Autism and immunity: revisited study

Autism spectrum disorder is of interest neurochemically because it represents a relatively homogeneous disorder with regard to disease development, abnormal cognitive development and intellectual development disturbance. A consistent finding in autistic children is a high number of mast cells and a high level of serotonin which is also found at elevated concentrations in the urine of autistic patients. In addition, a dysfunction of clinical conditions, such as gastrointestinal and immunological symptoms, is frequently noted in autistic children, however, IgE does not appear to be prevalent in these children but probably an increase of cytokines/chemokines produced by mast cells at an early age may play an important role. Therefore an immune hypothesis, involving also autoimmunity, is one possible pathogenetic mechanism in autism. In conclusion, mast cell activation could contribute to immune and neuroinflammatory abnormalities that are evident in patients with autism spectrum disorders.

Chlamydia pneumoniae and atherosclerosis: the role of mast cells

Chlamydia pneumoniae (C. pneumoniae), a respiratory pathogen, has been implicated in the pathogenesis of atherosclerosis, an inflammatory progressive disease, characterized by the formation of atherosclerotic plaques. Among several types of inflammatory cells involved in the atherogenesis process, recently particular attention has been directed toward the mast cells. Experimental studies have provided several mechanisms by which C. pneumoniae and mast cells could play a role in all stages of atherosclerosis, from initial inflammatory lesions to plaque rupture. C. pneumoniae, as well as mast cells, may actively participate both through the production of cytokines and matrix-degrading metalloproteinases and by provoking apoptosis of atheroma-associated vascular cells, key events in plaque rupture. This mini-review provides a brief overview on adventitial inflammatory effects of C. pneumoniae and mast cells and their potential role in plaque instability. In addition, in this paper we review the role of mast cells in innate immunity.

Occupational stress, job insecurity and perception of the health status in Italian teachers with stable or temporary employment

The object of this study is to analyse job stress and insecurity and the perception of symptoms (health status) of 374 teachers (30 women and 74 men) with stable or temporary employment in schools in Pescara, a town in Central Italy. Job strain and job insecurity were analysed by an Italian version of the Karasek?s questionnaire, the perception of the health status by a 12 item test, and state and trait anxiety by STAI I and STAI II. There were no significant differences depending on the type of school. The young women with temporary contracts showed only higher levels of job insecurity than the women with stable employment, while those over 50 years old also showed more elevated values of job strain. Men with temporary contracts showed higher levels of both job insecurity and state and trait anxiety. The following highly significant correlations were observed: a) in women, job strain and perception of symptoms vs STAI I and STAI II (p<0.001); b) in men, job strain, job insecurity and perception of symptoms vs STAI II; job strain vs perception of symptoms as well as a negative correlation of decision latitude vs job insecurity, STAI I and STAI II (p<0.01). These results highlight differences in the perception of job insecurity between men and women. In particular, the decision latitude (skill decision + decision authority) plays an important role in men; temporary employment is mainly related to anxiety in men, while anxiety enhances the perception of poor health status mainly in women.

Is necroptosis a death pathway in aluminum-induced neuroblastoma cell demise?

Besides being an aggravating factor secondary to major physiological alterations in degenerative diseases, aluminum has also been considered as a risk factor in the etiology. Although many in vivo and in vitro data are in favor of apoptosis and necrosis being involved in Al induced neurodegenerative processes, there is considerable evidence that very complex events may contribute to neural cell death. Necroptosis, a novel cell death pathway, was recently reported to contribute to ischemia brain injury. It is different from, but associated with, apoptosis and necrosis, the two common major pathways of cell demise. In the present study, SH-SY5Y cells were put under stress by Al, a potential degenerative cell death inducer. Nec-1, a specific inhibitor, was used to identify necroptosis. The characteristics observed in Nec-1 and Al treated SH-SY5Y cells showed that necrotic morphological changes were reduced, and a sharp decrease of necrotic rate was detected. Besides, there were Al-induced mitochondria membrane potential decreasing, reactive oxygen species remaining, and autophagosomes declining. The mechanism of Nec-1s effect on cell death may be related to caspases pathways. To our best knowledge, this is the pioneer report on necroptosis in mixed human neural cell death pathways, which might offer a novel therapeutic target for neurodegenerative diseases, and an extended window for neuroprotection.

