Alekseeva O G, Vasil'eva E V, Orlova A A
Bull World Health Organ. 1974;51(1):51-8.
PULMONARY BERYLLIOSIS, A CHRONIC ALLERGIC PNEUMOSCLEROSIS RESULTING FROM INHALATION OF BERYLLIUM COMPOUNDS, MAY OCCUR IN TWO CLINICAL FORMS: interstitial, which is mild, slowly progressive, and presents moderate skin reactions of delayed-type hypersensitivity to haptens; and granulomatous, which is rapidly progressive after a short latent period and presents systemic lesions and significant allergic skin reactions. The investigation of experimental berylliosis in rats has revealed some factors that could lead to the abolition of natural tolerance. Six new beryllium-containing autoantigens, two of which accumulated in different tissues, were identified in the lung nucleoproteins accompanying a partial loss of normal tissue and serum antigens. Antibodies to the new antigens and to normal lung tissue (in smaller amounts) were found in the sera of rats with experimental berylliosis, as well as in patients. The patients with granulomatous berylliosis also had antibodies to DNA, RNA, and extracts of normal homologous heart, spleen, liver, and thyroid in quantities that correlated with the clinical picture and with the effectiveness of glucocorticoid therapy. The fact that natural tolerance mechanisms were interrupted in all cases and autoimmune granulomatous berylliosis developed only in some patients led to the assumption that the mechanism was effective under the influence of additional endogenous factors; diseases producing an accumulation of autoantibodies could provide the stimulus for the appearance of these factors.
肺铍中毒是一种因吸入铍化合物导致的慢性过敏性肺硬化症，可能有两种临床形式：间质型，症状较轻，进展缓慢，对半抗原呈现中度迟发型超敏反应的皮肤反应；肉芽肿型，在短暂潜伏期后迅速进展，出现全身性病变和明显的过敏性皮肤反应。对大鼠实验性铍中毒的研究揭示了一些可能导致天然耐受性丧失的因素。在伴有正常组织和血清抗原部分丧失的肺核蛋白中，鉴定出六种新的含铍自身抗原，其中两种在不同组织中积累。在实验性铍中毒大鼠以及患者的血清中，发现了针对新抗原和正常肺组织（数量较少）的抗体。肉芽肿型肺铍中毒患者还对DNA、RNA以及正常同源心脏、脾脏、肝脏和甲状腺的提取物产生抗体，其数量与临床症状以及糖皮质激素治疗的效果相关。在所有病例中天然耐受机制均被中断，而自身免疫性肉芽肿型肺铍中毒仅在部分患者中发生，这一事实导致人们推测该机制在额外内源性因素的影响下有效；产生自身抗体积累的疾病可能为这些因素的出现提供刺激。
