Newman L S, Lloyd J, Daniloff E
Departmet of Medicine, National Jewish Center for Immunology and Respiratory Medicine, Denver, Colorado 80206, USA.
Environ Health Perspect. 1996 Oct;104 Suppl 5(Suppl 5):937-43. doi: 10.1289/ehp.96104s5937.
With the advent of in vitro immunologic testing, we can now detect exposed individuals who are sensitized to beryllium and those who have chronic beryllium disease (CBD) with lung pathology and impairment. Earlier detection and more accurate diagnostic tools raise new questions about the natural history of sensitization and granulomatous disease. Preliminary data suggest that early detection identifies people who are sensitized to beryllium and that these individuals are at risk for progressing into clinical disease. This article discusses the historical, recent, and ongoing studies germane to our understanding of CBD natural history, including the immunologic and inflammatory basis of the disease, the environmental and host risk factors for disease progression, biological markers of disease severity and activity that may help predict outcome, and the implications for broad-based workplace screening to identify patients at the earliest stages of beryllium sensitization and disease.
随着体外免疫检测技术的出现，我们现在能够检测出对铍致敏的暴露个体以及患有慢性铍病（CBD）且伴有肺部病理改变和功能损害的个体。更早的检测和更精确的诊断工具引发了关于致敏和肉芽肿性疾病自然史的新问题。初步数据表明，早期检测能够识别出对铍致敏的个体，并且这些个体有发展为临床疾病的风险。本文讨论了与我们对CBD自然史的理解相关的历史、近期和正在进行的研究，包括该疾病的免疫和炎症基础、疾病进展的环境和宿主风险因素、可能有助于预测预后的疾病严重程度和活动度的生物标志物，以及广泛的工作场所筛查对识别处于铍致敏和疾病最早阶段患者的意义。
