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Lummus ZL, Kesavalu B, Kaufman K, Yao J, Weirauch MT, Kottyan LC, Miller D, Cartier A, Cruz MJ, Lemiere C, Muñoz X, Quirce S, Sastre J, Tarlo SM, Bernstein DI. Regulatory Variants of ATF3, CDH17 and FAM71A are Risk Factors for Diisocyanate Induced Occupational Asthma (DA). J Allergy Clin Immunol 2018. [DOI: 10.1016/j.jaci.2017.12.627] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Lummus ZL, Kaufman K, Weirauch MT, Cartier A, Cruz MJ, Kesavalu B, Lemiere C, Muñoz X, Perez-Camo I, Quirce S, Sastre J, Yucesoy B, Bernstein DI. Next Generation DNA Sequencing of Novel Loci in Workers with Diisocyanate Asthma (DA). J Allergy Clin Immunol 2017. [DOI: 10.1016/j.jaci.2016.12.609] [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] [Indexed: 10/20/2022]
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Yucesoy B, Kashon ML, Johnson VJ, Lummus ZL, Fluharty K, Gautrin D, Cartier A, Boulet LP, Sastre J, Quirce S, Tarlo SM, Cruz MJ, Munoz X, Luster MI, Bernstein DI. Genetic variants in TNFα, TGFB1, PTGS1 and PTGS2 genes are associated with diisocyanate-induced asthma. J Immunotoxicol 2015; 13:119-26. [PMID: 25721048 DOI: 10.3109/1547691x.2015.1017061] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
Abstract
Diisocyanates are the most common cause of occupational asthma, but risk factors are not well defined. A case-control study was conducted to investigate whether genetic variants in inflammatory response genes (TNFα, IL1α, IL1β, IL1RN, IL10, TGFB1, ADAM33, ALOX-5, PTGS1, PTGS2 and NAG-1/GDF15) are associated with increased susceptibility to diisocyanate asthma (DA). These genes were selected based on their role in asthmatic inflammatory processes and previously reported associations with asthma phenotypes. The main study population consisted of 237 Caucasian French Canadians from among a larger sample of 280 diisocyanate-exposed workers in two groups: workers with specific inhalation challenge (SIC) confirmed DA (DA(+), n = 95) and asymptomatic exposed workers (AW, n = 142). Genotyping was performed on genomic DNA, using a 5' nuclease PCR assay. After adjusting for potentially confounding variables of age, smoking status and duration of exposure, the PTGS1 rs5788 and TGFB1 rs1800469 single nucleotide polymorphisms (SNP) showed a protective effect under a dominant model (OR = 0.38; 95% CI = 0.17, 0.89 and OR = 0.38; 95% CI = 0.18, 0.74, respectively) while the TNFα rs1800629 SNP was associated with an increased risk of DA (OR = 2.08; 95% CI = 1.03, 4.17). Additionally, the PTGS2 rs20417 variant showed an association with increased risk of DA in a recessive genetic model (OR = 6.40; 95% CI = 1.06, 38.75). These results suggest that genetic variations in TNFα, TGFB1, PTGS1 and PTGS2 genes contribute to DA susceptibility.
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Affiliation(s)
- Berran Yucesoy
- a Division of Immunology , Allergy and Rheumatology, University of Cincinnati College of Medicine , Cincinnati , OH , USA .,b CDC/National Institute for Occupational Safety and Health, Health Effects Laboratory Division , Morgantown , WV , USA
| | - Michael L Kashon
- b CDC/National Institute for Occupational Safety and Health, Health Effects Laboratory Division , Morgantown , WV , USA
| | | | - Zana L Lummus
- a Division of Immunology , Allergy and Rheumatology, University of Cincinnati College of Medicine , Cincinnati , OH , USA
| | - Kara Fluharty
- b CDC/National Institute for Occupational Safety and Health, Health Effects Laboratory Division , Morgantown , WV , USA
| | - Denyse Gautrin
- d Université de Montréal, Hôpital du Sacré-Coeur de Montréal , Montreal , Quebec , Canada
| | - André Cartier
- d Université de Montréal, Hôpital du Sacré-Coeur de Montréal , Montreal , Quebec , Canada
| | | | - Joaquin Sastre
- f Department of Allergy , Fundación Jiménez Díaz and CIBER de Enfermedades Respiratorias CIBERES , Madrid , Spain
| | - Santiago Quirce
- g Department of Allergy , Hospital La Paz-IdiPAZ and CIBER de Enfermedades Respiratorias CIBERES , Madrid , Spain
| | - Susan M Tarlo
- h Department of Medicine , and.,i Dalla Lana School of Public Health, University of Toronto , Toronto , Ontario , Canada
| | - Maria-Jesus Cruz
- j Hospitals Vall D'Hebron, Barcelona and CIBER de Enfermedades Respiratorias CIBERES , Madrid , Spain , and
| | - Xavier Munoz
- j Hospitals Vall D'Hebron, Barcelona and CIBER de Enfermedades Respiratorias CIBERES , Madrid , Spain , and
| | - Michael I Luster
- k West Virginia University, School of Public Health , Morgantown , WV , USA
| | - David I Bernstein
- a Division of Immunology , Allergy and Rheumatology, University of Cincinnati College of Medicine , Cincinnati , OH , USA
