Redlich C A, Karol M H, Graham C, Homer R J, Holm C T, Wirth J A, Cullen M R
Department of Internal Medicine, Yale University School of Medicine, New Haven, Connecticut, USA.
Scand J Work Environ Health. 1997 Jun;23(3):227-31. doi: 10.5271/sjweh.203.
The clinical features, airway histology, and detection of hexamethylene diisocyanate (HDI) protein adducts in endobronchial biopsies from a patient with HDI asthma are described.
Isocyanate asthma was diagnosed by history, methacholine challenge, and workplace HDI challenge. Bronchoscopy was performed 24 h after challenge and immunohistochemical staining was performed.
Airway biopsies obtained at bronchoscopy demonstrated inflammatory changes typical for asthma, including increased airway eosinophils and T cells. Immunohistochemical staining with specific anti-HDI antibodies demonstrated the presence and localization of HDI adducts in human bronchial biopsies.
These studies confirm epithelial exposure to HDI following workplace challenge and demonstrate the feasibility of detecting and localizing isocyanate adducts in human lung tissue. Identifying and characterizing the airway macromolecules to which isocyanates bind in vivo are probably crucial to the understanding of how isocyanates cause sensitization and asthma. The ability to detect isocyanate adducts may also help characterize isocyanate exposure patterns and exposure-disease relationships.
描述一名六亚甲基二异氰酸酯（HDI）哮喘患者支气管活检的临床特征、气道组织学以及HDI蛋白加合物的检测情况。
通过病史、乙酰甲胆碱激发试验和工作场所HDI激发试验诊断异氰酸酯哮喘。激发试验24小时后进行支气管镜检查并进行免疫组织化学染色。
支气管镜检查时获取的气道活检显示出哮喘典型的炎症变化，包括气道嗜酸性粒细胞和T细胞增多。用特异性抗HDI抗体进行免疫组织化学染色显示HDI加合物在人支气管活检中的存在及定位。
这些研究证实了工作场所激发后上皮细胞暴露于HDI，并证明了在人肺组织中检测和定位异氰酸酯加合物的可行性。识别和表征体内异氰酸酯结合的气道大分子可能对于理解异氰酸酯如何引起致敏和哮喘至关重要。检测异氰酸酯加合物的能力也可能有助于表征异氰酸酯暴露模式和暴露-疾病关系。
