L Crooks
- Department of Biomedical Research.,Division of Biostatistics and Bioinformatics, National Jewish Health, Denver, Colorado.,Department of Epidemiology, Colorado School of Public Health, Aurora, Colorado; and
| | - John W Kappler
- Department of Biomedical Research.,Department of Immunology and Microbiology, University Colorado Anschutz Medical Campus, Aurora, Colorado
| | | | | | - Nabeel Hamzeh
- Department of Medicine, and.,Department of Medicine, Roy J. and Lucille A. Carver College of Medicine, University of Iowa, Iowa City, Iowa
| | - Philippa Marrack
- Department of Biomedical Research.,Department of Immunology and Microbiology, University Colorado Anschutz Medical Campus, Aurora, Colorado
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Abstract
Many metals are essential for living organisms, but at higher doses they may be toxic and carcinogenic. Metal exposure occurs mainly in occupational settings and environmental contaminations in drinking water, air pollution and foods, which can result in serious health problems such as cancer. Arsenic (As), beryllium (Be), cadmium (Cd), chromium (Cr) and nickel (Ni) are classified as Group 1 carcinogens by the International Agency for Research on Cancer. This review provides a comprehensive summary of current concepts of the molecular mechanisms of metal-induced carcinogenesis and focusing on a variety of pathways, including genotoxicity, mutagenesis, oxidative stress, epigenetic modifications such as DNA methylation, histone post-translational modification and alteration in microRNA regulation, competition with essential metal ions and cancer-related signaling pathways. This review takes a broader perspective and aims to assist in guiding future research with respect to the prevention and therapy of metal exposure in human diseases including cancer.
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Affiliation(s)
- Yusha Zhu
- Department of Environmental Medicine, New York University Grossman School of Medicine, New York, NY, USA
| | - Max Costa
- Department of Environmental Medicine, New York University Grossman School of Medicine, New York, NY, USA
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Frye BC, Quartucci C, Rakete S, Grubanovic A, Höhne K, Mangold F, Gieré R, Müller-Quernheim J, Zissel G. A Cluster of Beryllium Sensitization Traced to the Presence of Beryllium in Concrete Dust. Chest 2020; 159:1084-1093. [PMID: 32926872 DOI: 10.1016/j.chest.2020.09.073] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Revised: 09/01/2020] [Accepted: 09/04/2020] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Chronic beryllium disease (CBD), a granulomatous disease with similarities to sarcoidosis, arises only in individuals exposed to beryllium. Inhaled beryllium can elicit a T-cell-dominated alveolitis leading nonnecrotizing granulomata. CBD can be distinguished from sarcoidosis by demonstrating beryllium sensitization in a lymphocyte proliferation test. RESEARCH QUESTION Beryllium exposure usually occurs in an occupational setting. Because of the diagnosis of CBD in a patient without evident beryllium exposure, we performed a beryllium-lymphocyte proliferation test (BeLPT) among his work colleagues. STUDY DESIGN AND METHODS This field study investigated a cohort of work colleagues without obvious beryllium exposure. Twenty-one of 30 individuals were assessed in our outpatient clinic for beryllium sensitization. Therefore, BeLPT was performed with freshly collected peripheral blood mononuclear cells. Data were extracted from clinical charts, including geographical data. Beryllium content in dust samples collected at the workplace was measured by graphite-furnace atomic absorption spectroscopy and was compared with samples from different areas of Germany. RESULTS For the initial patient, the diagnosis of sarcoidosis was reclassified as CBD based on two positive BeLPT results. Assessment of his workplace did not identify a source of beryllium. However, BeLPTs performed on his workmates demonstrated beryllium sensitization in 5 of 21 individuals, suggesting a local beryllium source. Concrete dust obtained from the building yard, the workplace of the index patient, contained high amounts of beryllium (1138 ± 162 μg/kg), whereas dust from other localities (control samples) showed much lower beryllium content (range, 147 ± 18-452 ± 206 μg/kg). Notably, the control dust collected from different places all over Germany exhibit different beryllium concentrations. INTERPRETATION We describe a cluster of beryllium-sensitized workers from an industry not related to beryllium caused by environmental exposure to beryllium-containing concrete dust, which exhibited markedly elevated beryllium content. Importantly, analyses of dust samples collected from different localities showed that they contain markedly different amounts of beryllium. Thus, besides workplace-related exposure, environmental factors also are capable of eliciting a beryllium sensitization.
