甲苯二异氰酸酯（TDI）肺部疾病：免疫学与吸入激发试验研究

Toluene diisocyanate (TDI) pulmonary disease: immunologic and inhalation challenge studies.

作者信息

Butcher B T, Salvaggio J E, Weill H, Ziskind M M

出版信息

J Allergy Clin Immunol. 1976 Jul;58(1 PT 1):89-100. doi: 10.1016/0091-6749(76)90110-x.

Abstract

Clinical and serologic effects of TDI exposure were studied in 112 occupationally exposed plant workers. Sera were obtained before and after commencement of TDI production. All subjects were skin-tested with common inhalant allergens and a TDI-HSA conjugate. Total eosinophil counts, immunoglobulin quantitations, and specific antibody assays by PCA, P-K, and radioimmunoassay were performed. Clinically "sensitive" individuals were tested by provocative inhalation challenge with from 0.005 ppm to the threshold limit value of 0.02 ppm TDI. No TDI-induced immunologic changes were noted with the exception of 3 individuals who demonstrated small positive wheal-and-erythema reactions to TDI-HSA but not to HSA alone. Inhalation challenge with TDI vapor produced airways obstruction, as measured by FEF (25-75). These responses were of the immediate, delayed, and dual type, and were provoked in some cases with levels as low as 0.005 ppm TDI.

摘要

对112名职业性接触甲苯二异氰酸酯（TDI）的工厂工人进行了TDI接触的临床和血清学效应研究。在TDI生产开始之前和之后采集血清。所有受试者均用常见吸入性变应原和TDI-人血清白蛋白（HSA）结合物进行皮肤试验。进行了嗜酸性粒细胞总数、免疫球蛋白定量以及通过被动皮肤过敏反应（PCA）、普拉茨克-库姆斯试验（P-K）和放射免疫测定法进行的特异性抗体检测。对临床上“敏感”的个体进行了TDI激发吸入试验，浓度范围为0.005 ppm至阈限值0.02 ppm。除3名个体对TDI-HSA表现出小的阳性风团和红斑反应，但对单独的HSA无反应外，未观察到TDI诱导的免疫变化。用TDI蒸气进行吸入激发试验会导致气道阻塞，通过用力呼气流量（FEF）（25-75）进行测量。这些反应有速发型、迟发型和混合型，在某些情况下，低至0.005 ppm的TDI水平即可引发。