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Yucesoy B, Kaufman KM, Lummus ZL, Weirauch MT, Zhang G, Cartier A, Boulet LP, Sastre J, Quirce S, Tarlo SM, Cruz MJ, Munoz X, Harley JB, Bernstein DI. Genome-Wide Association Study Identifies Novel Loci Associated With Diisocyanate-Induced Occupational Asthma. Toxicol Sci 2015; 146:192-201. [PMID: 25918132 DOI: 10.1093/toxsci/kfv084] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
Diisocyanates, reactive chemicals used to produce polyurethane products, are the most common causes of occupational asthma. The aim of this study is to identify susceptibility gene variants that could contribute to the pathogenesis of diisocyanate asthma (DA) using a Genome-Wide Association Study (GWAS) approach. Genome-wide single nucleotide polymorphism (SNP) genotyping was performed in 74 diisocyanate-exposed workers with DA and 824 healthy controls using Omni-2.5 and Omni-5 SNP microarrays. We identified 11 SNPs that exceeded genome-wide significance; the strongest association was for the rs12913832 SNP located on chromosome 15, which has been mapped to the HERC2 gene (p = 6.94 × 10(-14)). Strong associations were also found for SNPs near the ODZ3 and CDH17 genes on chromosomes 4 and 8 (rs908084, p = 8.59 × 10(-9) and rs2514805, p = 1.22 × 10(-8), respectively). We also prioritized 38 SNPs with suggestive genome-wide significance (p < 1 × 10(-6)). Among them, 17 SNPs map to the PITPNC1, ACMSD, ZBTB16, ODZ3, and CDH17 gene loci. Functional genomics data indicate that 2 of the suggestive SNPs (rs2446823 and rs2446824) are located within putative binding sites for the CCAAT/Enhancer Binding Protein (CEBP) and Hepatocyte Nuclear Factor 4, Alpha transcription factors (TFs), respectively. This study identified SNPs mapping to the HERC2, CDH17, and ODZ3 genes as potential susceptibility loci for DA. Pathway analysis indicated that these genes are associated with antigen processing and presentation, and other immune pathways. Overlap of 2 suggestive SNPs with likely TF binding sites suggests possible roles in disruption of gene regulation. These results provide new insights into the genetic architecture of DA and serve as a basis for future functional and mechanistic studies.
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Affiliation(s)
- Berran Yucesoy
- *Division of Immunology, Allergy and Rheumatology, University of Cincinnati College of Medicine, Cincinnati, Ohio
| | - Kenneth M Kaufman
- Cincinnati Children's Hospital Medical Center, Center for Autoimmune Genomics and Etiology, and Cincinnati VA Medical Center
| | - Zana L Lummus
- *Division of Immunology, Allergy and Rheumatology, University of Cincinnati College of Medicine, Cincinnati, Ohio,Cincinnati Children's Hospital Medical Center, Center for Autoimmune Genomics and Etiology, and Cincinnati VA Medical Center,Cincinnati Children's Hospital Medical Center, Divisions of Biomedical Informatics and Developmental Biology,Cincinnati Children's Hospital Medical Center, Division of Human Genetics,Université de Montréal, Hôpital du Sacré-Coeur de Montréal, Montreal, Quebec, Canada,Université Laval, Hôpital Laval, Sainte-Foy, Québec, Canada,Department of Allergy, Fundación Jiménez Díaz and CIBER de Enfermedades Respiratorias CIBERES, Madrid, Spain,Department of Allergy, Hospital La Paz-IdiPAZ and CIBER de Enfermedades Respiratorias CIBERES, Madrid, Spain,University of Toronto, Toronto, Ontario, Canada and**Hospitals Vall D'Hebron, Barcelona and CIBER de Enfermedades Respiratorias CIBERES, Madrid, Spain
| | - Matthew T Weirauch
- Cincinnati Children's Hospital Medical Center, Center for Autoimmune Genomics and Etiology, and Cincinnati VA Medical Center, Cincinnati Children's Hospital Medical Center, Divisions of Biomedical Informatics and Developmental Biology
| | - Ge Zhang
- Cincinnati Children's Hospital Medical Center, Division of Human Genetics
| | - André Cartier
- Université de Montréal, Hôpital du Sacré-Coeur de Montréal, Montreal, Quebec, Canada
| | | | - Joaquin Sastre
- Department of Allergy, Fundación Jiménez Díaz and CIBER de Enfermedades Respiratorias CIBERES, Madrid, Spain
| | - Santiago Quirce
- Department of Allergy, Hospital La Paz-IdiPAZ and CIBER de Enfermedades Respiratorias CIBERES, Madrid, Spain
| | | | - Maria-Jesus Cruz
- **Hospitals Vall D'Hebron, Barcelona and CIBER de Enfermedades Respiratorias CIBERES, Madrid, Spain
| | - Xavier Munoz
- **Hospitals Vall D'Hebron, Barcelona and CIBER de Enfermedades Respiratorias CIBERES, Madrid, Spain
| | - John B Harley
- Cincinnati Children's Hospital Medical Center, Center for Autoimmune Genomics and Etiology, and Cincinnati VA Medical Center
| | - David I Bernstein
- *Division of Immunology, Allergy and Rheumatology, University of Cincinnati College of Medicine, Cincinnati, Ohio,