The latest interleukin: IL-33 the novel IL-1-family member is a potent mast cell activator

IL-33, a member of IL-1 family, induces the differentiation of T-cells (depending on the phosphorylation of MAPKs and NF-kB) and is involved in T-cell mediated immune responses. IL-33 is also involved in the production of IL-5, IL-4 and IL-13 and several chemokines. In this editorial we show the importance of IL-33 in allergic diseases and its role as an inflammatory cytokine. In addition, the induction of certain chemokines by IL-33 may candidate this new cytokine as a mediator in inflammatory and autoimmune diseases and may prove to be a therapeutic target for the prevention of these diseases.

Neuropeptide substance P induces mRNA expression and secretion of CXCL8 chemokine, and HDC in human umbilical cord blood mast cells

PURPOSE

Mast cells play an important role in innate and acquired immunity and are thought to be the cellular origin of most proteases and cytokines. Substance P (SP) and its receptor, NK-1R, play critical roles in immune regulation in human and animal models of inflammation.

METHODS

We used mature human cord blood mast cells (HCBMC) differentiated from cord blood CD34+ precursor activated with SP in culture.

RESULTS

Our data indicate that Substance P strongly activates mature HCBMC in releasing CXCL8 expression and secretion (

CONTROL

1.200 +/- 1.0; SP: 4.10 +/- 0.90; P < 0.01). Moreover, in a RT-PCR, HCBMC expressed CXCL8 mRNA after Substance P activation. Since calcium ionophore A23187 is a pharmacological activator that raises cytosolic free calcium ion concentraion and stimulates mast cells in the production and secretion of proinflammatory compounds, it was used as positive control. In addition, we found that HCBMCs generate the transcription of histidine decarboxylase (HDC), the enzyme responsible for the generation of histamine from histidine, after SP treatment. Since CXCL8 is a member of the CXC chemokine subfamily with potent chemotactic activity and is a primary inflammatory cytokine we conclude that our results, obtained from HCBMC cultures, a good and valid model in vitro, support the concept that the neurogenic system modulates inflammatory events by Substance P-mediated HCBMC chemokine CXCL8 release.

CONCLUSION

The expression, synthesis and release of CXCL8 suggest an increase of inflammatory process in vivo mediated by the recruitment and infiltration of inflammatory cells in inflamed tissues.

Blood natural killer activity is reduced in men with occupational stress and job insecurity working in a university

PURPOSE

To examine the immune response to job strain and insecurity of 88 men working in a university, divided according to age and type of employment.

METHODS

Anxiety, job strain, job insecurity and subjective symptoms were measured by questionnaires. Blood NK cytotoxic activity was determined by an in vitro method and lymphocyte subpopulations by flow-cytometry analysis.

RESULTS

Employees (over 40 years old) in a library showed higher values of job strain, anxiety and subjective symptoms and lower blood NK activity than the controls. The young employees with temporary employment showed high job insecurity and reduced blood NK activity, while the young sanitary staff with temporary position showed normal immune response. NK cytotoxic activity of the recruited men was negatively correlated with anxiety, work load and job insecurity.

CONCLUSIONS

Not only anxiety and depression but also high levels of job strain and/or insecurity may affect the health status by reducing blood NK activity.

How Do Rat Cortical Cells Cultured with Aluminum Die: Necrosis or Apoptosis?

Aluminum (Al) exposure has been implicated as the cause of neural cells loss in several neurodegenerative diseases. Therefore, defining the mechanism of neural cell death in Al toxicity and degenerative diseases might lead to the development of therapeutic agents which promote neural cell survival. Furthermore, knowledge of cell death pathways might facilitate the discovery of treatments for neurodegeneration. However, the death mode of neural cells triggered by Al has not been firmly established. The present study focuses on understanding the pathway of cells death in cultured cortical cells treated with Al. Primary neurons cultured alone, astrocytes cultured alone, and neuron/astrocyte co-cultures obtained from newborn rats were incubated with Al at the concentrations of 0, 0.5,1.0, or 2.0 mM for 72 h. Morphological changes were observed with an inverted phase microscope, a fluorescent microscope, and an electron microscope. Simultaneously, the rate of apoptosis was quantified with flow cytometry. Morphological characteristics of apoptosis such as cell shrinkage, aggregation and fragmentation of chromatin, membrane buds, and formation of membrane-bound apoptotic bodies were observed in Al-treated neurons, while none of these characteristics were found in Al-treated astrocytes. Quantitative results of apoptotic rates detected with flow cytometry indicated a typical apoptosis progression in neurons at various dosages. A concentration-dependent relationship between Al concentration and apoptotic rates confirmed that apoptosis is the prominent cause of cell death in primary cultured neurons, even at a concentration lower than 2 mM. Both necrosis and apoptosis are evident in neuron/astrocyte co-cultures, but the intensity of apoptosis is much less compared with that of neurons, suggesting that astrocytes may be especially important for neuronal survival in the presence of Al.