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Affiliation(s)
- Björn C Frye
- Department of Pneumology, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Caroline Quartucci
- Institute and Clinic for Occupational, Social and Environmental Medicine, LMU University Hospital Munich and Comprehensive Pneumology Center Munich, Member, German Center for Lung Research, Philadelphia, PA
| | - Stefan Rakete
- Institute and Clinic for Occupational, Social and Environmental Medicine, LMU University Hospital Munich and Comprehensive Pneumology Center Munich, Member, German Center for Lung Research, Philadelphia, PA
| | - Aleksandar Grubanovic
- Department of Pneumology, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Kerstin Höhne
- Department of Pneumology, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Felix Mangold
- Department of Pneumology, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Reto Gieré
- Department of Earth and Environmental Science, University of Pennsylvania, Philadelphia, PA
| | - Joachim Müller-Quernheim
- Department of Pneumology, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Gernot Zissel
- Department of Pneumology, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany.
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Abstract
INTRODUCTION Granulomatous lung diseases (GLD) are heterogeneous group of diseases that can be broadly categorized as infectious or noninfectious. This distinction is extremely important, as the misdiagnosis of a GLD can have serious consequences. In this manuscript, we describe the clinical manifestations, histopathology, and diagnostic approach to GLD. We propose an algorithm to distinguish infectious from noninfectious GLD. AREAS COVERED We have searched PubMed and Medline database from 1950 to December 2019, using multiple keywords as described below. Major GLDs covered include those caused by mycobacteria and fungi, sarcoidosis, hypersensitivity pneumonitis, and vasculidities. EXPERT OPINION The cause of infectious GLD is usually identified through microbiological culture and molecular techniques. Most noninfectious GLD are diagnosed by clinical and laboratory criteria, often with exclusion of infectious pathogens. Further understanding of the immunopathogenesis of the granulomatous response may allow improved diagnosis and treatment of GLD.
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Affiliation(s)
- Amit Chopra
- Department of Medicine, Pulmonary and Critical Care Medicine, Albany Medical Center , NY, USA
| | - Vaidehi Avadhani
- Department of Pathology and Laboratory Medicine, Emory University , Atlanta, USA
| | - Anupama Tiwari
- Department of Medicine, Pulmonary and Critical Care Medicine, Albany Medical Center , NY, USA
| | - Ellen C Riemer
- Department of Pathology, Medical University of South Carolina , SC, USA
| | - Gabriel Sica
- Department of Pathology and Laboratory Medicine, Emory University , Atlanta, USA
| | - Marc A Judson
- Department of Medicine, Pulmonary and Critical Care Medicine, Albany Medical Center , NY, USA
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Davidson KR, Ha DM, Schwarz MI, Chan ED. Bronchoalveolar lavage as a diagnostic procedure: a review of known cellular and molecular findings in various lung diseases. J Thorac Dis 2020; 12:4991-5019. [PMID: 33145073 PMCID: PMC7578496 DOI: 10.21037/jtd-20-651] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Bronchoalveolar lavage (BAL) is a commonly used procedure in the evaluation of lung disease as it allows for sampling of the lower respiratory tract. In many circumstances, BAL differential cell counts have been reported to be typical of specific lung disorders. In addition, more specific diagnostic tests including molecular assays such as polymerase chain reaction (PCR) or enzyme-linked immunosorbent assay, special cytopathologic stains, or particular microscopic findings have been described as part of BAL fluid analysis. This review focuses on common cellular and molecular findings of BAL in a wide range of lung diseases. Since the performance of the first lung irrigation in 1927, BAL has become a common and important diagnostic tool. While some pulmonary disorders have a highly characteristic signature of BAL findings, BAL results alone often lack specificity and require interpretation along with other clinical and radiographic details. Development of new diagnostic assays is certain to reinforce the utility of BAL in the future. Our review of the BAL literature is intended to serve as a resource to assist clinicians in the care of patients with lung disorders.