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Ouyang B, Bernstein DI, Lummus ZL, Ying J, Boulet LP, Cartier A, Gautrin D, Ho SM. Interferon-γ promoter is hypermethylated in blood DNA from workers with confirmed diisocyanate asthma. Toxicol Sci 2013; 133:218-24. [PMID: 23535363 DOI: 10.1093/toxsci/kft079] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
Risk factors have not been identified that determine susceptibility for development of diisocyanate-induced occupational asthma (DA). We hypothesized that diisocyanate (DI) exposure could modify gene promoter regions regulating transcription of cytokine mediators and thereby influence expression of DA. A cross-sectional study was designed to investigate the promoter methylation status of candidate genes in DI-exposed workers. Subjects consisted of 131 workers in three groups: 40 cases with DA confirmed by a positive specific inhalation challenge (SIC) (DA+), 41 exposed workers with lower respiratory symptoms and negative SIC (DA-), and 50 asymptomatic exposed workers (AWs). We studied four candidate genes (GSTM1, DUSP22, IFN-γ, and IL-4) for which altered promoter methylation has been previously investigated for relationships with a variety of other environmental exposures. Methylation status was determined using methylation-specific quantitative PCR performed on genomic DNA extracted from whole blood. Results showed that relative methylation of IFN-γ promoter was significantly increased in DA+ in comparison with both comparator groups (DA- and AW), and it exhibited good sensitivity (77.5%) and specificity (80%) for identifying DA workers in a multivariate predictive model after adjusting for type of DI exposure, smoking status, methacholine PC₂₀, and gender. IL-4 promoter was slightly less methylated only in DA+ compared with AW among nonsmoking workers. Both GSTM1 and DUSP22 promoter methylations were found not associated with DA. Our finding suggests that exposure to occupational chemicals could play a heretofore undefined mechanistic role via epigenetic modification of specific genes in the promoter region.
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Affiliation(s)
- Bin Ouyang
- Department of Environmental Health Sciences, University of Cincinnati Medical Center, Cincinnati, Ohio 45267-0056, USA
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Bernstein DI, Kashon M, Lummus ZL, Johnson VJ, Fluharty K, Gautrin D, Malo JL, Cartier A, Boulet LP, Sastre J, Quirce S, Germolec D, Tarlo SM, Cruz MJ, Munoz X, Luster MI, Yucesoy B. CTNNA3 (α-catenin) gene variants are associated with diisocyanate asthma: a replication study in a Caucasian worker population. Toxicol Sci 2012; 131:242-6. [PMID: 22977168 DOI: 10.1093/toxsci/kfs272] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
Recently, a genome-wide association study (GWAS) conducted in Korean subjects identified four CTNNA3 (alpha-T catenin) single nucleotide polymorphisms (SNPs) (rs10762058, rs7088181, rs1786929, and rs4378283) associated with diisocyanate-induced occupational asthma (DA). The CTNNA3 gene codes for a cadherin involved in formation of stretch-resistant cell-cell adhesions. We conducted a candidate gene association study to replicate these findings in Caucasian workers. Genotyping was performed on DNA using a 5' nuclease PCR assay collected from 410 diisocyanate-exposed and predominantly Canadian workers including 132 workers with DA confirmed by a specific inhalation challenge (DA+); 131 symptomatic workers in whom DA was excluded by a negative challenge (DA-); and 147 hexamethylene diisocyanate-exposed asymptomatic workers (AWs). As in the Korean study, highly linked CTNNA3 rs7088181 and rs10762058 SNPs (but not rs4378283 and rs1786929) were significantly associated with DA+ when compared with AWs but not in comparison with DA- workers (p ≤ 0.05). After adjusting for potentially confounding variables of age, smoking status, and duration of exposure, minor allele homozygotes of rs7088181 and rs10762058 SNPs were at increased risk for DA compared with AWs (OR = 9.05 [95% CI: 1.69, 48.54] and OR = 6.82 [95% CI: 1.65, 28.24], respectively). In conclusion, we replicated results from the only reported GWAS study of DA demonstrating an association between two closely linked CTNNA3 gene SNPs and DA. These findings lend further support to the clinical relevance of these genotypes in predicting susceptibility to DA and the potential importance of catenins in the disease process.
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Affiliation(s)
- David I Bernstein
- Division of Immunology, Allergy and Rheumatology, University of Cincinnati College of Medicine, Cincinnati, Ohio 45267, USA.