Combined effects of electromagnetic fields on immune and nervous responses

In technologically developed countries, there is concern about hazards from electromagnetic fields (EMFs). Several studies have reported that immune and neuroendocrine systems exert an integrated response to EMF exposure. The aim of this review is to summarize the results of studies on the effect of low and high frequency EMF on immune and neuroendocrine systems on which our research group has been working for several years.

[Technical survey of safety levels established in building sites in the Pescara area]

In 2006, in the context of the initiative aimed at "Promotion of safety and health of workers in construction yards", the Operative Unit of Occupational Health, University G. d'Annunzio, in collaboration with the Construction School of the Province of Pescara and INAIL, started a survey of construction yards around Pescara aimed at collecting data regarding respect of the specific law concerning construction yards and the risk perception of workers. The survey of 100 construction yards provided useful information towards a concise picture of safety levels obtained. In addition 300 interviews were carried out with workers to find out about their knowledge of accident prevention, how important they considered the use of personal protection devices, how often they used them, reasons for not using them, the devices most used,....and any injuries that occurred. The studied showed that, although the situation as improved compared to the past, further steps need to be taken.

[The perception of risk in construction workers]

Accidents in building sites led us to study risk perception in workers employed in this field. We disposed of 300 workers, aged 18-65, who had to answer to a questionnaries were signing among seven risks the more present in their activity, chosing among five levels. So for each risk the worker had to quantify parameters such as: danger, frequence of accidents, actitude to risk-control, training on risk. The risk of falling from high sites has been perceived as extremely dangerous but it is possible to control it. Less dangerous is eyes exposition to chemical agents or dust. Manual movementation of weight and lacerations would be the most frequent source of accidents. Moreover would be insufficient the capacity to control the rick related to Weight manual movementation and vibrations. Workers answered in questionnaries that risk training on vibration was not sufficient, on the contrary they knew the risk of falling from high site. So we conclude that to reduce accidents in building sites it is necessary make better training on field, modifying the individual behavior among workers.

[Occupational stress and job insecurity in men working in a university]

77 men working in a university were investigated. Trait and state anxiety were determined by STAI I and STAI II; job strain (job demand/decision latitude), social support and job insecurity were analysed by a 46 item Karasek's questionnaire and subjective symptoms by a 12 item test. The employees of a library (mean age 49 years), in contact with students, showed significantly higher values of job strain, STAI I, STAI II and subjective symptoms than a control group of employees with similar age. Young employees and sanitary staff with temporary employment showed higher level of job insecurity than control subjects with stable position. Blood cytotoxic activity (reported in another study) was significantly lower in the old employees with job strain or in the young employees with job insecurity (but not in the sanitary staff) than in the controls; this demonstrates that not only occupational stress but also job insecurity may play an important role in affecting the health status.

[Prevention of low back pain diseases in a center for the disabled]

Our unit of occupational medicine has been asked to solve the problem of an incrising percentage of workers affected by low-back pain in a clinic for patients with handicaps. The consequence of this affections caused frequently absences at work. We organized a course for training about correct methods for moving patient not self-sufficient. The 84 workers, all female (aged 30-45), had to sign on a card all the problems they found at work and their possible solutions according to them. Then we put the cards in a box and we red each one, signing on a blackboard the problems, using a red pen and the solutions proposed, in blue. Bed organization, turnation of patient, and the difficulties in the use of lifter were the principal problems, solved trought the training course made. Then we obtained a reduction in absence at work for low-back pain of about 40% after six months since the beginning of a course of posture exercises made in the same clinic one day a week after work.

[Risk perception in a group of dentists from Abruzzo]

Dentist's office represents an area with high infectious risk both for workers and patients. With our study we tried to analyse the relationship between dentists and prevention. We studied 104 dentists who had to answer to a questionnaire composed by 25 questions on topics such as job management, risk perception, measures adopted for prevention and knowledge about normatives regarding safety at work. From the answers we can conclude that dentists know the risk present in their work and use correctly the individual preventive dispositives; make blood control to test hepatitis markers, in particular HCV. But only 68% made HBV vaccination. Many dentists,even if they know the way of transmission of HIV, avoid to cure positive patient.

