Yamada K, Amitani R, Niimi A, Kuze F
Dept of Infection and Inflammation, Kyoto University, Japan.
Eur Respir J. 1995 Aug;8(8):1300-6. doi: 10.1183/09031936.95.08081300.
The inhalation of isocyanates, such as toluene diisocyanate (TDI), diphenylmethane diisocyanate (MDI), and hexamethylene diisocyanate (HDI) can induce hypersensitivity pneumonitis (HP) as well as bronchial asthma in humans, but the precise pathological features and their pathogenetic mechanisms have not been elucidated. To provide insight into the pathological features of isocyanate-induced hypersensitivity pneumonitis in humans, we repeatedly exposed guinea-pigs to TDI following previous sensitization to TDI and examined the inflammatory response in the pulmonary lesions. Following sensitization with 10% TDI ethyl acetate solution for seven consecutive days, guinea-pigs were exposed to 5% TDI ethyl acetate solution once a week for 4 weeks. As a control, guinea-pigs were exposed to ethyl acetate alone in the same manner. Furthermore, other guinea-pigs received a single exposure to 5 or 20% TDI ethyl acetate solution. The TDI solutions or ethyl acetate were applied to the bilateral nasal mucosa of guinea-pigs for 30 s-day-1. Histological examination of lung specimens of guinea-pigs repeatedly exposed to TDI after previous sensitization by TDI inhalation revealed interstitial pneumonitis-like lesions in which mononuclear cells and eosinophils were mainly involved. Lungs of control and nonsensitized guinea-pigs showed insignificant histological changes. We demonstrated that interstitial pneumonitis-like lesions, indistinguishable from isocyanate-induced hypersensitivity pneumonitis in humans, can be caused by repeated but not single exposure to TDI in guinea-pigs.
吸入异氰酸酯,如甲苯二异氰酸酯(TDI)、二苯基甲烷二异氰酸酯(MDI)和六亚甲基二异氰酸酯(HDI),可诱发人类过敏性肺炎(HP)和支气管哮喘,但确切的病理特征及其发病机制尚未阐明。为深入了解人类异氰酸酯诱发的过敏性肺炎的病理特征,我们在豚鼠先前对TDI致敏后,反复使其接触TDI,并检查肺部病变中的炎症反应。用10%TDI乙酸乙酯溶液连续致敏7天后,豚鼠每周一次接触5%TDI乙酸乙酯溶液,共4周。作为对照,豚鼠以相同方式仅接触乙酸乙酯。此外,其他豚鼠单次接触5%或20%TDI乙酸乙酯溶液。将TDI溶液或乙酸乙酯每天一次应用于豚鼠双侧鼻黏膜30秒。对先前通过吸入TDI致敏后反复接触TDI的豚鼠肺标本进行组织学检查,发现有间质性肺炎样病变,主要累及单核细胞和嗜酸性粒细胞。对照和未致敏豚鼠的肺组织学变化不明显。我们证明,豚鼠反复而非单次接触TDI可导致与人类异氰酸酯诱发的过敏性肺炎难以区分的间质性肺炎样病变。