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Yucesoy B, Johnson VJ, Lummus ZL, Kissling GE, Fluharty K, Gautrin D, Malo JL, Cartier A, Boulet LP, Sastre J, Quirce S, Germolec DR, Tarlo SM, Cruz MJ, Munoz X, Luster MI, Bernstein DI. Genetic variants in antioxidant genes are associated with diisocyanate-induced asthma. Toxicol Sci 2012; 129:166-73. [PMID: 22610343 DOI: 10.1093/toxsci/kfs183] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Diisocyanates are a common cause of occupational asthma, but risk factors are not well defined. A case-control study was conducted to investigate whether genetic variants of antioxidant defense genes, glutathione S-transferases (GSTM1, GSTT1, GSTM3, GSTP1), manganese superoxide dismutase (SOD2), and microsomal epoxide hydrolase (EPHX1) are associated with increased susceptibility to diisocyanate-induced asthma (DA). The main study population consisted of 353 Caucasian French-Canadians from among a larger sample of 410 diisocyanate-exposed workers in three groups: workers with specific inhalation challenge (SIC) confirmed DA (DA(+), n = 95); symptomatic diisocyanate workers with a negative SIC (DA(-), n = 116); and asymptomatic exposed workers (AW, n = 142). Genotyping was performed on genomic DNA, using a 5'-nuclease PCR assay. The SOD2 rs4880, GSTP1 rs1695, and EPHX1 rs2740171 variants were significantly associated with DA in both univariate and multivariate analyses. In the first logistic regression model comparing DA(+) and DA(-) groups, SOD2 rs4880, GSTM1 (null), GSTP1 rs762803, and EPHX1 rs2854450 variants were associated with DA (p = 0.004, p = 0.047, p = 0.021, p <0.001, respectively). Genotype combinations GSTT1*GSTP1 rs762803, GSTM1*EPHX1 rs2854450, EPHX1 rs2740168*EPHX1 rs1051741, and GSTP1 rs762803*EPHX1 rs2740168 were also associated with DA in this model (p = 0.027, p = 0.002, p = 0.045, p = 0.044, respectively). The GSTP1 rs1695 and EPHX1 rs1051741 and rs2740171 variants showed an association with DA in the second model comparing DA(+) and AW groups (p = 0.040, p = 0.019, p = 0.002, respectively). The GSTM3 rs110913*EPHX1 rs1051741 genotype combination was also associated with DA under this model (p = 0.042). The results suggest that variations in SOD2, GST, and EPHX1 genes and their interactions contribute to DA susceptibility.
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Affiliation(s)
- Berran Yucesoy
- CDC/National Institute for Occupational Safety and Health, Health Effects Laboratory Division, Morgantown, West Virginia 26505, USA.
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Abstract
Occupational asthma (OA) is one of the most common forms of work-related lung disease in all industrialized nations. The clinical management of patients with OA depends on an understanding of the multifactorial pathogenetic mechanisms that can contribute to this disease. This article discusses the various immunologic and nonimmunologic mechanisms and genetic susceptibility factors that drive the inflammatory processes of OA.
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Affiliation(s)
- Zana L Lummus
- Department of Internal Medicine, University of Cincinnati College of Medicine, 3255 Eden Avenue, Cincinnati, OH 45267-0563, USA
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Wilder LC, Langley RL, Middleton DC, Ernst K, Lummus ZL, Streicher RP, Campbell DS, Wattigney WA, Bernstein JA, Bernstein DI, Dearwent SM. Communities near toluene diisocyanate sources: an investigation of exposure and health. J Expo Sci Environ Epidemiol 2011; 21:587-594. [PMID: 21343954 DOI: 10.1038/jes.2011.5] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/29/2010] [Accepted: 10/20/2010] [Indexed: 05/30/2023]
Abstract
Toluene diisocyanate (TDI) is a well-known cause of occupational asthma, but we know little about the potential for exposure and health effects among residents who live near facilities that release TDI. In the mid-1990's, the North Carolina Department of Health and Human Services and the Agency for Toxic Substances and Disease Registry investigated exposures to TDI and health outcomes in one community, which left some unanswered questions. This cross-sectional study evaluated the potential associations between living near a TDI source and the prevalence of three variables: asthma or asthma-like respiratory symptoms, antibodies specific to TDI, and verifiable levels of TDI in residential air. Results among North Carolina residents living near such facilities (five target communities) were compared with the results from residents living further away (five comparison communities). Overall, the prevalence of reporting either asthma or asthma-like respiratory symptoms was higher (odds ratio = 1.60; 95% confidence interval = 0.97-2.54) among residents in target communities than those in comparison communities. However, this difference was not statistically significant. Symptom prevalence varied greatly among the community populations. The prevalence of respiratory symptoms was higher near facilities with historically higher TDI emissions. Among the 351 participants who provided blood samples, only one had immunoglobulin G specific antibodies to TDI. This participant lived in a target area and may have had non-occupational exposure. TDI was detected at an extremely low level (1 ppt) in one of the 45 air samples from target communities. One ppt is one-tenth the EPA reference concentration. Overall, air sample and antibody test results are not consistent with recent or ongoing exposure to TDI.
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Affiliation(s)
- Lynn C Wilder
- Agency for Toxic Substances and Disease Registry, Division of Health Studies, Atlanta, Georgia 30341, USA.
