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Lescoat A, Leinardi R, Pouxvielh K, Yakoub Y, Lelong M, Pochet A, Dumontet E, Bellamri N, Le Tallec E, Pavan C, Turci F, Paris C, Huaux F, Lecureur V. Effects of different amosite preparations on macrophages, lung damages, and autoimmunity. J Mol Med (Berl) 2024; 102:197-211. [PMID: 38015242 DOI: 10.1007/s00109-023-02401-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Revised: 11/09/2023] [Accepted: 11/14/2023] [Indexed: 11/29/2023]
Abstract
The underlying mechanisms of asbestos-related autoimmunity are poorly understood. As the size, surface reactivity, and free radical activity of asbestos particles are considered crucial regarding the health effects, this study aims to compare the effects of exposure to pristine amosite (pAmo) or milled amosite (mAmo) particles on lung damage, autoimmunity, and macrophage phenotype. Four months after lung exposure to 0.1 mg of amosite, BAL levels of lactate dehydrogenase, protein, free DNA, CCL2, TGF-β1, TIMP-1, and immunoglobulin A of pAmo-exposed C57Bl/6 mice were increased when compared to fluids from control- and mAmo-exposed mice. Effects in pAmo-exposed mice were associated with lung fibrosis and autoimmunity including anti-double-strand DNA autoantibody production. mAmo or pAmo at 20 µg/cm2 induced a pro-inflammatory phenotype characterized by a significant increase in TNFα and IL-6 secretion on human monocyte-derived macrophages (MDMs). mAmo and pAmo exposure induced a decrease in the efferocytosis capacities of MDMs, whereas macrophage abilities to phagocyte fluorescent beads were unchanged when compared to control MDMs. mAmo induced IL-6 secretion and reduced the percentage of MDMs expressing MHCII and CD86 markers involved in antigen and T-lymphocyte stimulation. By contrast, pAmo but not mAmo activated the NLRP3 inflammasome, as evaluated through quantification of caspase-1 activity and IL-1β secretion. Our results demonstrated that long-term exposure to pAmo may induce significant lung damage and autoimmune effects, probably through an alteration of macrophage phenotype, supporting in vivo the higher toxicity of entire amosite (pAmo) with respect to grinded amosite. However, considering their impact on efferocytosis and co-stimulation markers, mAmo effects should not be neglected. KEY MESSAGES: Lung fibrosis and autoimmunity induced by amosite particles depend on their physicochemical characteristics (size and surface) Inhalation exposure of mice to pristine amosite fibers is associated with lung fibrosis and autoimmunity Anti-dsDNA antibody is a marker of autoimmunity in mice exposed to pristine amosite fibers Activation of lung mucosa-associated lymphoid tissue, characterized by IgA production, after exposure to pristine amosite fibers Pristine and milled amosite particle exposure reduced the efferocytosis capacity of human-derived macrophages.
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Affiliation(s)
- Alain Lescoat
- Univ Rennes, CHU Rennes, INSERM, EHESP, IRSET (Institut de Recherche en Santé, environnement et travail)-UMR_S 1085, 35000, Rennes, France
- Department of Internal Medicine & Clinical Immunology, Rennes University Hospital, 35000, Rennes, France
| | - Riccardo Leinardi
- Louvain Centre for Toxicology and Applied Pharmacology (LTAP), Institut de Recherche Expérimentale Et Clinique (IREC), Université Catholique de Louvain (UCL), Avenue Hippocrate 57, Bte B-1.57.06, 1200, Brussels, Belgium
| | - Kévin Pouxvielh
- Univ Rennes, CHU Rennes, INSERM, EHESP, IRSET (Institut de Recherche en Santé, environnement et travail)-UMR_S 1085, 35000, Rennes, France
| | - Yousof Yakoub
- Louvain Centre for Toxicology and Applied Pharmacology (LTAP), Institut de Recherche Expérimentale Et Clinique (IREC), Université Catholique de Louvain (UCL), Avenue Hippocrate 57, Bte B-1.57.06, 1200, Brussels, Belgium
| | - Marie Lelong
- Univ Rennes, CHU Rennes, INSERM, EHESP, IRSET (Institut de Recherche en Santé, environnement et travail)-UMR_S 1085, 35000, Rennes, France
| | - Amandine Pochet
- Louvain Centre for Toxicology and Applied Pharmacology (LTAP), Institut de Recherche Expérimentale Et Clinique (IREC), Université Catholique de Louvain (UCL), Avenue Hippocrate 57, Bte B-1.57.06, 1200, Brussels, Belgium
| | | | - Nessrine Bellamri
- Univ Rennes, CHU Rennes, INSERM, EHESP, IRSET (Institut de Recherche en Santé, environnement et travail)-UMR_S 1085, 35000, Rennes, France
| | - Erwan Le Tallec
- Univ Rennes, CHU Rennes, INSERM, EHESP, IRSET (Institut de Recherche en Santé, environnement et travail)-UMR_S 1085, 35000, Rennes, France
- Department of Internal Medicine & Clinical Immunology, Rennes University Hospital, 35000, Rennes, France
| | - Cristina Pavan
- "G. Scansetti" Interdepartmental Center for Studies On Asbestos and Other Toxic Particulates, University of Turin, Via Pietro Giuria 7, 10125, Turin, Italy
- Department of Chemistry, University of Turin, Via Pietro Giuria 7, 10125, Turin, Italy
| | - Francesco Turci
- "G. Scansetti" Interdepartmental Center for Studies On Asbestos and Other Toxic Particulates, University of Turin, Via Pietro Giuria 7, 10125, Turin, Italy
- Department of Chemistry, University of Turin, Via Pietro Giuria 7, 10125, Turin, Italy
| | - Christophe Paris
- Univ Rennes, CHU Rennes, INSERM, EHESP, IRSET (Institut de Recherche en Santé, environnement et travail)-UMR_S 1085, 35000, Rennes, France
- Service de Santé Au Travail Et Pathologie Professionnelle, CHU Rennes, 35000, Rennes, France
| | - François Huaux
- Louvain Centre for Toxicology and Applied Pharmacology (LTAP), Institut de Recherche Expérimentale Et Clinique (IREC), Université Catholique de Louvain (UCL), Avenue Hippocrate 57, Bte B-1.57.06, 1200, Brussels, Belgium
| | - Valérie Lecureur
- Univ Rennes, CHU Rennes, INSERM, EHESP, IRSET (Institut de Recherche en Santé, environnement et travail)-UMR_S 1085, 35000, Rennes, France.
- UMR-INSERM 1085, Campus Santé, 2 Avenue du Pr Léon Bernard, 35043, Rennes Cedex, France.
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Hiéronimus L, Huaux F. B-1 cells in immunotoxicology: Mechanisms underlying their response to chemicals and particles. FRONTIERS IN TOXICOLOGY 2023; 5:960861. [PMID: 37143777 PMCID: PMC10151831 DOI: 10.3389/ftox.2023.960861] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2022] [Accepted: 03/31/2023] [Indexed: 05/06/2023] Open
Abstract
Since their discovery nearly 40 years ago, B-1 cells have continued to challenge the boundaries between innate and adaptive immunity, as well as myeloid and lymphoid functions. This B-cell subset ensures early immunity in neonates before the development of conventional B (B-2) cells and respond to immune injuries throughout life. B-1 cells are multifaceted and serve as natural- and induced-antibody-producing cells, phagocytic cells, antigen-presenting cells, and anti-/pro-inflammatory cytokine-releasing cells. This review retraces the origin of B-1 cells and their different roles in homeostatic and infectious conditions before focusing on pollutants comprising contact-sensitivity-inducing chemicals, endocrine disruptors, aryl hydrocarbon receptor (AHR) ligands, and reactive particles.