[Anxiety, job stress and job insecurity among teachers with indefinite or definite time contract]

Object of this study was the occupational stress of 336 teachers (276 women and 60 men) with stable or temporary employment in schools of Pescara, town of Central Italy. The levels of anxiety were determined by STAI and STAI II, those of job strain", "job insecurity" and social support by the Karasek's questionnaire, and the perception of subjective symptoms by a 12 item test. There were no significant differences depending on the type of school. The women with temporary contract showed higher levels of "job insecurity", while the men with temporary job showed also higher values of STAI I and STAI II. The scores of anxiety of the women were positively correlated with "job strain", "job insecurity" and perception of subjective symptoms and negatively with social support, while the only correlations of STAI I and STAI II of men showing statistical significance of men was that with "job insecurity. Job strain was negatively correlated with the perception of symptoms both in women and men. These results evidence differences in the occupational stress of men and women; in particular, job insecurity may enhance anxiety in men.

Quality in emergency departments: a study on 3,285,440 admissions

INTRODUCTION

A multi-centre study has been conducted, during 2005, by means of a questionnaire posted on the Italian Society of Emergency Medicine (SIMEU) web page. Our intention was to carry out an organisational and functional analysis of Italian Emergency Departments (ED) in order to pick out some macro-indicators of the activities performed. Participation was good, in that 69 ED (3,285,440 admissions to emergency services) responded to the questionnaire.

METHODS

The study was based on 18 questions: 3 regarding the personnel of the ED, 2 regarding organisational and functional aspects, 5 on the activity of the ED, 7 on triage and 1 on the assessment of the quality perceived by the users of the ED.

RESULTS AND CONCLUSION

The replies revealed that 91.30% of the ED were equipped with data-processing software, which, in 96.83% of cases, tracked the entire itinerary of the patient. About 48,000 patients/year used the ED: 76.72% were discharged and 18.31% were hospitalised. Observation Units were active in 81.16% of the ED examined. Triage programmes were in place in 92.75% of ED: in 75.81% of these, triage was performed throughout the entire itinerary of the patient; in 16.13% it was performed only symptom-based, and in 8.06% only on-call. Of the patients arriving at the ED, 24.19% were assigned a non-urgent triage code, 60.01% a urgent code, 14.30% a emergent code and 1.49% a life-threatening code. Waiting times were: 52.39 min for non-urgent patients, 40.26 min for urgent, 12.08 for emergent, and 1.19 for life-threatening patients.

Occupational asthma due to low molecular weight agents

Occupational asthma is defined as variable airflow obstruction and airways hyperresponsiveness caused by exposure to agents present in the workplace. Low molecular weight agents such as isocyanates, aldehydes, anhydrides, colophony, dyes, persulphate, amines, acrylates and metals are steadily increasing as causative agents of occupational asthma. Isocyanates, aldehydes and anhydrides my cause sensitisation through an IgE mediated response in some workers. These agents act as haptens which combine with a carrier protein to form a complete antigen. Assays for the detection of specific IgE are standardized for very few agents and have a good specificity, but poor sensitivity. The diagnosis of occupational asthma relies not only on a suggestive hystory showing that asthma is caused or exacerbated specifically by work exposure, but in most cases needs to be confirmed by objective means. Combined monitoring of lung function parameters, such as peak expiratory flow rate at the work site and non specific bronchial hyperresponsiveness during and away from exposure, is necessary. The "gold standard" for confirming a diagnosis in an individual worker still remains the specific bronchoprovocation test, which has now reached a high degree of sensitivity, specificity and reproducibility for agents such a s isocyanates. In occupation asthma due to low molecular weight agents there are no individual risk factors which could predict the susceptibility to develop the disease. The primary prevention is based on appropriate interventions tn the workplace. The strict medical surveillance of workers may allow the early diagnosis and removal from further exposure in order to prevent morbidity and disability.