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Bernstein IL, Bernstein DI, Lummus ZL, Bernstein JA. A case of progesterone-induced anaphylaxis, cyclic urticaria/angioedema, and autoimmune dermatitis. J Womens Health (Larchmt) 2011; 20:643-8. [PMID: 21417747 DOI: 10.1089/jwh.2010.2468] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
OBJECTIVE Women have exhibited anaphylaxis, urticaria/angioedema, and autoimmune progesterone dermatitis (APD) coinciding with the progesterone premenstrual rise. We report a detailed immunological evaluation of such a woman responsive to a gonadotropin hormone-releasing agonist (GHRA). METHODS Skin testing, enzyme-linked immunosorbent assays (ELISAs), leukocyte histamine release (LHR), and inhibition assays were performed to demonstrate progesterone immunoresponsiveness. RESULTS Serum specific-progesterone immunoglobulin G (IgG) and IgE were detected initially and disappeared 6 months after GHRA treatment. Dose-response LHR using patient basophils was observed for different hormones but after 3 months persisted only for 5β-pregnanediol. Preincubation with mouse antiprogesterone monoclonal antibody (PmAb) or mifepristone, a progesterone inhibitor, over a range of doses inhibited specific progesterone-induced LHR. Experiments with varying progesterone concentrations and a fixed dose of anti-IgE resulted in 100% LHR at a concentration as low as 0.016 nmol/mL, which, without anti-IgE, failed to release histamine. CONCLUSIONS This is the first report of combined recurrent anaphylaxis, cyclic urticaria/angioedema, and APD induced by immunoresponsiveness to progesterone.
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Affiliation(s)
- I Leonard Bernstein
- Department of Internal Medicine, Division of Immunology/Allergy Section, University of Cincinnati College of Medicine, Cincinnati, OH 45267-0563, USA
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Campo P, Kalra HK, Levin L, Reponen T, Olds R, Lummus ZL, Cho SH, Khurana Hershey GK, Lockey J, Villareal M, Stanforth S, LeMasters G, Bernstein DI. Influence of dog ownership and high endotoxin on wheezing and atopy during infancy. J Allergy Clin Immunol 2006; 118:1271-8. [PMID: 17157656 PMCID: PMC2233938 DOI: 10.1016/j.jaci.2006.08.008] [Citation(s) in RCA: 82] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2005] [Revised: 07/27/2006] [Accepted: 08/01/2006] [Indexed: 11/15/2022]
Abstract
BACKGROUND Increased exposure to microbial products early in life may protect from development of atopic disorders in childhood. Few studies have examined the relationship of endotoxin exposure and pet ownership on atopy and wheezing during infancy. OBJECTIVE Evaluate relationships among high endotoxin exposure, pet ownership, atopy, and wheezing in high-risk infants. METHODS Infants (n = 532; mean age, 12.5 +/- 0.8 months) with at least 1 parent with confirmed atopy were recruited. A complete medical history and skin prick testing to foods and aeroallergens were performed at age 1 year. House dust samples were analyzed for endotoxin. RESULTS Prevalences of wheezing were not independently associated with dog or cat ownership or endotoxin levels. Percutaneous reactivity to at least 1 allergen was observed in 28.6% of infants. Univariate analyses showed significant associations of any wheezing, recurrent wheezing, and recurrent wheezing with an event with daycare attendance, number of siblings, respiratory infections, maternal smoking, and history of parental asthma. Logistic regression adjusting for the latter variables showed that recurrent wheezing (odds ratio, 0.4; 95% CI, 0.1-0.9) as well as 2 other wheeze outcomes were significantly reduced in homes with high endotoxin exposure in the presence of 2 or more dogs. CONCLUSION Pet ownership or endotoxin did not independently modify aeroallergen sensitization or wheezing during infancy. However, high endotoxin exposure in the presence of multiple dogs was associated with reduced wheezing in infants. CLINICAL IMPLICATIONS A home environment with many dogs and high levels of endotoxin may be conducive to reduced wheezing in infancy.
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Affiliation(s)
- Paloma Campo
- Department of Internal Medicine, Immunology Division, University of Cincinnati, Cincinnati, Ohio
| | - Harpinder K. Kalra
- Department of Internal Medicine, Immunology Division, University of Cincinnati, Cincinnati, Ohio
| | - Linda Levin
- Department of Environmental Health, University of Cincinnati, Cincinnati, Ohio
| | - Tiina Reponen
- Department of Environmental Health, University of Cincinnati, Cincinnati, Ohio
| | - Rolanda Olds
- Department of Internal Medicine, Immunology Division, University of Cincinnati, Cincinnati, Ohio
| | - Zana L. Lummus
- Department of Internal Medicine, Immunology Division, University of Cincinnati, Cincinnati, Ohio
| | - Seung-Hyun Cho
- Department of Environmental Health, University of Cincinnati, Cincinnati, Ohio
| | | | - James Lockey
- Department of Environmental Health, University of Cincinnati, Cincinnati, Ohio
| | - Manuel Villareal
- Department of Internal Medicine, Immunology Division, University of Cincinnati, Cincinnati, Ohio
| | - Sherry Stanforth
- Department of Internal Medicine, Immunology Division, University of Cincinnati, Cincinnati, Ohio
| | - Grace LeMasters
- Department of Environmental Health, University of Cincinnati, Cincinnati, Ohio
| | - David I. Bernstein
- Department of Internal Medicine, Immunology Division, University of Cincinnati, Cincinnati, Ohio
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Abstract
PURPOSE OF REVIEW Diagnosing occupational asthma (OA) is a complex undertaking, the primary goal of which is to demonstrate a causal relation between exposure to a specific agent encountered at work and asthmatic responses. Recent development or refinement of diagnostic tools may improve the diagnostic accuracy, which may have important economic and social consequences for both employers and workers. RECENT FINDINGS Although specific inhalation challenge (SIC) testing is the gold standard for diagnosis of OA, these tests are not widely available in many countries. Thus, new less invasive techniques used in the measurement of airway inflammation, such as exhaled nitric oxide and induced sputum are highlighted as are recent developments in both in vivo and in vitro immunologic testing. SUMMARY Although new perspectives are being evaluated, the diagnosis of occupational asthma still relies mostly on specific inhalation challenge. Further studies are required to confirm the utility of these new techniques in the diagnosis of OA.
