Selected immunological changes in patients with Goeckerman’s therapy TNF-alpha, sE-selectin, sP-selectin, sICAM-1 and IL-8

Psoriasis is one of the most frequent inflammatory skin diseases in which abnormal individual immune reactivity plays an important role. The aim of the present study was to describe selected immunological changes, concerning pro-inflammatory cytokines (TNF-alpha, IL-8) and adhesion molecules (sE-selectin, sP-selectin, sICAM-1), in 56 patients cured by Goeckerman's therapy (GT). GT includes dermal application of crude coal tar (containing polycyclic aromatic hydrocarbons) and exposure to UV radiation. When compared with the control group (healthy blood donors), the patients before GT had significantly increased serum levels of sE-selectin (p<0.001), sP-selectin (p<0.001), sICAM-1 (p<0.001) and IL-8 (p<0.001). Significantly decreased serum levels of sE-selectin (p<0.05) and significantly increased serum levels of IL-8 (p<0.05) were found after GT therapy. Serum levels of sICAM significantly correlated with the disease activity and with serum levels of sE-selectin. The level of PASI score (Psoriasis Area and Severity Index) significantly decreased after GT (p<0.001) and confirms the high efficiency GT. These findings confirmed that pro-inflammatory chemokine (IL-8) and adhesion molecules (sE-selectin, sP-selectin, sICAM-1) play an important role in the development and regulation of inflammation in psoriasis. Determination of sE-selectin and sICAM seems to be a promising marker of psoriasis's activity. Chemokine pathway (IL-8) and TNF-alpha activity seem to be modulated by Goeckerman's therapy (polycyclic aromatic hydrocarbons).

Cytogenetic and immunological changes after dermal exposure to polycyclic aromatic hydrocarbons and UV radiation

Goeckerman's therapy (GT), which combines exposure to coal tar (polycyclic aromatic hydrocarbons - PAHs) and UV radiation (UV) is often used as the first option for treatment of psoriasis. However, PAHs and UV represent mutagenic, carcinogenic and immunotoxic agents. Therefore GT can represent a health risk for the patients. The group under observation consisted of thirty patients undergoing GT. Before and after the treatment, blood samples were collected and chromosomal aberrations and selected immunological markers were determined. The relationships between chromosomal aberrations and immunological markers and the extent (duration) of exposure to GT were evaluated. The Psoriasis Area and Severity Index (PASI) score confirmed the high efficacy of GT. However, significantly elevated levels of chromosomal aberrations of peripheral lymphocytes were also found after the therapy (p<0.001). The levels of chromosomal abnormalities correlated to the extent and the total duration of exposure to PAHs (r = 0.682, p<0.01 and r = 0.605, p<0.05). After the therapy, significantly decreased levels of IgE, IgM isotypes of immunoglobulin, alpha(2)-macroglobulin and transferrin together with beta(2)-microglobulin were found. From the immunological markers listed above only the decreased level of alpha(2)-macroglobulin correlated to the extent of exposure to PAHs (r = -0.568, p<0.05). No correlation was found between chromosomal aberrations, significantly changed immunological markers and the duration of UV exposure. Our study revealed that GT has a significant impact on both genetic and immunological parameters of psoriatic patients. The results indicate that GT could increase genotoxic risk and modulates immunity of treated patients.

Possible genotoxic risk of combined exposure to pharmaceutical coal tar and UV-B radiation

Goeckerman's therapy of psoriasis combines exposure to pharmaceutical coal tar and UV-B radiation. In the pilot study (15 patients had been diagnosed with psoriasis, the average time period in hospital therapy was 24 days, the average age of the patients was 29 years, 47% of them were smokers) a level of genotoxic risk from therapy was evaluated by using chromosomal aberration of peripheral lymphocytes. The study suggested the presence of an increased genotoxic risk from the therapy. The PASI scores (Psoriasis Area and Severity Index) were monitored.

