Carlsten C, de Roos A J, Kaufman J D, Checkoway H, Wener M, Seixas N
University of Washington, Department of Medicine, 4225 Roosevelt Way NE, Suite 100, Seattle, WA 98105, USA.
Arthritis Rheum. 2007 Feb 15;57(1):147-53. doi: 10.1002/art.22483.
Cement masons are known to have significant silica exposure, and silica exposure and silicosis are thought to increase risk of autoimmune disease. Because the mechanisms remain obscure, with inconclusive reports of systemic immune effects following silica exposure, our goal was to identify potential early markers of silica-related immunologic and respiratory effects.
We conducted a cross-sectional study of cement mason apprentices and electrician (control) apprentices. Demographics, dust exposure history, symptoms, spirometry, exhaled nitric oxide, and blood (for immunoglobulins, cytokines, cell counts, and surface markers) were obtained from 11 cement mason apprentices and a comparison group of 21 electrician apprentices.
Masons had significantly higher (P < 0.05) masonry dust exposure (42 versus 9 dust-hour-years), serum interleukin-1beta (IL-1beta; 12 versus 9 pg/ml), IL-2 (20 versus 8 pg/ml), IL-4 (193 versus 67 pg/ml), IL-10 (44 versus 21 pg/ml), and interferon-gamma (139 versus 65 pg/ml) compared with electricians. In contrast, masons had significantly lower percentages of CD25+ (12% versus 20%) and CD69+ (4% versus 9%) lymphocytes.
Mason apprentices had higher levels of serum proinflammatory cytokines and lower percentages of CD25+ and CD69+ lymphocytes than did electrician apprentices. These preliminary findings suggest that mason apprentices may be at greater risk of a systemic proinflammatory state that is potentially linked to immune dysregulation. Although distinct limitations of this preliminary data are recognized, this is consistent with early biologic effects leading to increased incidence of autoimmune disease among silica-exposed workers. Prospective studies are needed to validate these initial findings and clarify the temporal sequence of observed relationships.
已知水泥工有大量二氧化硅暴露,且二氧化硅暴露和矽肺病被认为会增加自身免疫性疾病的风险。由于其机制仍不清楚,关于二氧化硅暴露后全身免疫效应的报道尚无定论,我们的目标是确定二氧化硅相关免疫和呼吸效应的潜在早期标志物。
我们对水泥工学徒和电工(对照)学徒进行了一项横断面研究。从11名水泥工学徒和21名电工学徒的对照组中获取了人口统计学信息、粉尘暴露史、症状、肺功能、呼出一氧化氮以及血液(用于检测免疫球蛋白、细胞因子、细胞计数和表面标志物)。
与电工相比,水泥工的砖石粉尘暴露量显著更高(P < 0.05)(42粉尘 - 小时 - 年 vs 9粉尘 - 小时 - 年),血清白细胞介素 - 1β(IL - 1β;12 pg/ml vs 9 pg/ml)、IL - 2(20 pg/ml vs 8 pg/ml)、IL - 4(193 pg/ml vs 67 pg/ml)、IL - 10(44 pg/ml vs 21 pg/ml)和干扰素 - γ(139 pg/ml vs 65 pg/ml)。相比之下,水泥工的CD25 +淋巴细胞百分比(12% vs 20%)和CD69 +淋巴细胞百分比(4% vs 9%)显著更低。
与电工学徒相比,水泥工学徒的血清促炎细胞因子水平更高,CD25 +和CD69 +淋巴细胞百分比更低。这些初步发现表明,水泥工学徒可能面临更大的全身促炎状态风险,这可能与免疫失调有关。尽管认识到这些初步数据存在明显局限性,但这与早期生物学效应一致,即导致二氧化硅暴露工人自身免疫性疾病发病率增加。需要进行前瞻性研究来验证这些初步发现,并阐明观察到的关系的时间顺序。