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Affiliation(s)
- Paloma Campo
- Division of Immunology-Allergy, Department of Internal Medicine, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
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Lummus ZL, Cartier A, Boulet LP, Côté J, Malo JL, Wanner M, Milot J, L'Archevéque J, Bernstein DI. MCP-1 synthesis by diisocyanate antigen stimulated PBMCs is a more sensitive in vitro assay for diisocyanate asthma than specific antibodies. J Allergy Clin Immunol 2002. [DOI: 10.1016/s0091-6749(02)81993-5] [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] [Indexed: 11/25/2022]
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Boeniger MF, Lummus ZL, Biagini RE, Bernstein DI, Swanson MC, Reed C, Massoudi M. Exposure to protein aeroallergens in egg processing facilities. Appl Occup Environ Hyg 2001; 16:660-70. [PMID: 11414516 DOI: 10.1080/10473220118319] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Proteinaceous materials in the air can be highly allergenic and result in a range of immunologically mediated respiratory effects, including asthma. We report on the largest evaluation of exposure to date of airborne egg protein concentrations in an egg breaking and processing plant that had cases of occupational asthma. Personal air samples for egg protein were analyzed in duplicate on each PTFE filter using two analytical methods: (1) a commercial assay for non-specific total protein, and (2) indirect competitive inhibition assay using an ELISA method to quantify specific egg protein components. The highest concentrations were found in the egg washing room (mean exposure 644 microg/m3) and breaking room (255 microg/m3), which were also the areas where the risk of being sensitized was the greatest. There was excellent quantitative agreement between the airborne concentrations of total protein and sum of the specific protein antigens (ovalbumin, ovomucoid, and lysozyme). The correlation coefficient of the log-transformed data from the two methods was 0.88 (p < 0.0001). Size-selective sampling also indicated that most of the aerosol was capable of reaching the small airways. The methods described can be utilized to evaluate employee exposure to egg proteins. Exposure documentation, coupled with recommended exposure reduction strategies, could facilitate prevention of future employee sensitization and allergic respiratory responses by identifying high-exposure jobs and evaluating control measures.
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Affiliation(s)
- M F Boeniger
- National Institute for Occupational Safety and Health, Cincinnati, Ohio, USA
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15
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Lummus ZL, Alam R, Bernstein JA, Bernstein DI. Diisocyanate antigen-enhanced production of monocyte chemoattractant protein-1, IL-8, and tumor necrosis factor-alpha by peripheral mononuclear cells of workers with occupational asthma. J Allergy Clin Immunol 1998; 102:265-74. [PMID: 9723671 DOI: 10.1016/s0091-6749(98)70095-8] [Citation(s) in RCA: 45] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
BACKGROUND Previous studies have shown a significant association between confirmed diisocyanate-induced asthma (DOA) and in vitro production of diisocyanate antigen-stimulated histamine-releasing factors by PBMCs. Chemokines found in PBMC supernatants are known to express histamine-releasing factor activity. OBJECTIVE PBMCs of diisocyanate-exposed workers were tested in vitro for diisocyanate antigen-specific enhancement of monocyte chemoattractant protein-1 (MCP-1), monocyte chemoattractant protein-3 (MCP-3), macrophage inflammatory protein-1alpha, RANTES, IL-8, and T-cell cytokines that could play a regulatory role in chemokine synthesis (IL-4, IL-5, IFN-gamma, and TNF-alpha. METHODS Secretion of chemokines and cytokines was determined by quantitative immunochemical assays of PBMC supernatants. Synthesis of mRNA for beta-chemokines was determined by reverse transcription-polymerase chain reaction. RESULTS PBMCs of workers with DOA showed significantly enhanced secretion for MCP-1 compared with diisocyanate-exposed asymptomatic workers (P < .05). In vitro induction of antigen-stimulated MCP-1 mRNA synthesis in cultured PBMCs was demonstrated by reverse-transcription polymerase chain reaction. Quantitation of cytokines in supernatants showed increased mean production of IL-8 and TNF-alpha. IFN-gamma, IL-4, and IL-5 were not enhanced in subjects with DOA. CONCLUSION Antigen stimulation of MCP-1 and TNF-alpha suggest that diisocyanate-specific cellular immune reactions result in activation of macrophages, which may be important in the pathogenesis of DOA.