[New findings in monitoring health status of welders and grinders of stainless steel]

During the occupational preventive care check up we investigated a group of 20 stainless steel welders and grinders in the factory producing technology for chemical industry. Results have been compared with 21 healthy persons--blood donors. In the group exposed there have not been discovered any marked deviations in either their health status, or in the CBC and biochemical screening results, though there had been found substantially increased chromium and nickel concentrations, mainly in grinders. Also the levels of polycyclic aromatic hydrocarbons were in some cases even higher than on the busy city crossing. The chromosome aberrations investigations proved to be very sensitive and confirmed that employees of the followed up factory are exposed to an increased genotoxic risk.

Environmental exposure of small children to polycyclic aromatic hydrocarbons

OBJECTIVES

The aim of the study was to assess the intake (by various routes of exposure) of polycyclic aromatic hydrocarbons (PAH) by children living in a Czech city, and its effect on excretion of 1-hydroxypyrene (1-OHP) in summer and winter periods.

METHODS

Four groups of children (3-6 years old) were chosen: (1) two groups from a kindergarten situated in the city center with a higher traffic density ("polluted" area); (2) two groups from a kindergarten situated in a green zone of the same city ("non-polluted" area). Food consumption was recorded in all children and PAH intake from foodstuffs was estimated. Ambient air samples were collected from the playground and inside the kindergartens. Soil samples were collected too. Morning and evening urine samples were collected during sampling days.

RESULTS

In both seasons, the mean outdoor total PAH concentration (sum of 12 individual PAH) in the -polluted" area was approximately three-times higher than that in the "non-polluted" area. Indoor concentration in the "polluted" area was more than six-times higher than that in the "non-polluted" area in summer, and almost three-times higher in winter. The same trend was observed for pyrene and for the sum of carcinogenic PAH. The contribution to the total pyrene absorbed dose from food consumption was much more important than that from inhalation and from ingestion of soil dust. Significantly higher urinary concentrations of 1-OHP (evening samples) were found in children from the "polluted" kindergarten in both seasons. The number of significant relationships between 1-OHP and pyrene absorbed dose was weak.

CONCLUSIONS

Food seems to be the main source of total pyrene and total PAH intake in small children, even under relatively higher air PAH exposure in the city. Estimated pyrene ingestion from soil had a negligible contribution to the total pyrene absorbed dose. Urinary 1-OHP seems to be an uncertain (non-sensitive) marker of the environmental inhalation exposure to pyrene (PAH) if the pollution of air by pyrene (PAH) is not excessive and the pyrene (PAH) dose by this route is much less than by ingestion. Usefulness of the urinary 1-OHP as an indicator of overall environmental exposure to PAH needs further investigation.

[Effect of polycyclic aromatic hydrocarbons on the immune system]

Polycyclic aromatic hydrocarbons (PAHs) are ubiquitous compounds in our environment. They are formed during incomplete burning of coal, oil, gas, wood, garbage or other organic substances such as tobacco and charbroiled meat. PAHs enter the environment mostly as releases to air from volcanoes, forest fires, residential wood and coal burning and exhaust from automobiles and trucks. There are more than 100 different PAHs. Some of them have danger toxic properties including mutagenic and carcinogenic potential. Since 1993 PAHs are classified as the compounds which can cause immunosuppression. They reduce the body resistance against infection and cancer diseases. Immunosuppressive, carcinogenic and hypersensitivity effects of some PAHs representatives were described well in experimental studies. On the other hand, only sporadic information about immunological changes after long-term occupational exposure to PAHs were found from existing human epidemiological database. In addition, these studies usually did not cover the complex immunological profile represented by cellular and humoral activity.

