Xia W, Xue M Q, Yang C X, Shan L, Niu Q, He P
Medical College, Shihezi University, Shihezi 832000, China.
Office of Occupational Health Quality Control, the Third People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi 830091, China.
Zhonghua Lao Dong Wei Sheng Zhi Ye Bing Za Zhi. 2024 Jul 20;42(7):510-516. doi: 10.3760/cma.j.cn121094-20231023-00091.
To explore the risk factors of coal workers' pneumoconiosis, reveal the molecular mechanism of pyroptosis in peripheral blood of coal workers' pneumoconiosis patients, and provide new strategies and potential diagnostic biomarkers for the treatment of the disease. From January 1, 2020 to December 31, 2022, workers with suspected occupational diseases who were diagnosed with coal workers' pneumoconiosis in the Third People's Hospital of Xinjiang Uygur Autonomous Region were included in the study, including 77 patients with coal workers' pneumoconiosis stage Ⅰ, 10 patients with stage Ⅱ, 6 patients with stage Ⅲ, and 49 workers with dust-free lung disease as the control group. General information of the subjects was collected, blood samples were collected for routine blood and blood biochemical results, and plasma levels of interleukin (IL) -1β and IL-18 were measured. Combined with the results of clinical examination, multi-factor ordered logistic regression analysis was carried out to evaluate the influencing factors of coal workers' pneumoconiosis. At the same time, the expression of pyroptosis related proteins in blood cells was detected to reveal the molecular mechanism of coal workers' pneumoconiosis. All 142 subjects were male, with an average age of (51.65±6.31) years old and an average working age of (15.94±9.38) years. There were significant differences in smoking age (=4.95, =0.003) and lunch break distribution (=8.84, =0.031) among all groups. The hemoglobin content of stage Ⅰ patients was higher than that of stage Ⅱ patients, and the neutrophil percentage of stage Ⅲ patients was higher than that of the other 3 groups (<0.05). The levels of total bilirubin and indirect bilirubin in stage Ⅰ patients were higher than those in control group, while the erythrocyte sedimentation rate in stage Ⅱ patients was higher than that in the other 3 groups (<0.05). The levels of IL-18 and IL-1β in stage Ⅲ of coal workers' pneumoconiosis were higher than those in the other 3 groups (<0.05). Multiple logistic regression analysis showed that smoking age (=1.03, 95%: 1.00-1.06) and IL-1β level (=4.61, 95%: 1.59-13.32) were independent risk factors for coal workers' pneumoconiosis (<0.05). Compared with the control group, the expression levels of nucleotide-binding of oligomeric domain-like receptor protein 3 (NLRP3), Caspase-1, GSDMD, Caspase-4 and other proteins in stage Ⅲ of coal workers' pneumoconiosis were significantly increased (<0.05) . Smoking age is a risk factor for coal workers' pneumoconiosis, IL-1β may be a potential biomarker for the diagnosis of coal workers' pneumoconiosis, and pyroptosis may play a role in the development of peripheral inflammation of coal workers' pneumoconiosis.
为探讨煤工尘肺的危险因素，揭示煤工尘肺患者外周血焦亡的分子机制，为该病的治疗提供新策略及潜在诊断生物标志物。选取2020年1月1日至2022年12月31日在新疆维吾尔自治区第三人民医院诊断为煤工尘肺的疑似职业病工人纳入研究，其中煤工尘肺Ⅰ期患者77例、Ⅱ期患者10例、Ⅲ期患者6例，选取49例无尘肺疾病工人作为对照组。收集受试者一般资料，采集血样检测血常规及血液生化结果，测定血浆白细胞介素（IL）-1β和IL-18水平。结合临床检查结果，进行多因素有序logistic回归分析以评估煤工尘肺的影响因素。同时，检测血细胞中焦亡相关蛋白的表达以揭示煤工尘肺的分子机制。142例受试者均为男性，平均年龄（51.65±6.31）岁，平均工龄（15.94±9.38）年。各组间吸烟年龄（=4.95，=0.003）和午休情况分布（=8.84，=0.031）差异有统计学意义。Ⅰ期患者血红蛋白含量高于Ⅱ期患者，Ⅲ期患者中性粒细胞百分比高于其他3组（<0.05）。Ⅰ期患者总胆红素和间接胆红素水平高于对照组，Ⅱ期患者红细胞沉降率高于其他3组（<0.05）。煤工尘肺Ⅲ期患者IL-18和IL-1β水平高于其他3组（<0.05）。多因素logistic回归分析显示，吸烟年龄（=1.03，95%可信区间：1.00-1.06）和IL-1β水平（=4.61，95%可信区间：1.59-13.32）是煤工尘肺的独立危险因素（<0.05）。与对照组相比，煤工尘肺Ⅲ期患者核苷酸结合寡聚化结构域样受体蛋白3（NLRP3）、半胱天冬酶-1、Gasdermin D、半胱天冬酶-4等蛋白表达水平显著升高（<0.05）。吸烟年龄是煤工尘肺的危险因素，IL-1β可能是煤工尘肺诊断的潜在生物标志物，焦亡可能在煤工尘肺外周炎症发展中起作用。