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Affiliation(s)
- Z L Lummus
- Department of Internal Medicine, University of Cincinnati College of Medicine, Ohio 45267-0563, USA
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16
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Bernstein JA, Munson J, Lummus ZL, Balakrishnan K, Leikauf G. T-cell receptor V beta gene segment expression in diisocyanate-induced occupational asthma. J Allergy Clin Immunol 1997; 99:245-50. [PMID: 9042053 DOI: 10.1016/s0091-6749(97)70104-0] [Citation(s) in RCA: 36] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
BACKGROUND Diisocyanates are the most common cause of occupational asthma induced by low-molecular-weight chemicals. The disease appears to be immunologically mediated but is independent of IgE antibody synthesis. An underlying genetic susceptibility is suggested by the fact that the disease only develops in approximately 5% to 10% of exposed workers. OBJECTIVE The study was designed to determine whether disease susceptibility is influenced by HLA and T-cell receptor V beta gene segment usage. METHODS T-cell receptor V beta repertoires were quantitated by using primer pairs specific for V beta gene segments in conjunction with a common C beta region primer. One group of workers with diisocyanate-induced occupational asthma produced diisocyanate-specific IgG and IgE antibodies, whereas the other group did not produce specific antibodies. Occupational asthma was previously confirmed by either workplace challenge or laboratory specific diisocyanate bronchoprovocation. Control groups consisted of diisocyanate-exposed workers who were free of symptoms, patients with nonoccupational asthma, and unexposed subjects who were free of symptoms. RESULTS Lymphocytes from workers with diisocyanate-induced occupational asthma had significantly decreased V beta 1 and V beta 5 gene segment expression before in vitro exposure to diisocyanates, compared with control groups. Percent V beta 1 and V beta 5 gene segment expression was selectively increased when peripheral blood mononuclear cells were stimulated in vitro with diisocyanate-conjugated proteins. Low-resolution HLA class II phenotyping revealed no significant differences in the distribution of HLA-DR or HLA-DQ alleles between diisocyanate-induced occupational asthma and control groups. CONCLUSIONS These findings are consistent with a hypothesis that antigen-specific T-cell subpopulations may be sequestered in the lungs of workers with diisocyanate-induced occupational asthma and clonally expand after further exposure to diisocyanates.
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Affiliation(s)
- J A Bernstein
- Division of lummunology, University of Cincinnati College of Medicine, OH 45267-0563, USA
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17
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Abstract
Immunologic mechanisms contributing to diisocyanate-induced occupational asthma (OA) are poorly defined. There is a relatively low incidence of diisocyanate-specific IgE antibody responses. The frequent occurrence of delayed onset asthmatic responses in workers with diisocyanate asthma suggests a role for cellular immune mechanisms. We have shown in vitro production of antigen-specific mononuclear cell-derived histamine releasing factors (HRF) by peripheral blood mononuclear cells (PBMCs) of workers with OA. Monocyte chemoattractant protein-1 (MCP-1) and RANTES (acronym for "regulated on activation normal T expressed and secreted") are chemokines found in PBMC supernatants that express HRF activity. Diisocyanate-exposed workers were tested for diisocyanate antigen-stimulated enhancement of HRF, MCP-1, and RANTES production in supernatants of PBMCs and for serum specific IgE and IgG antibody levels to diisocyanate antigens bound to human serum albumin (HSA). PBMCs of workers with diisocyanate OA showed significantly increased production of antigen-specific HRF activity and MCP-1 ( > 300 ng/ml) compared to diisocyanate-exposed asymptomatic workers (P < 0.05). Antigen-stimulated enhancement of MCP-1 mRNA was demonstrated by reverse-transcription PCR. RANTES mRNA and chemokine secretion ( < 1 ng/ml) was also demonstrated in PBMCs, but did not show antigen enhancement in OA workers. Hapten specificity for the diisocyanate chemical to which a patient had been exposed was demonstrated for HRF enhancement and for IgG antibody reactions, but not for IgE reactions. HRF production was demonstrated in PBMC subpopulations, including lymphocytes and purified T cells. OA subjects showed increased CD8+ cells by immunofluorescence (mean CD4+: CD8+ = 1.2 +/- 0.2). The results suggest that diisocyanate antigen enhancement of HRF and MCP-1 production are stimulated by hapten-specific T cell reactions. Since a weak association has been found between IgE antibody synthesis and induction of diisocyanate OA, the role of T cell cytokines and chemokines in the pathogenesis of OA requires further investigation.