[Phenotyping of cytochrome P-450 1A2 and N-acetyltransferase (NAT2) using the in vivo caffeine test as a tool for determining individual susceptibility to selected xenobiotics]

An in vivo phenotyping method of CYP1A2 (cytochrome P-450 1A2) and NAT2 (N-acetyltransferase, isoform 2) based on caffeine test (Butler et al. Pharmacogenetics 1992;2:116-127) with modifications has been established. Molar concentrations of caffeine and its metabolites in urine were determined by HPLC with gradient elution and spectral detection (200-350 nm). The results obtained with this method were sufficiently accurate and precise and allowed to calculate the respective parameters which were subsequently used to evaluate the CYP1A2 and NAT2 activities.

[Polycyclic aromatic hydrocarbons. II. Toxic effects]

Polycyclic aromatic hydrocarbons (PAH) represent dangerous environmental pollutants. Many of them have toxic and carcinogenic potential. Presented work summarizes most of available data on the absorption, metabolism and elimination of PAH. The second part of article contains descriptions and evaluations of toxicological studies and epidemiological investigations and provides conclusions, where possible, on the relevance of toxicity and toxicokinetic data to public health. In the third part of article, the populations with higher susceptibility to exposure to PAH are described and the influences of chemical interaction of PAH to biological effects are mentioned.

[Polycyclic aromatic hydrocarbons. Biological indicators of exposure and possibilities of prevention]

Polycyclic aromatic hydrocarbons (PAH) represent an extensive group of ubiquitous environmental pollutants disposing of a considerable toxic and carcinogenic potential. According to the IARC data (International Agency for Research on Cancer), PAH represent the largest group of chemical carcinogens produced during combustion, pyrolysis and pyrosynthesis of organic matter. PAH can be identified in atmosphere, water, soil, food and other materials which are in daily contact which the general population. Presented work summarizes most of available data on the biological markers used to identify or quantify the exposure to PAH and on the biological markers used to characterize the effects caused by PAH. The digest of possibilities of reduction toxic effects of PAH concludes the work.

[Polycyclic aromatic hydrocarbons. I. Environmental contamination and environmental exposure]

Polycyclic aromatic hydrocarbons (PAHs) represent danger ubiquitous environmental pollutants. A lot of them have toxic and carcinogenic potential. Presented work summarises most of available data describing properties, origin and occupational and non-occupational sources of PAHs. Contamination of environment is described separately for air, water, soil, sediments and food. Possibilities of occupational and non-occupational exposure of persons are discussed and populations with potentially high exposures to PAHs are defined. The work is concluded by digest of regulations and guidelines regarding environmental contamination of PAHs.

[Biological monitoring of occupational exposure in welders of stainless steel. Immunologic methods]

Biological monitoring of occupational exposure to toxic compounds enables an early detection of adverse health effects. Apart from the standard biological monitoring methods of occupational exposure represented by metabolites and enzymes activities analysis also immunological detection methods seem to be promising. The changes of immunological system are demonstrable extraordinary sensitive markers of load of organism. The process of welding belongs between important sources of pollution of working environment with heavy metals and other harmful compounds including polycyclic aromatic hydrocarbons. According to IARC classification the welding fumes are included into group 2B and are supposed as possible human carcinogens. Numbers of different epidemiological studies have proved relationship between welding and serious health disorders namely malignancies. We recorded a number of changes in immunological parameters when compared with those in control group in our study. The results of analysis were statistically evaluated. The statistically significant reduction of number of phagocytosis capable cells was found in the group of welders when compared with the control group. The levels of neopterin, beta-2-microglobulin and IL-1 beta have indirectly monitored cell component of immunological response. In the case of these markers a statistically significant increases were found in the group of welders. We found statistically significant IgM decrease and statistically significant IgA increase in humoral responses with the same group when compared with control group.