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Affiliation(s)
- Kevin R Davidson
- Division of Pulmonary Sciences & Critical Care Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - Duc M Ha
- Division of Pulmonary Sciences & Critical Care Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA.,Rocky Mountain Regional Veterans Affairs Medical Center, Aurora, Colorado, USA.,Institute for Health Research, Kaiser Permanente Colorado, Aurora, Colorado, USA
| | - Marvin I Schwarz
- Division of Pulmonary Sciences & Critical Care Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - Edward D Chan
- Division of Pulmonary Sciences & Critical Care Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA.,Rocky Mountain Regional Veterans Affairs Medical Center, Aurora, Colorado, USA.,National Jewish Health, Denver, Colorado, USA
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Toyooka T, Koda S. [Management of occupational health for adverse health effects of beryllium and its compounds in workplaces - Recent trends and issues in Japan]. Sangyo Eiseigaku Zasshi 2020; 63:31-42. [PMID: 32788509 DOI: 10.1539/sangyoeisei.2020-030-a] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVES Beryllium is primarily used in its metallic form, in alloys, or in beryllium oxide ceramics. Its physical and mechanical properties make it useful for many applications across a range of industries. Because beryllium is recognized as a sensitizing and carcinogenic agent, the management of occupational health for workers who may be occupationally exposed to beryllium has long been an important issue in the world. Under these circumstances, the U.S. Occupational Safety and Health Administration (OSHA) had published a rule in January 2017, to prevent the development of chronic beryllium disease and lung cancer. This rule strengthens the regulations governing the use of beryllium and its compounds. With the announcement of the OSHA rule in January 2017, the purpose of this study is to gain insight into the health problems and industrial hygiene associated with the use of beryllium and share the issues related to the management of occupational health for persons working with beryllium in Japan. METHODS We collected information regarding the beryllium industry, beryllium exposure, beryllium-induced health disorders, OSHA rule of January 2017, and regulations for beryllium use in Japan. After reviewing them, we discussed the issues concerning occupational health management of workers exposed to beryllium in Japan. RESULTS It has been reconfirmed that in recent years, the most serious health problem due to beryllium exposure is chronic beryllium disease caused by beryllium sensitization. Management of occupational health that emphasizes reduction of beryllium sensitization and early detection of beryllium-sensitized workers is important. CONCLUSIONS It was suggested that the following should be considered as the issues of management of occupational health of workers exposed to beryllium in Japan: (1) Collect epidemiologic data on health hazards from beryllium exposure in Japan. (2) Review the diagnostic items of special medical check-ups. (3) Review the definition of beryllium and its compounds in the Ordinance on Prevention of Hazards due to Specified Chemical Substances.
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Affiliation(s)
| | - Shigeki Koda
- National Institute of Occupational Safety and Health
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MacMurdo MG, Mroz MM, Culver DA, Dweik RA, Maier LA. Chronic Beryllium Disease: Update on a Moving Target. Chest 2020; 158:2458-2466. [PMID: 32768458 DOI: 10.1016/j.chest.2020.07.074] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2020] [Revised: 06/05/2020] [Accepted: 07/19/2020] [Indexed: 10/23/2022] Open
Abstract
Beryllium exposure remains an ongoing occupational health concern for workers worldwide. Since the initial Occupational Safety and Health Administration (OSHA) ruling on a permissible exposure limit (PEL) for beryllium in 1971, our understanding of the risks of beryllium sensitization and chronic beryllium disease (CBD) has evolved substantially. A new OSHA ruling released in early 2017 and implemented in late 2018 reduced the PEL for beryllium, increased requirements for medical screening and monitoring, and may ultimately enhance worker protection. This review highlights advances in our understanding of the pathway from beryllium exposure to sensitization and progression to CBD that guided the development of this OSHA ruling. Screening workers exposed to beryllium and management of CBD will also be discussed. Finally, we will discuss the role of beryllium as a cause of morbidity and mortality among exposed workers in this potentially preventable occupational lung disease.
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Affiliation(s)
| | - Margaret M Mroz
- Division of Environmental and Occupational Health Sciences, National Jewish Health, Denver, CO
| | | | - Raed A Dweik
- Respiratory Institute, Cleveland Clinic, Cleveland, OH
| | - Lisa A Maier
- Division of Environmental and Occupational Health Sciences, National Jewish Health, Denver, CO
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Virji MA, Schuler CR, Cox-Ganser J, Stanton ML, Kent MS, Kreiss K, Stefaniak AB. Associations of Metrics of Peak Inhalation Exposure and Skin Exposure Indices With Beryllium Sensitization at a Beryllium Manufacturing Facility. Ann Work Expo Health 2020; 63:856-869. [PMID: 31504146 DOI: 10.1093/annweh/wxz064] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2019] [Revised: 05/31/2019] [Accepted: 07/19/2019] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVES Peak beryllium inhalation exposures and exposure to the skin may be relevant for developing beryllium sensitization (BeS). The objective of this study was to identify risk factors associated with BeS to inform the prevention of sensitization, and the development of chronic beryllium disease (CBD). METHODS In a survey of short-term workers employed at a primary beryllium manufacturing facility between the years 1994-1999, 264 participants completed a questionnaire and were tested for BeS. A range of qualitative and quantitative peak inhalation metrics and skin exposure indices were created using: personal full-shift beryllium exposure measurements, 15 min to 24 h process-specific task and area exposure measurements, glove measurements as indicator of skin exposure, process-upset information gleaned from historical reports, and self-reported information on exposure events. Hierarchical clustering was conducted to systematically group participants based on similarity of patterns of 16 exposure variables. The associations of the exposure metrics with BeS and self-reported skin symptoms (in work areas processing beryllium salts as well as in other work areas) were evaluated using correlation analysis, log-binomial and logistic regression models with splines. RESULTS Metrics of peak inhalation exposure, indices of skin exposure, and using material containing beryllium salts were significantly associated with skin symptoms and BeS; skin symptoms were a strong predictor of BeS. However, in this cohort, we could not tease apart the independent effects of skin exposure from inhalation exposure, as these exposures occurred simultaneously and were highly correlated. Hierarchical clustering identified groups of participants with unique patterns of exposure characteristics resulting in different prevalence of BeS and skin symptoms. A cluster with high skin exposure index and use of material containing beryllium salts had the highest prevalence of BeS and self-reported skin symptoms, followed by a cluster with high inhalation and skin exposure index and a very small fraction of jobs in which beryllium salts were used. A cluster with low inhalation and skin exposure and no workers using beryllium salts had no cases of BeS. CONCLUSION Multiple pathways and types of exposure were associated with BeS and may be important for informing BeS prevention. Prevention efforts should focus on controlling airborne beryllium exposures with attention to peaks, use of process characteristics (e.g. the likelihood of upset conditions to design interventions) minimize skin exposure to beryllium particles, and in particular, eliminate skin contact with beryllium salts to interrupt potential exposure pathways for BeS risk.
