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人类呼吸并发症及血清免疫球蛋白升高与饮用水砷中毒的关联。

Association of respiratory complications and elevated serum immunoglobulins with drinking water arsenic toxicity in human.

作者信息

Islam Laila N, Nabi A H M Nurun, Rahman M Mahfuzur, Zahid M Shamim H

机构信息

Department of Biochemistry and Molecular Biology, University of Dhaka, Bangladesh.

出版信息

J Environ Sci Health A Tox Hazard Subst Environ Eng. 2007 Oct;42(12):1807-14. doi: 10.1080/10934520701566777.

Abstract

We assessed the relationship between chronic arsenic exposure through drinking water with respiratory complications and humoral immune response by measuring serum immunoglobulin profiles in the affected subjects (arsenicosis patients) living in the arsenic endemic rural villages of Bangladesh. The duration of exposure was determined through detailed history of the patients (n=125) and the levels of arsenic in the drinking water and urine samples were determined. The mean duration of exposure in the patients was 7.4+/-5.3 y, and the levels of arsenic in the drinking water and urine samples were 216+/-211 and 223+/-302 micro g/L, respectively, compared to 11+/-20 and 29+/-19 microg/L, respectively, in the unexposed subjects. There was high prevalence of respiratory complications like breathing problems including chest sound, asthma, bronchitis and cough associated with drinking water arsenic toxicity. Arsenicosis patients had significantly elevated levels of IgG (P<0.001) and IgE (P<0.001) while the levels of IgA were also significantly higher (P<0.005) but IgM were similar to that of the control subjects. Analysis of the clinical symptoms based on skin manifestations showed the levels of both IgG and IgE were significantly elevated during the initial stages while IgE were further elevated with the duration of arsenic exposure. Arsenicosis patients with respiratory complications had mean serum IgE levels of 706+/-211 IU/mL compared to 542+/-241 IU/mL in patients without apparent involvement with the respiratory system (P<0.01). The eosinophil counts in the patients did not differ significantly from the unexposed subjects indicating that elevated levels of serum IgE might not be due to allergic diseases, rather it could be due to direct effects of arsenic. We found significant linear relationships between the levels of serum IgE and inorganic phosphorus (P<0.05), and serum IgA levels with urinary excretion of arsenic (P<0.001). These observations suggested that arsenic toxicity caused respiratory complications, induced changes in the humoral as well as mucosal immune responses.

摘要

我们通过测量生活在孟加拉国砷中毒流行农村地区的受影响人群(砷中毒患者)的血清免疫球蛋白谱,评估了饮用水中慢性砷暴露与呼吸道并发症及体液免疫反应之间的关系。通过详细询问患者(n = 125)的病史确定暴露持续时间,并测定饮用水和尿液样本中的砷含量。患者的平均暴露持续时间为7.4±5.3年,饮用水和尿液样本中的砷含量分别为216±211μg/L和223±302μg/L,相比之下,未暴露人群的这两个值分别为11±20μg/L和29±19μg/L。与饮用水砷中毒相关的呼吸并发症如呼吸问题(包括胸部听诊异常、哮喘、支气管炎和咳嗽)的患病率很高。砷中毒患者的IgG(P<0.001)和IgE(P<0.001)水平显著升高,而IgA水平也显著升高(P<0.005),但IgM与对照组相似。基于皮肤表现对临床症状进行分析显示,在初始阶段IgG和IgE水平均显著升高,而IgE随着砷暴露时间的延长进一步升高。有呼吸道并发症的砷中毒患者血清IgE平均水平为706±211IU/mL,而无明显呼吸系统受累的患者为542±241IU/mL(P<0.01)。患者的嗜酸性粒细胞计数与未暴露人群无显著差异,这表明血清IgE水平升高可能不是由于过敏性疾病,而是可能由于砷的直接作用。我们发现血清IgE水平与无机磷之间存在显著的线性关系(P<0.05),血清IgA水平与尿砷排泄之间存在显著线性关系(P<0.001)。这些观察结果表明,砷中毒导致了呼吸道并发症,引起了体液以及黏膜免疫反应的变化。

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