Wang Z, Larsson K, Palmberg L, Malmberg P, Larsson P, Larsson L
Dept of Occupational Health, National Institute for Working Life, Solna, Sweden.
Eur Respir J. 1997 Feb;10(2):381-7. doi: 10.1183/09031936.97.10020381.
In healthy subjects, acute inhalation of swine dust causes an influx of inflammatory cells into the airways and increased bronchial responsiveness. The exposure may also cause fever and generalized symptoms. It seems likely that proinflammatory cytokines are involved in the response to inhaled swine dust. Nasal and bronchoalveolar lavage (BAL) were performed before, and 7 and 24 h after the start of 3 h exposure to swine dust, during a period of work in a swine confinement building, in 22 healthy subjects. Lavage fluids were analysed with regard to the cellular response and concentrations of interleukin (IL)-1 alpha, IL-1 beta, IL-6 and tumour necrosis factor-alpha (TNF-alpha). Each subject carried personal samplers for exposure measurements. Inhalable dust and airborne endotoxin, 3-hydroxylated (2-OH) fatty acid and muramic acid were measured. Bronchial responsiveness to methacholine was investigated 1-2 weeks before and 7 h after the start of the exposure. Exposure caused fever (> 38 degrees C) in three subjects, and approximately 25% of the subjects experienced symptoms. Bronchial responsiveness to methacholine increased by 3.5 (1.6-4.8) doubling doses (median (25th-75th percentile)). Following exposure, granulocytes increased more than 50 fold in BAL fluid and more than 40 fold in nasal lavage fluid. IL-1 alpha and IL-1 beta increased significantly in BAL fluid (p < 0.05) and nasal lavage fluid (p < 0.01). IL-6 increased 25 fold in BAL and 15 fold in nasal lavage fluid (p < 0.001). TNF-alpha was below detection limit (0.25 ng.L-1) in most subjects before exposure and increased following exposure to 3.8 (2.4-5.7) and 1.3 (0.6-2.3) ng.L-1 in BAL and nasal lavage fluid, respectively, (p < 0.001). Total inhalable dust was 20.5 (14.6-30.0) mg.m-3 and the concentrations of airborne endotoxin, 3-OH fatty acid and muramic acid were 1.2 (0.8-1.4), 3.5 (2.2-4.5) and 0.9 (0.3-1.9) microgram.m-3, respectively. There was a significant correlation between the IL-6 response in BAL fluid and exposure to dust endotoxin activity and 3-OH fatty acids (p < 0.05). Otherwise, no significant correlations were found between exposure and the cytokine response. We conclude that exposure to swine dust causes an intense upper and lower airway inflammation, which involves the proinflammatory cytokines interleukin-1, interleukin-6 and tumour necrosis factor-alpha.
在健康受试者中,急性吸入猪舍灰尘会导致炎症细胞流入气道,并增加支气管反应性。这种接触还可能引起发热和全身症状。促炎细胞因子似乎参与了对吸入猪舍灰尘的反应。在22名健康受试者于猪舍工作期间,在接触猪舍灰尘3小时开始前、开始后7小时和24小时进行了鼻腔和支气管肺泡灌洗(BAL)。对灌洗液进行了细胞反应以及白细胞介素(IL)-1α、IL-1β、IL-6和肿瘤坏死因子-α(TNF-α)浓度的分析。每位受试者都携带个人采样器进行接触测量。测量了可吸入粉尘、空气中的内毒素、3-羟基化(2-OH)脂肪酸和胞壁酸。在接触开始前1-2周和开始后7小时研究了对乙酰甲胆碱的支气管反应性。接触导致3名受试者发热(>38℃),约25%的受试者出现症状。对乙酰甲胆碱的支气管反应性增加了3.5(1.6-4.8)倍剂量(中位数(第25-75百分位数))。接触后,BAL液中的粒细胞增加了50多倍,鼻腔灌洗液中增加了40多倍。BAL液(p<0.05)和鼻腔灌洗液(p<0.01)中的IL-1α和IL-1β显著增加。BAL液中IL-6增加了25倍,鼻腔灌洗液中增加了15倍(p<0.001)。大多数受试者接触前TNF-α低于检测限(0.25 ng·L-1),接触后BAL液和鼻腔灌洗液中分别增加至3.8(2.4-5.7)和1.3(0.6-2.3)ng·L-1(p<0.001)。BAL液中IL-6反应与接触粉尘内毒素活性和3-OH脂肪酸之间存在显著相关性(p<0.05)。否则,未发现接触与细胞因子反应之间存在显著相关性。我们得出结论,接触猪舍灰尘会导致强烈的上、下呼吸道炎症,这涉及促炎细胞因子白细胞介素-1、白细胞介素-6和肿瘤坏死因子-α。