[Health status of persons occupationally exposed to chromium, nickel, manganese and polycyclic aromatic hydrocarbons]

Occupational environment monitoring and biological-medical monitoring of persons professionally exposed to welding fumes have been performed. Chromium, manganese and polycyclic aromatic hydrocarbons in welding fumes represents an important health risk. Pollutant concentrations found in metal welding fumes represented only fractions of those acceptable ones. Polycyclic aromatic hydrocarbons have been reached the concentration found in a busy road crossing in Hradec Králové (compared with these as in Czech Republic no maximum acceptable levels for PAHs having been declared). Family, personal and occupational history have been taken. Health state including total haematological count, biochemical and cytogenetical changes of 19 stainless steel welders were checked-up. The level of mercapturates in urine were examined as well. The data were statistically compared with those of non exposed (control group). No changes witnessing the above mentioned risk factors influence on the haematological, biochemical and cytogenetical findings were ever proved. In conclusion, our results did not confirm an increased professional risk in this group of welders.

Assessment of multipathway exposure of small children to PAH

The aim of study was to assess the uptake of polycyclic aromatic hydrocarbons (PAH) by children living in a city and its effect on 1-hydroxypyrene (1-OHP) excretion. Two groups of children (n=11 and 13; 3-6 years old) were chosen: (1) a group from a kindergarten situated near a road with a high traffic density ('polluted' area); (2) a group from a kindergarten situated in a green zone ('non polluted' area). Food consumption was recorded in all children and PAH uptake from foodstuffs was estimated. Ambient air samples were collected on the playground and indoor of kindergartens during 3 days in summer 1997. Soil samples were collected on the playground. Urine samples were collected in the morning and in the evening. Mean outdoor total PAH concentration (sum of 12 individual PAH) in 'polluted' area was 12 times higher than that in 'non polluted' area (22.9 vs. 1.9 ng/m(3)). However, indoor concentrations were similar (3.0 vs. 2.1 ng/m(3)). The same trend was observed for pyrene concentrations. The contribution to the total pyrene absorbed dose from food consumption (estimated daily absorbed dose of 167 and 186 ng, respectively, in 'polluted' and 'non polluted' area) was much more important than that from inhalation (8.4 and 5.4 ng, respectively) in both areas. The estimated daily absorbed doses of pyrene from the soil were 0.061 and 0.104 ng in 'polluted' and 'non polluted' kindergarten, respectively, which correspond to 0.032 and 0.059% of the total absorbed dose. Higher urinary concentrations of 1-OHP were found in children from 'polluted' kindergarten. In conclusion, the food seems to be a main source of the total pyrene and total PAH uptake in small children, even under a relative high PAH air exposure in the city. Pyrene concentration in soil had a negligible contribution to the total pyrene absorbed dose. Usefulness of the urinary 1-OHP as an indicator of the environmental exposure to PAH needs further research.

[Biological and medical monitoring of persons with occupational exposure to fibrous materials]

Health status indicators in 3 groups of workers professionally exposed to fibrous materials and 1 control group have been followed. In spite of the fact that asbestos as a compound of friction elements has been forbidden and replaced by non-asbestos materials, quite important changes in peripheral lymphocytes aberrations we found in persons working with these new materials.

[Chemical load in the population and its evaluation]

Human health is determined by the interplay between heredity and the environment. Air, water, food and soil contain chemical, physical and biological agents some of which are known to be harmful to health. Chemical substances that pose the risk to human health and safety and to the environment are subject to governmental regulation. The regulatory decision-making process and regulatory actions are based on two distinct elements: risk assessment and risk management. Air pollution (outdoor, indoor) is a world problem afflicting densely populated urban centers and heavily industrialised areas. Industrialization and the widespread use of chemicals coupled with modern intensive agricultural practices have raised a global concern about the contamination of soil and water. Three categories of environmental chemical contaminants generally occur in food--natural and synthetic organic compounds and traces of toxic metals. Human health protection against chemical exposure can be realised in three ways. Environmental monitoring assesses exposure to a chemical agent by measuring its concentration in the environment (i.e., air, soil, food, water). Biological monitoring assesses internal exposure to a chemical agent by measuring the chemical, its metabolites or nonadverse biological response in body fluids, tissues, expired air or excreta. Health surveillance entails the periodic medical examinations of exposed humans with the purpose of protecting health and preventing disease.