Follow up study on the immune response to low frequency electromagnetic fields in men and women working in a museum

Seven women and eight men, exposed to low frequency (50 Hz) electromagnetic fields (EMFs) in a museum for 20 hours a week, were investigated in the years 1999 and 2005. During the first study, the mean EMF exposure in the working place was 1.7 microT and 1.1 microT, respectively. In the first investigation, the EMF-exposed men showed reduced blood NK lymphocytes in relation to controls, while EMF-exposed women presented reduced PHA-stimulated IFN-gamma release from peripheral blood mononuclear cells (PBMC). In the year 2005, blood cytotoxic activity, state and trait anxiety (STAI I and II, respectively) and occupational stress were also investigated. The scores of STAI I and II of the control women were slightly higher than those of the control men. EMF-exposed men showed higher occupational stress but normal immune parameters. EMF-exposed women showed, in relation to controls, lower PHA-stimulated IFN-gamma release from PBMC and reduced blood cytotoxic activity/CD45+-CD16+-56+ NK lymphocytes (but not per ml of blood). One of the women exposed to EMF, who worked a night shift, showed marked lymphopenia with very low NK lymphocytes and reduced IFN-gamma release; these immune parameters returned to normal following a change of work site. This study suggests that low frequency EMFs affect the immune functions of women more than those of men. Moreover, the determination of immune parameters seems to be a useful marker of the health effects of exposure to EMFs.

Effect of occupational stress and anxiety on natural killer lymphocyte activity of men and women employed in a university

The aim of this study is the immune response of the staff of a university and a museum (referent group). 46 women and 40 men with similar mean age (44 years) were investigated. The first group of women (A) worked in libraries, B in offices in contact with students, C as secretaries and D in a museum. One group of men (E) was composed of employees of the university, one worked in a library temporarily located underground (F) and the last group (G) in a museum. STAI I and II (state and trait anxiety, respectively), and occupational stress were measured by questionnaires. Blood samples were collected for determining NK cytotoxic activity vs human erythroleukaemia cells and the lymphocyte subsets CD45+, CD45+-CD3+, CD45+-CD3+-CD4+, CD45+-CD3+-CD8+, CD45+-CD3-CD8+, CD3+-CD16+-56+ and CD3+-CD19+. Group B showed significantly higher score of occupational stress and STAI I (but not of STAI II) than the other groups of women. Group F of men showed higher levels of occupational stress and both STAI I and II than groups E and G. Group B of women and F of men also showed significantly lower values of blood cytotoxic activity. The scores of STAI I and II were negatively correlated with the cytotoxic activity expressed per ml of blood and/or total lymphocytes. and/or NK CD45+-CD16+-CD56+ cells. In conclusion, this study shows that occupational stress may increase anxiety which is negatively correlated with blood cytotoxic activity. This is a useful tool for determining the health effects of stress.

The immune response of women with prolonged exposure to electromagnetic fields produced by radiotelevision broadcasting stations

Twelve women, five of them housewives, exposed in their residences to electromagnetic fields (EMFs)emitted by radio-television broadcasting stations for a mean period of 13 years, were investigated. The EMFs in the balconies of the homes were (mean + S.D.) 4.3 + 1.4 V/m in the year 2000 and 3.7 + 1.3 V/m in 2005, while the exposure in the nearby area was <2.0 V/m. The EMF exposed women showed in 2000 reduced blood NK lymphocytes as well as PHA stimulated PBMC proliferation and IL-2 and IFN-gamma release. In the year 2005, the EMF exposed women and 48 control women with similar ages(mean 43 years), smoking habits, atopy and social level were investigated. State (temporary) and trait(tendency of the personality) anxiety were determined by STAI I and II, respectively. Blood cytotoxic activity and lymphocyte subsets were also determined. The ratio STAI I/STAI II of the EMF exposed group was lower than that of the control group. The blood cytotoxic activity of the exposed women was lower (p<0.01), percent of B CD45+-CD19+ lymphocytes higher and percent of CD45+-CD3+-CD8+ cells lower (p<0.05). Moreover, cytotoxic activity/CD45+-CD16+-56+ NK lymphocytes of the controls was negatively correlated with STAI I and STAI II (p<0.001). In conclusion, this study demonstrates reduced blood cytotoxic activity and increased trait anxiety in relation to state anxiety in EMF exposed women. An effect of EMFs on immune functions, in part mediated by nervous mechanisms, may be hypothesized. However, the influence of lifestyle may not be excluded.