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Celen H, Dens AC, Ronsmans S, Michiels S, De Langhe E. Airborne pollutants as potential triggers of systemic autoimmune rheumatic diseases: a narrative review. Acta Clin Belg 2021; 77:874-882. [PMID: 34666637 DOI: 10.1080/17843286.2021.1992582] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
The pathogenesis of systemic autoimmune rheumatic diseases (SARDs) is complex and remains insufficiently understood. It is commonly accepted that both intrinsic and extrinsic environmental factors interact to induce a self-reactive immune response. Case reports and observational studies have revealed an association between SARDs and specific airborne environmental factors, but the heterogeneity of the published studies hampers clear conclusions. The aim of this review is to provide an overview of the available epidemiological evidence on the relationship between airborne pollutants and SARDs. We performed a narrative review using the PubMed database. Observational studies have shown significant associations between airborne pollutants and SARDs. Cigarette smoking is strongly associated with the development of rheumatoid arthritis (RA) while the association between cigarette smoke and the development of other SARDs remains controversial. For decades, silica exposure has been linked to systemic sclerosis (SSc), RA and systemic lupus erythematosus (SLE). There is also strong evidence for a link between solvents and SSc. Recent observations even suggest that ambient air pollution is associated with the development of SARDs. Some studies have shown associations between asbestos, organic dust, metals and pesticides and SARDs, but more studies are needed to confirm these findings. Increasing evidence has linked airborne pollutants to SARDs. Although more studies are needed to understand the potential mechanisms by which these environmental agents contribute to disease pathogenesis, awareness of the link between environmental agents and SARDs is important to recognize and prevent work-related and environmentally induced diseases.
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Affiliation(s)
- Hannelore Celen
- Department of Rheumatology, University Hospitals Leuven, Leuven, Belgium
| | - Anne-Cathérine Dens
- Skeletal Biology and Engineering Research Centre, Department of Development and Regeneration, KU Leuven, Leuven, Belgium
- Department of Dermatology, University Hospitals Leuven, Leuven, Belgium
| | - Steven Ronsmans
- Clinic for Occupational and Environmental Medicine, Department of Pulmonary Medicine, University Hospitals Leuven, Leuven, Belgium
- Centre for Environment and Health, Department of Public Health and Primary Care, KU Leuven, Leuven, Belgium
| | - Stijn Michiels
- Department of Rheumatology, Imelda General Hospital, Bonheiden, Belgium
| | - Ellen De Langhe
- Department of Rheumatology, University Hospitals Leuven, Leuven, Belgium
- Skeletal Biology and Engineering Research Centre, Department of Development and Regeneration, KU Leuven, Leuven, Belgium
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Carey RN, Pfau JC, Fritzler MJ, Creaney J, de Klerk N, Musk AW(B, Franklin P, Sodhi-Berry N, Brims F, Reid A. Autoantibodies and cancer among asbestos-exposed cohorts in Western Australia. JOURNAL OF TOXICOLOGY AND ENVIRONMENTAL HEALTH. PART A 2021; 84:475-483. [PMID: 33678145 PMCID: PMC10726378 DOI: 10.1080/15287394.2021.1889424] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Asbestos exposure is associated with many adverse health conditions including malignant mesothelioma and lung cancer as well as production of autoantibodies. Autoantibodies may serve as biomarkers for asbestos exposure in patients with cancer, and autoimmune dysfunction has been linked to increased rates of various cancers. The aim of this study was to examine the hypothesis that autoantibodies are more frequent in asbestos-exposed individuals with either lung cancer or mesothelioma than those without these conditions. Asbestos-exposed individuals from Western Australia who had lung cancer (n = 24), malignant mesothelioma (n = 24), or no malignancy (n = 51) were tested for antinuclear autoantibodies (ANA) using indirect immunofluorescence and specific extractable nuclear autoantibodies (ENA) employing a multiplexed addressable laser bead immunoassay. Contrary to the hypothesis, data demonstrated that individuals without malignancy were more likely to be positive for ANA compared to those with cancer. However, autoantibodies to histone and Ro-60 were found to be associated with lung cancer. These results support a possible predictive value for specific autoantibodies in the early detection of lung cancer and/or in our understanding of the role of autoimmune processes in cancer. However, further studies are needed to identify specific target antigens for the antibodies.
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Affiliation(s)
- Renee N Carey
- School of Public Health, Curtin University, Bentley, Australia
| | - Jean C Pfau
- Department of Microbiology and Immunology, Montana State University, Bozeman, Montana, USA
| | | | - Jenette Creaney
- National Centre for Asbestos Related Diseases, University of Western Australia, Nedlands, Australia
- Department of Respiratory Medicine, Sir Charles Gairdner Hospital, Nedlands, Australia
| | - Nicholas de Klerk
- Telethon Kids Institute, University of Western Australia, Nedlands, Australia
- School of Population and Global Health, University of Western Australia, Nedlands, Australia
| | - Arthur W (Bill) Musk
- Department of Respiratory Medicine, Sir Charles Gairdner Hospital, Nedlands, Australia
- School of Population and Global Health, University of Western Australia, Nedlands, Australia
| | - Peter Franklin
- School of Population and Global Health, University of Western Australia, Nedlands, Australia
| | - Nita Sodhi-Berry
- School of Population and Global Health, University of Western Australia, Nedlands, Australia
| | - Fraser Brims
- Department of Respiratory Medicine, Sir Charles Gairdner Hospital, Nedlands, Australia
- Curtin Medical School, Curtin University, Bentley, Australia
| | - Alison Reid
- School of Public Health, Curtin University, Bentley, Australia
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Ma Q, Pollard KM, Brown JM, Italiani P, Moghimi SM. Editorial: Immune Mechanisms in the Pathologic Response to Particles, Fibers, and Nanomaterials. Front Immunol 2021; 12:665810. [PMID: 33815427 PMCID: PMC8017123 DOI: 10.3389/fimmu.2021.665810] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Accepted: 02/24/2021] [Indexed: 11/22/2022] Open
Affiliation(s)
- Qiang Ma
- Health Effects Laboratory Division, National Institute for Occupational Safety and Health, Morgantown, WV, United States
| | - Kenneth Michael Pollard
- Department of Molecular Medicine, The Scripps Research Institute, La Jolla, CA, United States
| | - Jared M Brown
- Skaggs School of Pharmacy, University of Colorado Anschutz Medical Campus, Aurora, CO, United States
| | - Paola Italiani
- Institute of Biochemistry and Cell Biology, National Research Council (CNR), Naples, Italy
| | - Seyed Moein Moghimi
- School of Pharmacy, Newcastle University, Newcastle upon Tyne, United Kingdom
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6
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Asbestos exposure and autoantibody titers. Ann Occup Environ Med 2020; 32:e32. [PMID: 33072343 PMCID: PMC7533291 DOI: 10.35371/aoem.2020.32.e32] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2019] [Accepted: 08/13/2020] [Indexed: 11/20/2022] Open
Abstract
Background Asbestos is a well-known hazardous substance that causes occupational and environmental diseases including asbestosis (lung fibrosis). Silica exposure which causes silicosis (another type of lung fibrosis) has long been linked to the development of autoimmune diseases; however, there are few studies on the relationship between asbestos exposure and autoimmune diseases. Methods A total of 54 individuals who had worked in a former asbestos textile factory underwent autoantibody-related blood tests, chest X-ray imaging, and pulmonary function tests. Based on the job exposure matrix (JEM), the estimated asbestos exposure concentrations were determined, and the presence of asbestosis was determined by chest radiography. Results Scleroderma (Scl-70) and ribonucleoprotein (RNP) antibodies were significantly lowered in the pleural plaque present group than in the absent group. Additionally, Scl-70, RNP, and Sjögren's syndrome type B (SS-B) antibodies were significantly lowered in the asbestosis present group. When stratifying variables with or without asbestosis, Scl-70, Smith, SS-B, and RNP antibodies decreased in female, crocidolite handling group, and higher estimated asbestos exposure level group. Conclusions Contrary to our expectations that autoantibody titers would be higher in groups with high asbestos exposure or in the asbestosis group, those with asbestosis showed lower titers. But as our research has some methodological limitations, the lowered titer of autoimmune antibody in our asbestos exposed subjects could not be simply interpreted as a lowered risk of autoimmune diseases. So careful interpreting should be taken when examine autoantibodies to screening or diagnose autoimmune diseases in people with asbestos exposure. In addition, it is necessary to establish relevance of asbestosis and autoantibodies through further studies of larger scale and higher confidence levels.