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Affiliation(s)
- Z L Lummus
- Department of Internal Medicine, University of Cincinnati College of Medicine, OH 45267-0563, USA
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18
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Abstract
We report the case of a 55-year-old male who experienced cough, dyspnea, wheezing, and nasal congestion immediately upon exposure to FD&C Blue Dye No. 2 (Indigotine) at work. The patient had worked for 10 years mixing and grinding powdered synthetic red, yellow, and blue dyes for use in foods; symptoms had occurred for 2 years and only with exposure to Indigotine (C16H8N2Na2O8S2), a free flowing blue powder. Prick testing to Indigotine (20 mg/mL) was negative. ELISA failed to detect specific IgE, IgA, IgM, or IgG to Indigotine-HSA conjugates. Bronchial challenge was done according to the method of Pepys et al. beginning with 4 x 10(-4) lactose dilution of Indigotine powder. After 5 minutes of exposure to 4 gm Indigotine/100 gm lactose, the patient developed dyspnea and audible wheezing. At 20 minutes postexposure, there was a 20% decline in FEV1 from prechallenge baseline; no late phase response was observed. A second bronchial challenge with sodium sulfate, the major nondye product additive was negative. To our knowledge, this is the first documented case of occupational asthma due to FD&C Blue Dye No. 2. The pathogenesis is uncertain but does not appear to be IgE mediated.
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Affiliation(s)
- M E Miller
- Department of Internal Medicine, University of Cincinnati, OH 45267-0563, USA
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Bernstein DI, Lummus ZL, Santilli G, Siskosky J, Bernstein IL. Machine operator's lung. A hypersensitivity pneumonitis disorder associated with exposure to metalworking fluid aerosols. Chest 1995; 108:636-41. [PMID: 7656609 DOI: 10.1378/chest.108.3.636] [Citation(s) in RCA: 130] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Abstract
Six auto parts manufacturing workers were referred for evaluation of a 6-week history of work-related dyspnea, cough, and fatigue. Two workers also reported fever and weight loss. All six worked in a machining area where a waterbased metalworking fluid was used and recirculated under high pressure, thereby creating an aerosol. Chest radiographs revealed pulmonary interstitial infiltrates in four workers. Lung function tests showed that four workers had decreased diffusing capacity. After removal from the work area, all workers recovered. The metalworking fluid was cultured for bacteria and fungi. Isolates from broth cultures were sonicated to obtain antigen extracts. Serum precipitins to one or more of the microbial isolates were identified in all six workers but not in eight of nine nonexposed control subjects. The most frequent precipitin response (six of six workers) was against antigens of Pseudomonas fluorescens, which was cultured from the metalworking fluid. In all workers, precipitins to at least one other cultured organism were detected; these included Aspergillus niger, Staphylococcus capitas, an acid-fast Rhodococcus sp, and Bacillus pumilus. This represents the first report of hypersensitivity pneumonitis associated with industrial exposure to aerosolized metalworking fluid. Observed precipitin responses to a variety of microbial contaminants in metalworking fluid strongly suggest a causative role for microbial antigens in the induction and elicitation of this manifestation of hypersensitivity pneumonitis.
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Affiliation(s)
- D I Bernstein
- University of Cincinnati College of Medicine, Department of Internal Medicine, OH, USA
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Abstract
Transplacental exposure to the carcinogen, benzo(a)pyrene BaP, leads to depressed immune function and increased tumor incidence in mice. This paper reports ontogenetic T-cell changes in BALB/c mice after exposure to BaP in utero. Monoclonal antibodies (MAbs) were produced to fetal liver T-cells (FLT) and newborn spleen (NBS) lymphocytes purified from offspring of pregnant BALB/c mice that were given one injection of BaP (150 mg/kg body weight) in mid-gestation (day 11-13). The MAbs reacted with two T-cell membrane antigens (FLT and NBS) found in fetal liver, neonatal and adult thymus and spleen. Lymphocytes of BaP-exposed 19-day fetuses showed decreased subpopulation frequencies (P < 0.05) in fetal liver total T-cells (from 56% to 16%), Ly1 cells (from 33% to 9%), and Ly2 cells (from 56% to 1%) compared with untreated controls. In contrast, BaP increased the subpopulation frequencies (P < 0.05) in FLT cells in fetal liver (from 20% to 52%) and in newborn spleen (from 21% to 51%), and increased NBS cells in newborn spleen (from 24% to 59%). The increased frequency in FLT and NBS cells was due to their relative resistance to BaP toxicity and/or BaP-enhanced proliferation in the neonatal period. Compared with untreated controls, BaP treatment resulted in reduced numbers of T-cells in fetal liver and showed a selective toxicity for Ly1 cells (89% reduction) and Ly2 cells (99% reduction), whereas FLT cells were not reduced and NBS cells were reduced by 60%. Six-week-old juvenile mice exposed to BaP in utero showed recovery of total T-cells to control levels in spleen and thymus, but showed depletion (P < 0.01) in thymic FLT cells (from 81% to 12%) and in splenic NBS cells (from 55% to 16%). The monoclonal antibodies developed for this study recognize novel cellular changes in the murine immune system that are associated with transplacental BaP. The FLT and NBS antigens may be useful biomarkers for developmental immune dysfunctions in progeny exposed to BaP in utero.
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Affiliation(s)
- Z L Lummus
- National Institute for Occupational Safety and Health, Centers for Disease Control, Cincinnati, OH 45226-1998, USA
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