The effects of subchronical exposure to SO2 on biochemical and hematological parameters in guinea pigs

The effects of subchronical exposure to SO2 (400ppm, 3 hours daily, 28 days) on biochemical and hematological parameters were investigated in guinea pigs. Mostly no significant changes in the values of biochemical parameters and no significant changes in hematological parameters were found. The levels of investigated ions (K+, Na+, Cl-, Ca++, Mg++ and phosphates), proteins (albumines, globulines, total proteins), enzymes (LD, ALT, AST, CK) and other biochemical parameters (urea, creatinine, bilirubin) were not significantly different between groups, with the exception of a significantly higher ALP concentration in the exposed group as compared with controls (2.17 mukat and 1.85 mukat, respectively. It can be concluded that a subchronical exposure to sulphur dioxide mostly did not induce any definite changes in biochemical and hematological parameters in guinea pigs.

[Effect of acute exposure to SO2 on cellular defense mechanisms in the lung (pilot study)]

Sulphur dioxide is one of the most important and most frequent atmospheric pollutant of our environmental setting. In presented pilot-study we describe the influence of acute exposure to sulphur dioxide on alveolar macrophages of guinea pigs. The alveolar macrophages represent the main part of mononuclear phagocytic system, which is responsible for the defence of respiratory tract against foreign compounds. The experimental animals were exposed over three hours to sulphur dioxide with the concentration of about 400 ppm. After exposure we did not find significant changes in phagocytic activity of alveolar macrophages.

[Biological monitoring of chemical exposure]

In this paper we described the biological monitoring as a capable exposure assessment tool that has provided important information used in public health decisions. Biological monitoring is based on determination of biological markers of exposure which are presented as the quantity of a chemical substance or its metabolites or as the deviation of biological parameters (enzyme activity etc.) induced by this substance in exposed humans. The greatest advantage of biological monitoring is the fact that the biological marker of exposure is more directly related to the adverse effects than any environment measurement. Another advantage of biological monitoring is based on the reality that the nonoccupational background exposure (leisure activity, residency, dietary habits, smoking, etc.) may also be expressed in the biological level. Biological parameters can be unfortunately affected by various factors that influence the fate of xenobiotic in vivo. The "BEL" (BTV-biological tolerance value for occupational exposures) is defined as the maximum permissible quantity of a chemical substance or its metabolites or the maximum permissible deviation from the norm of biological parameters during or after exposure. It should be subject to regular revision in the light of new scientific data.

Environmental exposure to polycyclic aromatic hydrocarbons in Czech Republic

1 Objectives of this study were (1) to compare concentrations of individual polycyclic aromatic hydrocarbons (PAH) in air of polluted and nonpolluted area of Czech Republic during winter and summer periods and (2) to verify if urinary 1-hydroxypyrene (1-OHP), as supposed practical biological marker, permits the assessment of spacial and temporal variations in environmental PAH exposure. 2 The study population consisted of three groups: (1) a group of 22 physical exercise students who regularly train outside, from the university situated in a polluted town, spending 14 days in winter and 14 days in summer in 'non-polluted' mountains; (2) a control group of 22 residents from the town and (3) a control group of 18 residents from the mountains. 3 The total PAH concentrations (sum of 13 individual PAH) were 19.3 and 104.6 ng/m3 in town and in mountains, respectively, during summer and 86.6 and 261 ng/m3 during winter. 4 Median 1-OHP levels ranged between 0.03 and 0.13 mumol/mol creatinine for controls and between 0.04 and 0.12 mumol/mol creatinine for students. No relationship was found between pyrene levels in air and group means of urinary 1-OHP. Our results show that other factors (probably PAH in food) contribute in masking air pollution influence on urinary 1-OHP levels in subjects non-occupationally exposed to PAH.

Benzo(a)pyrene-albumin adducts in humans exposed to polycyclic aromatic hydrocarbons in an industrial area of Poland

OBJECTIVES

The interaction of benzo(a)pyrene with serum albumin was measured in an attempt to identify the actual exposure and to evaluate albumin adduct measurements as biomarkers for exposure monitoring.