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The Effects of Asbestos Fibers on Human T Cells. Int J Mol Sci 2020; 21:ijms21196987. [PMID: 32977478 PMCID: PMC7584019 DOI: 10.3390/ijms21196987] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2020] [Revised: 09/14/2020] [Accepted: 09/22/2020] [Indexed: 01/20/2023] Open
Abstract
Asbestos exposure causes malignant tumors such as lung cancer and malignant mesothelioma. The effects of asbestos fibers on immunocompetent cells, however, have not been well studied. Asbestos physically comprises a fibrous substance, which differs from silica particles which are a particulate substance, although chemically it is a mineral silicate. Since silicosis patients previously exposed to silica particles often suffer from lung and autoimmune diseases, it is clear that silica exposure impairs immune tolerance. Similarly, asbestos may alter the immune system in asbestos-exposed individuals. Given that malignant tumors can result following exposure to asbestos, the attenuation of anti-tumor immunity in cases of asbestos exposure is an important area of investigation. We observed the effect of asbestos fibers on T lymphocytes, such as CD8+ cytotoxic T lymphocytes (CTLs), CD4+ helper T (Th), and regulatory T (Treg) cells, and showed that anti-tumor immunity was attenuated, as demonstrated in a system that stimulates fresh cells isolated from peripheral blood in vitro and a system that is continuously exposed to a cell line. In this manuscript, we introduce the experiments and results of studies on CTLs, as well as Th and Treg cells, and discuss how future changes in immunocompetent cells induced by asbestos fibers can be clinically linked.
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Pollard KM, Cauvi DM, Mayeux JM, Toomey CB, Peiss AK, Hultman P, Kono DH. Mechanisms of Environment-Induced Autoimmunity. Annu Rev Pharmacol Toxicol 2020; 61:135-157. [PMID: 32857688 DOI: 10.1146/annurev-pharmtox-031320-111453] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Although numerous environmental exposures have been suggested as triggers for preclinical autoimmunity, only a few have been confidently linked to autoimmune diseases. For disease-associated exposures, the lung is a common site where chronic exposure results in cellular toxicity, tissue damage, inflammation, and fibrosis. These features are exacerbated by exposures to particulate material, which hampers clearance and degradation, thus facilitating persistent inflammation. Coincident with exposure and resulting pathological processes is the posttranslational modification of self-antigens, which, in concert with the formation of tertiary lymphoid structures containing abundant B cells, is thought to promote the generation of autoantibodies that in some instances demonstrate major histocompatibility complex restriction. Under appropriate gene-environment interactions, these responses can have diagnostic specificity. Greater insight into the molecular and cellular requirements governing this process, especially those that distinguish preclinical autoimmunity from clinical autoimmunedisease, may facilitate determination of the significance of environmental exposures in human autoimmune disease.
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Affiliation(s)
- K Michael Pollard
- Department of Molecular Medicine, The Scripps Research Institute, La Jolla, California 92037, USA;
| | - David M Cauvi
- Department of Surgery, University of California San Diego School of Medicine, La Jolla, California 92093, USA
| | - Jessica M Mayeux
- Department of Molecular Medicine, The Scripps Research Institute, La Jolla, California 92037, USA;
| | - Christopher B Toomey
- Department of Ophthalmology, University of California San Diego, La Jolla, California 92093, USA
| | - Amy K Peiss
- Department of Molecular Medicine, The Scripps Research Institute, La Jolla, California 92037, USA;
| | - Per Hultman
- Departments of Clinical Pathology and Biomedical and Clinical Sciences, Linköping University, SE-581 85 Linköping, Sweden
| | - Dwight H Kono
- Department of Immunology and Microbiology, The Scripps Research Institute, La Jolla, California 92037, USA
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Ma Q. Polarization of Immune Cells in the Pathologic Response to Inhaled Particulates. Front Immunol 2020; 11:1060. [PMID: 32625201 PMCID: PMC7311785 DOI: 10.3389/fimmu.2020.01060] [Citation(s) in RCA: 42] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2019] [Accepted: 05/01/2020] [Indexed: 12/30/2022] Open
Abstract
Polarization of immune cells is commonly observed in host responses associated with microbial immunity, inflammation, tumorigenesis, and tissue repair and fibrosis. In this process, immune cells adopt distinct programs and perform specialized functions in response to specific signals. Accumulating evidence indicates that inhalation of micro- and nano-sized particulates activates barrier immune programs in the lung in a time- and context-dependent manner, including type 1 and type 2 inflammation, and T helper (Th) 17 cell, regulatory T cell (Treg), innate lymphoid cell (ILC), and myeloid-derived suppressor cell (MDSC) responses, which highlight the polarization of several major immune cell types. These responses facilitate the pulmonary clearance and repair under physiological conditions. When exposure persists and overwhelms the clearance capacity, they foster the chronic progression of inflammation and development of progressive disease conditions, such as fibrosis and cancer. The pulmonary response to insoluble particulates thus represents a distinctive disease process wherein non-infectious, persistent exposures stimulate the polarization of immune cells to orchestrate dynamic inflammatory and immune reactions, leading to pulmonary and pleural chronic inflammation, fibrosis, and malignancy. Despite large variations in particles and their associated disease outcomes, the early response to inhaled particles often follows a common path. The initial reactions entail a barrier immune response dominated by type 1 inflammation that features active phagocytosis by M1 macrophages and recruitment of neutrophils, both of which are fueled by Th1 and proinflammatory cytokines. Acute inflammation is immediately followed by resolution and tissue repair mediated through specialized pro-resolving mediators (SPMs) and type 2 cytokines and cells including M2 macrophages and Th2 lymphocytes. As many particles and fibers cannot be digested by phagocytes, resolution is often extended and incomplete, and type 2 inflammation becomes heightened, which promotes interstitial fibrosis, granuloma formation, and tumorigenesis. Recent studies also reveal the involvement of Th17-, Treg-, ILC-, and MDSC-mediated responses in the pathogenesis caused by inhaled particulates. This review synopsizes the progress in understanding the interplay between inhaled particles and the pulmonary immune functions in disease pathogenesis, with focus on particle-induced polarization of immune cells and its role in the development of chronic inflammation, fibrosis, and cancer in the lung.