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Affiliation(s)
- M Abbas Virji
- National Institute for Occupational Safety and Health, Respiratory Health Division, Morgantown, WV, USA
| | - Christine R Schuler
- National Institute for Occupational Safety and Health, Respiratory Health Division, Morgantown, WV, USA.,National Institute for Occupational Safety and Health, Division of Safety Research, Morgantown, WV, USA
| | - Jean Cox-Ganser
- National Institute for Occupational Safety and Health, Respiratory Health Division, Morgantown, WV, USA
| | - Marcia L Stanton
- National Institute for Occupational Safety and Health, Respiratory Health Division, Morgantown, WV, USA
| | | | - Kathleen Kreiss
- National Institute for Occupational Safety and Health, Respiratory Health Division, Morgantown, WV, USA
| | - Aleksandr B Stefaniak
- National Institute for Occupational Safety and Health, Respiratory Health Division, Morgantown, WV, USA
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Denisova O, Chernogoryuk G, Baranovskaya N, Rikhvanov L, Shefer N, Chernjavskaya G, Palchikova I, Kalacheva T. Trace Elements in the Lung Tissue Affected by Sarcoidosis. Biol Trace Elem Res 2020; 196:66-73. [PMID: 31686394 DOI: 10.1007/s12011-019-01915-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2019] [Accepted: 09/20/2019] [Indexed: 10/25/2022]
Abstract
In the lungs of 76 patients with verified sarcoidosis, 28 chemical elements were identified with neutron activation analysis. High levels of Ca, Fe, Cr, Co, Cs, Eu, Lu, Th, Hf, Au, and U and low level of Na compared to the control samples were determined in sarcoidosis. There were no significant differences in the content of Zn, Rb, La, Sm, Sr, Nd, As, Br, Ag, Tb, Sc, Ta, Sb, Ba, and Yb. Spearman correlation analysis shows multiple positive associations, with the maximum being in pairs as follows: Fe-Cr, Eu-La, Ce-Lu, Hf-Cr, Sc-Zn, Fe-Hf, Ce-Co, and Sb-Cr. These studies support the hypothesis that sarcoidosis is a response of the organism in the form of granulomatous inflammation when exposed to heavy metals and rare earth elements in the environment. We assume that the role of calcium and iron is to separate granulomas from the tissues of the body.
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Affiliation(s)
- Olga Denisova
- Hospital Therapy Department, Siberian State Medical University, Moskovsky Trakt 2, Tomsk, 634050, Russia.
| | - George Chernogoryuk
- Hospital Therapy Department, Siberian State Medical University, Moskovsky Trakt 2, Tomsk, 634050, Russia
| | - Natalya Baranovskaya
- Division for Geology of the School of Earth Sciences and Engineering, Tomsk Polytechnic University, Tomsk, Russia
| | - Leonid Rikhvanov
- Division for Geology of the School of Earth Sciences and Engineering, Tomsk Polytechnic University, Tomsk, Russia
| | - Nikolaj Shefer
- Surgery department, Tomsk Regional Oncologic Dispensary, Tomsk, Russia
| | - Galina Chernjavskaya
- Hospital Therapy Department, Siberian State Medical University, Moskovsky Trakt 2, Tomsk, 634050, Russia
| | - Inna Palchikova
- Department of Internal Medicine, Tomsk Regional Clinical Hospital, Tomsk, Russia
| | - Tatyana Kalacheva
- Department of General Practice and Polyclinic Therapy, Siberian State Medical University, Tomsk, Russia
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