METHODS

Benzo(a)pyrene-diol-epoxide (BPDE)-albumin adducts were measured by competitive enzyme linked immunosorbent assay (ELISA) in plasma of coke oven plant workers from three plants and from people living in a highly industrialised area of Silesia in Poland. Due to the high air concentrations of polycyclic aromatic hydrocarbons (PAHs) in this area, a control group was selected from a rural non-industrialised area in Poland. Breathing zone air measurements of PAHs were collected from some of the participants.

RESULTS

Coke oven plant workers and non-occupationally exposed people had similar concentrations of albumin adducts whereas the rural controls were significantly lower (2.74 fmol adducts/microgram albumin (SEM 0.124)). The mean concentration of BPDE-albumin adduct in plasma of both the occupational and the environmental groups were significantly higher in the summer samples (4.34 fmol adducts/microgram albumin (SEM 0.335) and 4.55 fmol adducts/microgram albumin (SEM 0.296), respectively) than in the winter samples (3.06 fmol adducts/microgram albumin (SEM 0.187) and 3.04 fmol adducts/microgram albumin (SEM 0.184), respectively) even though the air measurements showed higher concentrations of PAHs in the winter. The statistical analysis did not show any effects of air exposures on concentrations of BPDE-albumin adduct.

CONCLUSIONS

A multiple regression analysis of the measured concentrations of BPDE-albumin adducts for all the groups, during both seasons, indicates that occupational exposures do not contribute significantly to the formation of adducts. In general, the concentrations of albumin adducts found vary within relatively small limits for the two seasons and between the various groups of participants. No extreme differences were found.

Environmental health

A short history of the close connections between human health an ambient environment (environmental health) in the global and national (Czech Republic) sense is presented. Concrete tasks and prospects for the near future are mentioned, including the human ecology education programme.

Distribution of nickel in body fluids and organs of rats chronically exposed to nickel sulphate

1. Male and female rats were given 100 mg Ni L-1 (as nickel sulphate) in drinking water for 6 months. 2. The feeding of nickel was associated with an increased concentration of nickel in body fluids and organs. The highest concentrations of nickel were found in the liver of both male and female rats. In male rats nickel levels decreased in the order: liver > kidney = whole blood = serum > testes > urine. In female rats the decreasing order was similar: liver > kidney = whole blood = serum = plasma > urine > ovaries. 3. No significant differences were found between nickel concentrations in organs (except ovaries), blood and urine of rats exposed for 3 months and those exposed for 6 months indicating the reaching of a steady state of nickel in the rat during long-term exposure. 4. The urinary excretion of the orally administered nickel was only 2% of absorbed dose (supposing 1% Ni absorption).

Renal alterations in female rats following subchronic lead exposure

Female Wistar rats were given 1% or 0.1% lead acetate in drinking water for 2 or 4 months, respectively. Urinary beta 2-microglobulin, N-acetyl-beta-D-glucosaminidase, lactate dehydrogenase and lysozyme were used as markers of tubular dysfunction. Excretion of albumin and glomerular filtration rate were used as indicators of glomerular impairment. Kidney and body weights and morphological changes in the kidney were also studied. Exposure to 1% lead acetate induced a mean blood lead level of 1730 micrograms l-1 and caused only an increase of beta 2-microglobulin excretion and relative kidney weight. Light microscopy of kidney revealed morphological changes mainly in the epithelial cells of the proximal tubules. The role of acetate or reduced water intake on kidney function was excluded because 1% sodium acetate or the restriction of water intake to the volume consumed by the rats of the lead-exposed group was ineffective. Exposure to 0.1% lead acetate induced a blood lead level of 376 micrograms l-1, corresponding to the current level in industry workers, without any sign of nephrotoxicity. Comparison of this study with the results of a previous study on male rats indicates no sex difference in the nephrotoxicity of lead.