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Affiliation(s)
- Qiang Ma
- Receptor Biology Laboratory, Toxicology and Molecular Biology Branch, Health Effects Laboratory Division, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Morgantown, WV, United States
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Larson TC, Williamson L, Antao VC. Follow-Up of the Libby, Montana Screening Cohort: A 17-Year Mortality Study. J Occup Environ Med 2020; 62:e1-e6. [PMID: 31714372 PMCID: PMC8157313 DOI: 10.1097/jom.0000000000001760] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
OBJECTIVE To evaluate mortality patterns among participants in a community-based screening program for asbestos-related disease. METHODS We calculated standardized mortality ratios (SMRs) and stratified results by exposure group (three occupational exposure groups, household contacts and residents without occupational asbestos exposure) and by radiographic abnormality presence. RESULTS All-cause mortality (15.8%; 1,429/8,043) was statistically lower than expected. Asbestosis was statistically elevated in all exposure groups. Lung cancer was moderately associated with vermiculite miner/miller employment. Mesothelioma was elevated in that same exposure group and among residents. Systemic autoimmune disease mortality was also elevated. Radiographic parenchymal abnormalities were associated with lung cancer mortality. CONCLUSION In addition to asbestos-related mortality in occupational exposure groups, this initial follow-up of this cohort also shows elevated mortality for some asbestos-related causes in non-occupational exposure groups.
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Affiliation(s)
- Theodore C Larson
- Division of Toxicology and Human Health Sciences, Agency for Toxic Substances and Disease Registry, Atlanta, Georgia (Mr Larson); Montana Department of Public Health and Human Services, Helena, Montana (Ms Williamson); Hospital for Special Surgery, New York, New York (Dr Antao)
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Winters CA, Kuntz SW. A Comparison of Environmental Concerns in Two Disparate Montana and Nevada Communities. ANNUAL REVIEW OF NURSING RESEARCH 2019; 38:113-130. [PMID: 32102958 DOI: 10.1891/0739-6686.38.113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Asbestos refers to six fibrous minerals that occur naturally in the environment in the United States and throughout the world. Deposits may be found in soil, rocks, and deposits of other minerals such as vermiculite and talc. These naturally occurring asbestos (NOA) minerals belong to the serpentine and amphibole family of minerals. This chapter reports shared components of community-driven environmental concerns related to exposure to NOA in a rural Montana and a suburban Nevada community. The specific aim is to establish an understanding of the community and community member's primary concern(s) related to NOA in both communities. The knowledge that NOA is commonly found in areas across the United States supports the need for additional research into the health effects of environmental exposure and best-practices to reduce exposure risk while allowing communities to thrive economically.
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Pfau JC, McNew T, Hanley K, Swan L, Black B. Autoimmune markers for progression of Libby amphibole lamellar pleural thickening. Inhal Toxicol 2019; 31:409-419. [PMID: 31814459 DOI: 10.1080/08958378.2019.1699616] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Exposure to Libby Asbestiform Amphibole (LAA) is associated with asbestos-related diseases, including mesothelioma, pulmonary carcinoma, pleural fibrosis, and systemic autoimmune diseases. The pleural fibrosis can manifest as a rapidly progressing lamellar pleural thickening (LPT), which causes thoracic pain, dyspnea, and worsening pulmonary function tests (PFT). It is refractory to treatment and frequently fatal.Objective: Because of the immune dysfunction that has been described in the LAA-exposed population and the association of pleural manifestations with the presence of autoantibodies, this study tested whether specific immunological factors were associated with progressive LPT and whether they could be used as markers of progressive disease.Methods: Subjects were placed into three study groups defined as (1) progressive LPT, (2) stable LPT, (3) no LPT. Serum samples were tested for antinuclear autoantibodies, mesothelial cell autoantibodies, anti-plasminogen antibodies, IL1 beta, and IL17; which have all been shown to be elevated in mice and/or humans exposed to LAA.Results: Group 1 had significantly higher mean values for all of the autoantibodies, but not IL1 or IL-17, compared to the control Group 3. All three autoantibody tests had high specificity but low sensitivity, but ROC area-under-the-curve values for all three antibodies were over 0.7, statistically higher than a test with no value. When all LPT subjects were combined (Progressive plus Stable), no marker had predictive value for disease.Conclusion: The data support the hypothesis that progressive LPT is associated with immunological findings that may serve as an initial screen for progressive LPT.
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Affiliation(s)
- Jean C Pfau
- Department of Microbiology and Immunology, Montana State University, Bozeman, MT, USA
| | - Tracy McNew
- Center for Asbestos Related Diseases, Libby, MT, USA
| | | | - Lindsay Swan
- Department of Microbiology and Immunology, Montana State University, Bozeman, MT, USA
| | - Brad Black
- Center for Asbestos Related Diseases, Libby, MT, USA
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Wallen T, Jagan N, Krishnan M, Depew Z. A 75 year old male with recurrent unilateral pleural effusion and positive ANA. Respir Med Case Rep 2019; 26:301-303. [PMID: 30859065 PMCID: PMC6396095 DOI: 10.1016/j.rmcr.2019.02.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2019] [Revised: 02/20/2019] [Accepted: 02/20/2019] [Indexed: 11/29/2022] Open
Abstract
This case report describes the clinical course and diagnostic challenges arising in a 75 year old man who initially presented with progressive shortness of breath. Imaging revealed a pleural effusion, which was recurrent following thoracentesis. While his initial workup suggested an autoimmune etiology, further diagnostic testing revealed a diagnosis of malignant pleural mesothelioma. Curiously, the patient had no known asbestos exposure, which is classically associated with acquired mesothelioma. There are a small number of similar cases with a possible overlap between positive autoimmune serologies and mesothelioma; however, the underlying pathophysiology remains elusive. It is the authors' goal to contribute this case to the few cases describing such overlap syndromes.
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Affiliation(s)
- Tanner Wallen
- Department of Internal Medicine, Creighton University School of Medicine, Omaha, NE, United States
- Corresponding author. Department of Internal Medicine, Creighton University School of Medicine, 7500 Mercy Road Omaha, NE, 68124, United States.
| | - Nikhil Jagan
- Department of Pulmonary, Critical Care, and Sleep Medicine, Creighton University School of Medicine, Omaha, NE, United States
| | - Mridula Krishnan
- Department of Oncology and Hematology, University of Nebraska Medical Center, Omaha, NE, United States
| | - Zachary Depew
- Department of Pulmonary, Critical Care, and Sleep Medicine, Creighton University School of Medicine, Omaha, NE, United States
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Rakhra A, Munir A, Chilukuri RS, Nahas J. A Rare Case of Malignant Mesothelioma Presenting with Systemic Lupus Erythematosus Seropositivity: A Case Report and Review of Literature. Cureus 2019; 11:e4092. [PMID: 31032152 PMCID: PMC6472718 DOI: 10.7759/cureus.4092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
While malignant mesothelioma may initially present in a variety of ways, it is uncommon to present with systemic lupus erythematosus (SLE) seropositivity and thus obscuring its diagnosis. Our case involves a 75-year-old Caucasian male with a past medical history of essential hypertension, remote prostate cancer status post prostatectomy, and lifetime nontobacco use presenting with progressive shortness of breath over one month. After a negative cardiac assessment, a postcardiac catheterization chest X-ray (CXR) revealed a right-sided moderate-to-large pleural effusion that, on further workup, was found to be exudative. Effusion studies were negative for malignancy and bacterial growth. Recurrent accumulation of fluid after a thoracentesis one week prior prompted an autoimmune work up. Positive markers included antinuclear antibodies, anti-double stranded DNA antibodies, and anti-histone antibodies, while anti-Smith antibodies were negative. Although SLE was initially suspected based on serologies, no clinical signs or symptoms were present to fulfill the diagnosis criteria. A trial of oral prednisone resulted in decreased pleural effusion size with no further recurrence. Additional studies included a CT scan of the chest that showed pleural masses confirmed with biopsy to be epithelioid mesothelioma. Given the patient’s age and new diagnosis of malignant mesothelioma, we hypothesized that the presence of autoantibodies was likely false positives due to acquired autoantibodies with age, hyperactivity of the immune system from malignancy, and possible prior asbestos exposure.