The effects of sub-acute exposure to palladium on cytokines in male Wistar rats

Palladium (Pd) and its compounds can cause sensitization, asthma and skin disorders. Sensitization to Pd is increasing in the European general population. In this study, Wistar rats were exposed for two weeks to 0, 1, 10,100 and 250 ng ml-1 of Pd as potassium hexachloro-palladate in drinking water. At the end of exposure, possible changes in two type-1 cytokines (IL-2, INF-gamma) and one type-2 cytokine (IL-4) in the serum were measured. Our findings suggest that, after a sub-acute exposure, a moderate level of Pd causes a strong Th2 response. This also occurs at higher concentrations. Although no effect on Th1 cells is observed up to a concentration of 250 ng/ml, a significant increase in IL-2 production is reported thereafter. These results therefore suggest that in sub-acute exposure, Pd exerts a significant immuno-modulating effect, altering the Th1/Th2 cytokine balance, even at low exposure doses. Our preliminary results indicate the need to carry out further studies to observe the effect of different types of Pd compounds and to measure other types of cytokines both in the animal model used in our study and in other models.

Shift work and autoimmune thyroid disorders

Stress induces autoimmune disorders by affecting the immune response modulation. Recent studies have shown that shift work stress may enhance the onset of the autoimmune Graves hyperthyroidism. On the other hand, the possible association between occupational stress and autoimmune hypothyroidism has not yet been investigated. In order to detect the possible association between shift work and subclinical autoimmune hypothyroidism we investigated the prevalence of isolated anti-peroxidase thyroid (TPO) autoantibodies in 220 shift workers and in 422 day-time workers. Subclinical autoimmune hypothyroidism was diagnosed by the concomitant presence of high anti-TPO values and TSH levels higher than 2.51 mU/l. Anti TPO antibodies were measured by chemiluminescent technology (Advia Centaur) (a value above 60 IU/l was considered altered). Subclinical autoimmune hypothyroidism was diagnosed in 7.7 percent shift workers and in 3.8 percent day-time workers with a statistically significant difference: Odds Ratio (OR) 2.12, 95 percent Confidence Interval (CI) 1.05 to 4.29; p=0.03. The difference persisted after multivariate analysis taking into account age, sex, smoking habits, alcohol intake, familial history of autoimmune thyroid disease and exposure to radiation as possible confounders: OR. 2.24, 95 percent CI.1.01 to 4.94, p 0.05. Altered anti- TPO autoantibodies were found in 13.6 percent shift workers and in 8.6 percent day-time workers OR. 1.64, 95 percent CI.1.03 to 2.74, p=0.05. The significant difference was still detectable after multivariate analysis: OR. 1.95, 95 percent CI. 1.09 to 3.48, p=0.02. Our data show a significant association between shift work and autoimmune hypothyroidism. This finding may have implications in the health surveillance programs.

Cobalt nano-particles modulate cytokine in vitro release by human mononuclear cells mimicking autoimmune disease

The use of particles from micro to nanoscale provides benefits to diverse scientific fields, but because a large percentage of their atoms lie on the surface, nanomaterials could be highly reactive and pose potential risks to humans. Due to their wide range of application, Cobalt nano-particles are of great interest both in industry and in life-science. To date, there are few studies on Co nano-particle toxicology. In this respect, this study aims at evaluating in vitro the potential interference of Co nano-particles on the production of several cytokines (IL-2, IL-4, IL-6, IL-10, IFNgamma and TNFalpha) by PBMCs, comparing their effects to those of Co micro-particles and Co solution (CoCl2). Cells were cultured in Opticell flasks with escalating concentrations (10-5, 10-6 and 10-7 M), of Co nano and micro-particles and CoCl2 or without metal. Cytokines were quantified in the supernatants using a human Th1/Th2 cytokine cytometric bead array. Co micro-particles showed a greater inhibitory effect compared to other Co forms. Its inhibitory activity was detected at all concentrations and towards all cytokines, whereas Co solutions selectively inhibited IL-2, IL-10 and TNF-alpha at maximal concentration. Co nano-particles induced an increase of TNF-alpha and IFN-gamma release and an inhibition of IL-10 and IL-2: a cytokine pattern similar to that detected in the experimental and clinical autoimmunity. On the basis of the obtained data, immune endpoints should be sought in the next series of studies both in vitro and in vivo in subjects exposed to cobalt nano-particles.

[Predisposition and evaluation of sanitary procedures in occupational medicine]

"Sanitary procedures" are used to perform preventive and periodic clinical examinations of workers. Their main purpose is to evaluate health status and function of target organs. Periodic medical procedures are used to evaluate the possible onset of precocious and reversible modifications of the health status induced by exposure to specific risk factors during working activities. Moreover, they must be considered an essential step of a correct management of the quality.