Li K, Keeling B, Churg A
Department of Pathology, University of British Columbia, Vancouver, Canada.
Am J Respir Crit Care Med. 1996 Feb;153(2):644-9. doi: 10.1164/ajrccm.153.2.8564112.
It is now accepted that workers with exposure to mineral dusts can develop airflow obstruction. The basis of this process is uncertain, but carefully performed morphologic studies suggest that coal, silica, and perhaps other dusts may produce emphysema in humans. To investigate the mechanisms involved in this process, we administered crystalline silica (quartz) or titanium dioxide (rutile) to rats in a single intratracheal instillation. At varying times after instillation, the animals' lungs were lavaged, the lavageate from one lung was dried and hydrolyzed, and the amounts of desmosine (DES),as a measure of elastin breakdown, and hydroxyproline (HP), as a measure of collagen breakdown, were determined. The lavageate from the other lung was counted for inflammatory cells. Both silica and titanium dioxide caused a dose-dependent increase in DES and HP 24 h after instillation. When an equivalent dose (30 mg) of silica or rutile was administered and animals were sacrificed at various times up to 21 d, a sustained increase in lavage DES and HP was seen in the silica-treated animals, and this was accompanied by a sustained increase in polymorphonuclear leukocytes (PMN); in contrast, both lavage PMN and lavage DES/HP rapidly peaked and then declined in the titanium dioxide-treated animals. Numbers of macrophages remained elevated over the 21-d period of sacrifice with both types of treatment. These data show for the first time that mineral dusts can cause connective-tissue breakdown in the lung, with the release of matrix components into the alveolar spaces. The amount of connective-tissue breakdown appears to parallel the number of PMN but not the number of macrophages in the alveolar spaces, suggesting that PMN-derived proteolytic enzymes are responsible for the breakdown. This process probably plays a role in dust-induced emphysema.
目前已公认,接触矿物粉尘的工人会出现气流阻塞。这一过程的基础尚不确定,但精心开展的形态学研究表明,煤尘、矽尘以及或许其他粉尘可能会在人类身上引发肺气肿。为了探究这一过程中涉及的机制,我们通过气管内单次滴注的方式给大鼠施用了结晶二氧化硅(石英)或二氧化钛(金红石)。在滴注后的不同时间,对动物的肺部进行灌洗,将一侧肺的灌洗液干燥并水解,测定作为弹性蛋白分解指标的锁链素(DES)以及作为胶原蛋白分解指标的羟脯氨酸(HP)的含量。对另一侧肺的灌洗液中的炎性细胞进行计数。二氧化硅和二氧化钛在滴注后24小时均导致DES和HP呈剂量依赖性增加。当施用等量剂量(30毫克)的二氧化硅或金红石,并在长达21天的不同时间点处死动物时,在接受二氧化硅处理的动物中,灌洗DES和HP持续增加,同时伴有多形核白细胞(PMN)持续增加;相比之下,在接受二氧化钛处理的动物中,灌洗PMN以及灌洗DES/HP迅速达到峰值,然后下降。在两种处理方式下,巨噬细胞数量在21天的处死期内均保持升高。这些数据首次表明,矿物粉尘可导致肺部结缔组织分解,并使基质成分释放到肺泡腔中。结缔组织分解的量似乎与肺泡腔中PMN的数量而非巨噬细胞的数量平行,这表明PMN衍生的蛋白水解酶是造成分解的原因。这一过程可能在粉尘诱发的肺气肿中起作用。