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Affiliation(s)
| | - Ahmed Munir
- Internal Medicine, Creighton University, Omaha, USA
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Vigliaturo R, Ventura GD, Choi JK, Marengo A, Lucci F, O'Shea MJ, Pérez-Rodríguez I, Gieré R. Mineralogical Characterization and Dissolution Experiments in Gamble's Solution of Tremolitic Amphibole from Passo di Caldenno (Sondrio, Italy). MINERALS (BASEL, SWITZERLAND) 2018; 8:557. [PMID: 31572620 PMCID: PMC6768406 DOI: 10.3390/min8120557] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
In nature, asbestos is often associated with minerals and other non-asbestiform morphologies thought to be harmless, but not much is known about the potential toxic effects of these phases. Therefore, the characterization of natural assemblages should not be limited to asbestos fibers only. This paper combines a multi-analytical characterization of asbestos from Valmalenco (Italy) with data from dissolution experiments conducted in a simulated interstitial lung fluid (Gamble's solution), and a detailed dimensional study that compares the particle population before and after this interaction. The sample is identified as a tremolitic amphibole, exhibiting a predominance of fiber and prismatic habits at lower magnification, but a bladed habit at higher magnification. The results show that at different magnification, the dimensional and habit distributions are notably different. After the dissolution experiments, the sample showed rounded edges and pyramid-shaped dissolution pits. Chemical analyses suggested that a nearly stoichiometric logarithmic loss of Si and Mg occurred associated with a relatively intense release of Ca in the first 24 h, whereas Fe was probably redeposited on the fiber surfaces. A rearrangement of the more frequent habits and dimensions was recorded after the dissolution experiment, with a peculiar increase of the proportion of elongated mineral particles.
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Affiliation(s)
- Ruggero Vigliaturo
- Department of Earth and Environmental Science, University of Pennsylvania, Philadelphia, PA 19104-6316, USA; (J.K.C.); (M.J.O.); (I.P.-R.); (R.G.)
| | - Giancarlo Della Ventura
- Dipartimento di Scienze, Università Roma Tre, Largo S. Leonardo Murialdo 1, I-00146 Roma, Italy; (G.D.V.); (F.L.)
- INFN Laboratori Nazionali di Frascati, Via E. Fermi 40, I-00044 Frascati/Rome, Italy
| | - Jessica K Choi
- Department of Earth and Environmental Science, University of Pennsylvania, Philadelphia, PA 19104-6316, USA; (J.K.C.); (M.J.O.); (I.P.-R.); (R.G.)
| | - Alessandra Marengo
- Dipartimento di Scienze della Terra, Università degli Studi di Torino, Via Valperga Caluso 35, I-10125 Torino, Italy;
| | - Federico Lucci
- Dipartimento di Scienze, Università Roma Tre, Largo S. Leonardo Murialdo 1, I-00146 Roma, Italy; (G.D.V.); (F.L.)
| | - Michael J O'Shea
- Department of Earth and Environmental Science, University of Pennsylvania, Philadelphia, PA 19104-6316, USA; (J.K.C.); (M.J.O.); (I.P.-R.); (R.G.)
| | - Ileana Pérez-Rodríguez
- Department of Earth and Environmental Science, University of Pennsylvania, Philadelphia, PA 19104-6316, USA; (J.K.C.); (M.J.O.); (I.P.-R.); (R.G.)
| | - Reto Gieré
- Department of Earth and Environmental Science, University of Pennsylvania, Philadelphia, PA 19104-6316, USA; (J.K.C.); (M.J.O.); (I.P.-R.); (R.G.)
- Center of Excellence in Environmental Toxicology, University of Pennsylvania, Philadelphia, PA 19104, USA
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Precision Medicine: The Role of the MSIDS Model in Defining, Diagnosing, and Treating Chronic Lyme Disease/Post Treatment Lyme Disease Syndrome and Other Chronic Illness: Part 2. Healthcare (Basel) 2018; 6:healthcare6040129. [PMID: 30400667 PMCID: PMC6316761 DOI: 10.3390/healthcare6040129] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2018] [Revised: 10/31/2018] [Accepted: 10/31/2018] [Indexed: 12/12/2022] Open
Abstract
We present a precision medical perspective to assist in the definition, diagnosis, and management of Post Treatment Lyme Disease Syndrome (PTLDS)/chronic Lyme disease. PTLDS represents a small subset of patients treated for an erythema migrans (EM) rash with persistent or recurrent symptoms and functional decline. The larger population with chronic Lyme disease is less understood and well defined. Multiple Systemic Infectious Disease Syndrome (MSIDS) is a multifactorial model for treating chronic disease(s), which identifies up to 16 overlapping sources of inflammation and their downstream effects. A patient symptom survey and a retrospective chart review of 200 patients was therefore performed on those patients with chronic Lyme disease/PTLDS to identify those variables on the MSIDS model with the greatest potential effect on regaining health. Results indicate that dapsone combination therapy decreased the severity of eight major Lyme symptoms, and multiple sources of inflammation (other infections, immune dysfunction, autoimmunity, food allergies/sensitivities, leaky gut, mineral deficiencies, environmental toxins with detoxification problems, and sleep disorders) along with downstream effects of inflammation may all affect chronic symptomatology. In part two of our observational study and review paper, we postulate that the use of this model can represent an important and needed paradigm shift in the diagnosis and treatment of chronic disease.
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Diegel R, Black B, Pfau JC, McNew T, Noonan C, Flores R. Case series: rheumatological manifestations attributed to exposure to Libby Asbestiform Amphiboles. JOURNAL OF TOXICOLOGY AND ENVIRONMENTAL HEALTH. PART A 2018; 81:734-747. [PMID: 29927712 DOI: 10.1080/15287394.2018.1485124] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
UNLABELLED An increased risk for Systemic Autoimmune Diseases (SAID) has been reported in Libby, Montana, where extensive exposures to fibrous amphiboles occurred due to mining and use of asbestos-laden vermiculite. In addition, positive antinuclear autoantibody tests are associated with exposure to Libby Asbestiform Amphiboles (LAA) in both humans and mice. Among 6603 subjects who underwent health screening at the Center for Asbestos Related Diseases (CARD, Libby MT), 13.8% were diagnosed with an autoimmune disease, with prevalence values for the most common SAID being significantly higher than expected in the United States. Among the CARD screening population, serological and clinical profiles are diverse, representing symptoms and autoantibodies reflective of systemic lupus erythematosus (SLE), scleroderma, rheumatoid arthritis, and other rheumatic syndromes, including undifferentiated connective tissue disease (UCTD). Based upon screening of medical records by physicians with rheumatology expertise, the evolving nature of rheumatological disease in these patients is often atypical, with mixed diagnostic criteria and with a 1:1 male-to-female ratio. Through the Libby Epidemiology Research Program, cases were identified that illustrate clinical autoimmune outcomes with LAA exposure. Our goal was to better characterize SAID in Libby, MT in order to improve recognition of autoimmune outcomes associated with this exposure. In view of recent discoveries of widespread exposure to fibrous minerals in several areas of the U.S. and globally, it is critical to evaluate rheumatologic manifestations in other cohorts so that screening, surveillance, and diagnostic procedures are able to detect and recognize potential autoimmune outcomes of asbestos exposure. ABBREVIATIONS ANA, antinuclear autoantibody; ARD, Asbestos-Related Diseases; ATSDR, Agency for Toxic Substances & Disease Registry; CARD, Center for Asbestos Related Diseases; CCP, Cyclic citrullinated peptide antibody; CREST, limited cutaneous form of scleroderma; CT, computed tomography; DIP, Distal Interphalangeal Joint; DLCO, Diffusing Capacity of the Lung for CO2; DMARD, Disease Modifying Anti-Rheumatic Drugs; ENA, Extractable Nuclear Antigen antibodies; FVC, Forced Vital Capacity; LAA, Libby Asbestiform Amphiboles; LERP, Libby Epidemiology Research Program; MCP, Metacarpal Phalangeal Joint; PIP, Proximal Interphalangeal Joint; PIP, rheumatoid arthritis; RV, Residual Volume; SAID, Systemic autoimmune diseases; SLE, systemic lupus erythematosus; SSc, Systemic Sclerosis; TLC, Total Lung Capacity.
