Andrýs C, Hanovcová I, Chýlková V, Tejral J, Eminger S, Procházková J
Department of Clinical Immunology and Allergology, University Hospital, Hradec Králové, Czech Republic.
Cent Eur J Public Health. 1997 Sep;5(3):136-42.
A panel of immunological parameters has been examined in a group of dry-cleaning workers (n = 21) and in a control group of administrators (n = 16) from the same plant. The results were also compared to long-term laboratory reference values (LRV) (n = 14-311). External exposure to tetrachloroethylene (PER) was represented by TWA (8 h) values in the range 11-752 mg PER/m3. Biological monitoring showed an amount from 9 to 344 mg PER/m3 in exhaled air by the end of workshift. 1. The exposed dry-cleaning workers compared to the controls from the plant had statistically significant changes in metabolic activity of phagocytes, alpha 2-macroglobulin, C3 and C4 complement component, salivary secretory IgA, and blastic transformation test. Most of the values were within the range of normal values. 2. The exposed dry-cleaning workers had several abnormal immune parameters compared to the long-term laboratory values (LRV) especially in the alpha 2-macroglobulin, C3 and percentage of T-lymphocytes. Most of the changes, even those that were statistically significant, were still within the range of normal values, but they might be classified as trends or shifts away from normal (spontaneous blastic transformation, absolute number of phagocyting cells, coeruloplasmin, circulating immunocomplexes, serum lysozyme). 3. The non-exposed controls from the same plant showed both quantitative and qualitative differences when compared to the LRV. Changes were seen in IgG, C4, CSI and in increased spontaneous metabolic activity of leucocytes, total leucocyte count, absolute number of phagocyting cells, alpha 2-macroglobulin, prealbumin, C4, circulating immunocomplexes and serum lysozyme. 4. The distribution analysis of all results detected a large number of abnormal values in both groups, more in the at-risk group. 5. As inhalation was the main route of PER exposure it was concluded that the changes might represent aspects of the response of the respiratory immune system, mainly of the alveolar macrophages. Additional postinfection effects could not be excluded in both studied groups. Individual differences in immune reactivity as well as individual range of exposure should be taken into consideration.
对一组干洗工人（n = 21）和来自同一工厂的管理对照组（n = 16）的一系列免疫参数进行了检测。结果还与长期实验室参考值（LRV）（n = 14 - 311）进行了比较。四氯乙烯（PER）的外部暴露以8小时时间加权平均（TWA）值表示，范围为11 - 752毫克PER/立方米。生物监测显示，在工作班次结束时，呼出空气中的含量为9 - 344毫克PER/立方米。1. 与工厂的对照组相比，接触PER的干洗工人在吞噬细胞的代谢活性、α2 - 巨球蛋白、C3和C4补体成分、唾液分泌型IgA以及 blast 转化试验方面有统计学上的显著变化。大多数值在正常值范围内。2. 与长期实验室值（LRV）相比，接触PER的干洗工人有几个免疫参数异常，特别是在α2 - 巨球蛋白、C3和T淋巴细胞百分比方面。大多数变化，即使是那些有统计学意义的变化，仍在正常值范围内，但它们可能被归类为偏离正常的趋势或变化（自发 blast 转化、吞噬细胞的绝对数量、铜蓝蛋白、循环免疫复合物、血清溶菌酶）。3. 来自同一工厂的未接触对照组与LRV相比，在定量和定性方面都有差异。在IgG、C4、CSI以及白细胞的自发代谢活性增加、白细胞总数、吞噬细胞的绝对数量、α2 - 巨球蛋白、前白蛋白、C4、循环免疫复合物和血清溶菌酶方面都有变化。4. 对所有结果的分布分析发现两组中都有大量异常值，高危组更多。5. 由于吸入是PER暴露的主要途径，得出的结论是这些变化可能代表呼吸道免疫系统，主要是肺泡巨噬细胞反应的方面。在两个研究组中都不能排除感染后的额外影响。应考虑免疫反应性的个体差异以及个体暴露范围。