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Affiliation(s)
| | - Brad Black
- b Center for Asbestos Related Diseases , Libby , MT
| | - Jean C Pfau
- c Department of Microbiology and Immunology , Montana State University , Bozeman , MT
| | - Tracy McNew
- b Center for Asbestos Related Diseases , Libby , MT
| | - Curtis Noonan
- d Department of Biomedical and Pharmaceutical Sciences , University of Montana , Missoula , MT
| | - Raja Flores
- e Icahn School of Medicine at Mt Sinai , New York NY
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Horowitz R, Freeman PR. Improvement of common variable immunodeficiency using embryonic stem cell therapy in a patient with lyme disease: a clinical case report. Clin Case Rep 2018; 6:1166-1171. [PMID: 29881587 PMCID: PMC5986024 DOI: 10.1002/ccr3.1556] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2018] [Revised: 03/21/2018] [Accepted: 04/04/2018] [Indexed: 12/30/2022] Open
Abstract
Bone marrow transplantation and stem cell therapies have been used for the treatment of common variable immunodeficiency (CVID) and other life-threatening medical disorders. This is the first known case report in the medical literature describing improvement of both Lyme disease and CVID with human embryonic stem cell therapy.
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Affiliation(s)
- Richard Horowitz
- HHS Tickborne Disease Working GroupWashingtonD.C.USA
- Hudson Valley Healing Arts Center4232 Albany Post RoadHyde ParkNew York12538
| | - Phyllis R. Freeman
- Hudson Valley Healing Arts Center4232 Albany Post RoadHyde ParkNew York12538
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Pfau JC, Barbour C, Black B, Serve KM, Fritzler MJ. Analysis of autoantibody profiles in two asbestiform fiber exposure cohorts. JOURNAL OF TOXICOLOGY AND ENVIRONMENTAL HEALTH. PART A 2018; 81:1015-1027. [PMID: 30230971 PMCID: PMC6336195 DOI: 10.1080/15287394.2018.1512432] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/13/2023]
Abstract
An increased risk for Systemic Autoimmune Diseases (SAID) was reported in the population of Libby, Montana, where extensive exposure to asbestiform amphiboles occurred through mining and use of asbestiform fiber-laden vermiculite. High frequencies of antinuclear autoantibodies (ANA) were detected in individuals and mice exposed to Libby Asbestiform Amphiboles (LAA). Among the 6603 individuals who have undergone health screening at the Center for Asbestos Related Diseases (CARD, Libby MT), the frequencies of rheumatoid arthritis, systemic lupus erythematosus, sarcoidosis, and systemic sclerosis are significantly higher than expected prevalence in the United States. While these data support the hypothesis that LAA can trigger autoimmune responses, evidence suggests that chrysotile asbestos does not. Serological testing was therefore performed in subjects exposed to LAA or predominantly chrysotile (New York steamfitters) using multiplexed array technologies. Analyses were performed in order to determine a) autoantibody profiles in each cohort, and b) whether the two populations could be distinguished through predictive modeling. Analysis using perMANOVA testing confirmed a significant difference between autoantibody profiles suggesting differential pathways leading to autoantibody formation. ANA were more frequent in the LAA cohort. Specific autoantibodies more highly expressed with LAA-exposure were to histone, ribosomal P protein, Sm/Ribonucleoproteins, and Jo-1 (histidyl tRNA synthetase). Myositis autoantibodies more highly expressed in the LAA cohort were Jo-1, PM100, NXP2, and Mi2a. Predictive modeling demonstrated that anti-histone antibodies were most predictive for LAA exposure, and anti-Sm was predictive for the steamfitters' exposure. This emphasizes the need to consider fiber types when evaluating risk of SAID with asbestos exposure.
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Affiliation(s)
- Jean C. Pfau
- Department of Microbiology & Immunology, Montana State University, Bozeman MT 59718
| | - Christopher Barbour
- Statistical Consulting and Research Services, Montana State University, Bozeman MT 59718
| | - Brad Black
- Center for Asbestos Related Diseases, Libby MT 59923
| | - Kinta M. Serve
- Idaho State University, Department of Biological Sciences, Pocatello ID 83209
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Gilmer J, Harding T, Woods L, Black B, Flores R, Pfau J. Mesothelial cell autoantibodies upregulate transcription factors associated with fibrosis. Inhal Toxicol 2017; 29:10-17. [PMID: 28183202 DOI: 10.1080/08958378.2016.1271841] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Amphibole asbestos exposure is associated with the production of mesothelial cell autoantibodies (MCAA). These MCAA have been linked with pleural fibrotic disease in the asbestos exposed community of Libby, Montana, and induce collagen deposition by cultured mesothelial cells. However, the exact intracellular mechanism by which these autoantibodies cause an increase in collagen deposition remains unknown. This study sought to gain insight into the transcription factors involved in the collagen production after human mesothelial cells are exposed to MCAA. In this study, transcription factor activation profiles were generated from human mesothelial cells (Met5A) treated with serum from Libby subjects, and were compared to cells treated with serum cleared of IgG, and therefore containing no MCAA. Analysis of those profiles indicated C/EBP-beta and hypoxia inducible factor 1 alpha (HIF-1α) are significantly increased in the nucleus, indicating activation, due to MCAA exposure compared to controls. Inhibition of either of these transcription factors significantly reduced collagen 1 deposition by these cells following exposure to MCAA. These data suggest autoantibodies are directly involved in type I collagen deposition and may elucidate potential therapeutic targets for autoantibody mediated fibrosis.
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Affiliation(s)
- John Gilmer
- a Department of Biological Sciences , Idaho State University , Pocatello , ID , USA
| | - Tanner Harding
- a Department of Biological Sciences , Idaho State University , Pocatello , ID , USA
| | - Linda Woods
- a Department of Biological Sciences , Idaho State University , Pocatello , ID , USA
| | - Brad Black
- b Center for Asbestos Related Diseases , Libby , MT , USA
| | - Raja Flores
- c Department of Thoracic Surgery , Icahn School of Medicine at Mt Sinai , New York , NY , USA
| | - Jean Pfau
- d Department of Microbiology and Immunology , Montana State University , Bozeman , MT , USA
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22
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Szeinuk J, Noonan CW, Henschke CI, Pfau J, Black B, Miller A, Yankelevitz DF, Liang M, Liu Y, Yip R, Linker L, McNew T, Flores RM. Pulmonary abnormalities as a result of exposure to Libby amphibole during childhood and adolescence-The Pre-Adult Latency Study (PALS). Am J Ind Med 2017; 60:20-34. [PMID: 27859510 DOI: 10.1002/ajim.22674] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/18/2016] [Indexed: 11/10/2022]
Abstract
BACKGROUND The purpose of Pre-Adult Latency Study was to evaluate lung findings among adults who had been environmentally exposed to Libby Amphibole only during childhood and adolescence. METHODS Recruitment was restricted to volunteers who attended primary and/or secondary school, lived in Libby, MT, prior to age 23 years for males and 21 years for females and subsequently left the area. Subjects completed exposure and respiratory questionnaires, underwent pulmonary function tests (PFTs), and chest CT scans. A Pleural Score was calculated for degree and extent of pleural thickening. Logistic regression and multivariate linear regression were used. RESULTS Of the 219 who met inclusion criteria, 198 participated. Pleural thickening was found in 96 (48%) of 198 participants. In almost half of these, it was of the lamellar type, not generally seen in exposure to other asbestos. Environmental Libby amphibole exposure was associated with pleural thickening, and the likelihood of pleural thickening increased with the number of years lived in the area. An inverse association between Pleural Score and PFT was found, which remained significant for FVC and DLco after additional sensitivity analyses. CONCLUSIONS Cumulative environmental exposure was associated with risk of pleural thickening. Among this cohort, quantitative measures of pleural thickening were associated with decreased PFT. Am. J. Ind. Med. 60:20-34, 2017. © 2016 Wiley Periodicals, Inc.
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Affiliation(s)
- Jaime Szeinuk
- Department of Occupational Medicine; Epidemiology and Prevention; North Shore-LIJ Health System; New Hyde Park New York
| | - Curtis W. Noonan
- Center for Environmental Sciences; University of Montana; Missoula Montana
| | | | - Jean Pfau
- Montana State University; Bozeman Montana
| | - Brad Black
- Center for Asbestos Related Disease; Libby Montana
| | - Albert Miller
- Center for Environmental Sciences; University of Montana; Missoula Montana
| | | | - Mingzhu Liang
- Mount Sinai Health System; Icahn School of Medicine; New York New York
| | - Ying Liu
- Mount Sinai Health System; Icahn School of Medicine; New York New York
| | - Rowena Yip
- Mount Sinai Health System; Icahn School of Medicine; New York New York
| | - Laura Linker
- Mount Sinai Health System; Icahn School of Medicine; New York New York
| | - Tracy McNew
- Center for Asbestos Related Disease; Libby Montana
| | - Raja M. Flores
- Mount Sinai Health System; Icahn School of Medicine; New York New York
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Gilmer J, Serve K, Davis C, Anthony M, Hanson R, Harding T, Pfau JC. Libby amphibole-induced mesothelial cell autoantibodies promote collagen deposition in mice. Am J Physiol Lung Cell Mol Physiol 2016; 310:L1071-7. [PMID: 27106292 DOI: 10.1152/ajplung.00462.2015] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2016] [Accepted: 04/17/2016] [Indexed: 11/22/2022] Open
Abstract
Libby amphibole (LA) causes a unique progressive lamellar pleural fibrosis (LPF) that is associated with pulmonary function decline. Pleural fibrosis among the LA-exposed population of Libby, MT, has been associated with the production of anti-mesothelial cell autoantibodies (MCAA), which induce collagen production from cultured human mesothelial cells. We hypothesized that the progressive nature of LPF could be at least partially attributed to an autoimmune process and sought to demonstrate that LA-induced MCAA trigger collagen deposition in vivo. C57BL/6 mice were exposed to LA for 7 mo, and serum was tested for MCAA by cell-based ELISA on primary mouse mesothelial cells. When treated in vitro with serum from mice exposed to LA, mesothelial cells upregulated collagen matrix production. This effect was lost when the serum was cleared of IgG using protein G beads, implicating IgG autoantibodies. Using the peritoneal cavity as a surrogate for the pleural cavity, groups of naïve (non-asbestos-exposed) mice were injected intraperitoneally with 1) control serum, 2) one dose of serum from LA-exposed mice (LA serum), 3) two doses of LA serum, or 4) two doses of LA serum cleared of IgG. After 1 mo, analysis of collagen in peritoneal walls using two-photon confocal microscopy (SHG analysis) and a hydroxyproline assay demonstrated significant increases in collagen by LA serum but not control or cleared serum. These data support the hypothesis that MCAA in LA-exposed mice induce fibrotic responses in vivo, demonstrating that an autoimmune component may be contributing to the progressive pleural fibrosis seen in LA-exposed patients.
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Affiliation(s)
- John Gilmer
- Department of Biological Sciences, Idaho State University, Pocatello, Idaho; and
| | - Kinta Serve
- Department of Natural Sciences, Mars Hill University, Mars Hill, North Carolina
| | - Chad Davis
- Department of Biological Sciences, Idaho State University, Pocatello, Idaho; and
| | - Marti Anthony
- Department of Biological Sciences, Idaho State University, Pocatello, Idaho; and
| | - Robert Hanson
- Department of Biological Sciences, Idaho State University, Pocatello, Idaho; and
| | - Tanner Harding
- Department of Biological Sciences, Idaho State University, Pocatello, Idaho; and
| | - Jean C Pfau
- Department of Biological Sciences, Idaho State University, Pocatello, Idaho; and
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Gavett SH, Parkinson CU, Willson GA, Wood CE, Jarabek AM, Roberts KC, Kodavanti UP, Dodd DE. Persistent effects of Libby amphibole and amosite asbestos following subchronic inhalation in rats. Part Fibre Toxicol 2016; 13:17. [PMID: 27083413 PMCID: PMC4832450 DOI: 10.1186/s12989-016-0130-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2015] [Accepted: 04/10/2016] [Indexed: 12/31/2022] Open
Abstract
Background Human exposure to Libby amphibole (LA) asbestos increases risk of lung cancer, mesothelioma, and non-malignant respiratory disease. This study evaluated potency and time-course effects of LA and positive control amosite (AM) asbestos fibers in male F344 rats following nose-only inhalation exposure. Methods Rats were exposed to air, LA (0.5, 3.5, or 25.0 mg/m3 targets), or AM (3.5 mg/m3 target) for 10 days and assessed for markers of lung inflammation, injury, and cell proliferation. Short-term results guided concentration levels for a stop-exposure study in which rats were exposed to air, LA (1.0, 3.3, or 10.0 mg/m3), or AM (3.3 mg/m3) 6 h/day, 5 days/week for 13 weeks, and assessed 1 day, 1, 3, and 18 months post-exposure. Fibers were relatively short; for 10 mg/m3 LA, mean length of all structures was 3.7 μm and 1 % were longer than 20 μm. Results Ten days exposure to 25.0 mg/m3 LA resulted in significantly increased lung inflammation, fibrosis, bronchiolar epithelial cell proliferation and hyperplasia, and inflammatory cytokine gene expression compared to air. Exposure to 3.5 mg/m3 LA resulted in modestly higher markers of acute lung injury and inflammation compared to AM. Following 13 weeks exposure, lung fiber burdens correlated with exposure mass concentrations, declining gradually over 18 months. LA (3.3 and 10.0 mg/m3) and AM produced significantly higher bronchoalveolar lavage markers of inflammation and lung tissue cytokines, Akt, and MAPK/ERK pathway components compared to air control from 1 day to 3 months post-exposure. Histopathology showed alveolar inflammation and interstitial fibrosis in all fiber-exposed groups up to 18 months post-exposure. Positive dose trends for incidence of alveolar epithelial hyperplasia and bronchiolar/alveolar adenoma or carcinoma were observed among LA groups. Conclusions Inhalation of relatively short LA fibers produced inflammatory, fibrogenic, and tumorigenic effects in rats which replicate essential attributes of asbestos-related disease in exposed humans. Fiber burden, inflammation, and activation of growth factor pathways may persist and contribute to lung tumorigenesis long after initial LA exposure. Fiber burden data are being used to develop a dosimetry model for LA fibers, which may provide insights on mode of action for hazard assessment. Electronic supplementary material The online version of this article (doi:10.1186/s12989-016-0130-z) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Stephen H Gavett
- National Health and Environmental Effects Research Laboratory, U.S. Environmental Protection Agency, Research Triangle Park, NC, 27711, USA.
| | - Carl U Parkinson
- The Hamner Institutes for Health Sciences, Research Triangle Park, NC, 27711, USA
| | - Gabrielle A Willson
- Experimental Pathology Laboratories, Inc. (EPL®), Research Triangle Park, NC, 27711, USA
| | - Charles E Wood
- National Health and Environmental Effects Research Laboratory, U.S. Environmental Protection Agency, Research Triangle Park, NC, 27711, USA
| | - Annie M Jarabek
- National Center for Environmental Assessment, U.S. Environmental Protection Agency, Research Triangle Park, NC, 27711, USA
| | - Kay C Roberts
- The Hamner Institutes for Health Sciences, Research Triangle Park, NC, 27711, USA
| | - Urmila P Kodavanti
- National Health and Environmental Effects Research Laboratory, U.S. Environmental Protection Agency, Research Triangle Park, NC, 27711, USA
| | - Darol E Dodd
- The Hamner Institutes for Health Sciences, Research Triangle Park, NC, 27711, USA
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Scarselli A, Corfiati M, Di Marzio D. Occupational exposure in the removal and disposal of asbestos-containing materials in Italy. Int Arch Occup Environ Health 2016; 89:857-65. [PMID: 26970752 DOI: 10.1007/s00420-016-1126-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2015] [Accepted: 03/02/2016] [Indexed: 01/08/2023]
Abstract
PURPOSE A great variety of asbestos-containing materials are present in both residential and work settings because of the widespread use made in the past, and many occupational activities still entail the risk of asbestos exposure in Italy, more than 2 decades after the total national ban, mainly those involved in the removal and disposal of asbestos. The aim of the study was to evaluate the level and extent of asbestos exposure in Italy between the years 1996-2013 in the sector of asbestos abatement. METHODS Data were collected from firm registries of asbestos-exposed workers and descriptive statistics were calculated for exposure-related variables. RESULTS Overall, 15,860 measurements of asbestos exposure were selected from the national database of registries, mostly referring to the construction sector (N = 11,353). Despite the mean exposure levels are low, the air concentration of asbestos fibers measured during these activities may overcome the action level established by the Italian legislation and, in a limited number of cases, can exceed even the occupational limit value. Among occupations at higher risk, there are also garbage collectors and insulation workers. CONCLUSIONS Starting from the analysis of the Italian database of occupational exposure registries, this study outlines the current levels of asbestos exposure in abatement-related sectors, discussing their possible implications for public health policies and surveillance programs.
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Affiliation(s)
- Alberto Scarselli
- Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, Italian Workers' Compensation Authority (INAIL), Rome, Italy.
| | - Marisa Corfiati
- Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, Italian Workers' Compensation Authority (INAIL), Rome, Italy
| | - Davide Di Marzio
- Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, Italian Workers' Compensation Authority (INAIL), Rome, Italy
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Abstract
Inhalation of dust containing crystalline silica is associated with a number of acute and chronic diseases including systemic autoimmune diseases. Evidence for the link with autoimmune disease comes from epidemiological studies linking occupational exposure to crystalline silica dust with the systemic autoimmune diseases systemic lupus erythematosus, systemic sclerosis, and rheumatoid arthritis. Although little is known regarding the mechanism by which silica exposure leads to systemic autoimmune disease, there is a voluminous literature on silica exposure and silicosis that may help identify immune processes that precede development of autoimmunity. The pathophysiology of silicosis consists of deposition of silica particles in the alveoli of the lung. Ingestion of these particles by macrophages initiates an inflammatory response, which stimulates fibroblasts to proliferate and produce collagen. Silica particles are encased by collagen leading to fibrosis and the nodular lesions characteristic of the disease. The steps in the development of silicosis, including acute and chronic inflammation and fibrosis, have different molecular and cellular requirements, suggesting that silica-induced inflammation and fibrosis may be mechanistically separate. Significantly, it is unclear whether silica-induced inflammation and fibrosis contribute similarly to the development of autoimmunity. Nonetheless, the findings from human and animal model studies are consistent with an autoimmune pathogenesis that begins with activation of the innate immune system leading to proinflammatory cytokine production, pulmonary inflammation leading to activation of adaptive immunity, breaking of tolerance, and autoantibodies and tissue damage. The variable frequency of these immunological features following silica exposure suggests substantial genetic involvement and gene/environment interaction in silica-induced autoimmunity. However, numerous questions remain unanswered.
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Affiliation(s)
- Kenneth Michael Pollard
- Department of Molecular and Experimental Medicine, The Scripps Research Institute , La Jolla, CA , USA
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Approaching a Unified Theory for Particle-Induced Inflammation. CURRENT TOPICS IN ENVIRONMENTAL HEALTH AND PREVENTIVE MEDICINE 2016. [DOI: 10.1007/978-4-431-55732-6_3] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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Carlin DJ, Larson TC, Pfau JC, Gavett SH, Shukla A, Miller A, Hines R. Current Research and Opportunities to Address Environmental Asbestos Exposures. ENVIRONMENTAL HEALTH PERSPECTIVES 2015; 123:A194-7. [PMID: 26230287 PMCID: PMC4529018 DOI: 10.1289/ehp.1409662] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
Abstract
Asbestos-related diseases continue to result in approximately 120,000 deaths every year in the United States and worldwide. Although extensive research has been conducted on health effects of occupational exposures to asbestos, many issues related to environmental asbestos exposures remain unresolved. For example, environmental asbestos exposures associated with a former mine in Libby, Montana, have resulted in high rates of nonoccupational asbestos-related disease. Additionally, other areas with naturally occurring asbestos deposits near communities in the United States and overseas are undergoing investigations to assess exposures and potential health risks. Some of the latest public health, epidemiological, and basic research findings were presented at a workshop on asbestos at the 2014 annual meeting of the Society of Toxicology in Phoenix, Arizona. The following focus areas were discussed: a) mechanisms resulting in fibrosis and/or tumor development; b) relative toxicity of different forms of asbestos and other hazardous elongated mineral particles (EMPs); c) proper dose metrics (e.g., mass, fiber number, or surface area of fibers) when interpreting asbestos toxicity; d) asbestos exposure to susceptible populations; and e) using toxicological findings for risk assessment and remediation efforts. The workshop also featured asbestos research supported by the National Institute of Environmental Health Sciences, the Agency for Toxic Substances and Disease Registry, and the U.S. Environmental Protection Agency. Better protection of individuals from asbestos-related health effects will require stimulation of new multidisciplinary research to further our understanding of what constitutes hazardous exposures and risk factors associated with toxicity of asbestos and other hazardous EMPs (e.g., nanomaterials).
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Affiliation(s)
- Danielle J Carlin
- Division of Extramural Research and Training, National Institute of Environmental Health Sciences (NIEHS), National Institutes of Health (NIH), Department of Health and Human Services (DHHS), Research Triangle Park, North Carolina, USA
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Niccoli L, Cassarà E, Kaloudi O, Nannini C, Romagnoli M, Cantini F. Systemic autoimmune disease in asbestosis rapidly responding to anti-interleukin-1beta antibody canakinumab: a case report. BMC Musculoskelet Disord 2015; 16:146. [PMID: 26071911 PMCID: PMC4465479 DOI: 10.1186/s12891-015-0602-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2014] [Accepted: 05/28/2015] [Indexed: 11/01/2022] Open
Abstract
BACKGROUND Asbestosis is characterized by lung and pleural fibrosis and by immune system dysregulation, with autoantibody production and systemic immune-mediated disease. No specific therapies are available for asbestosis. Recently, the pivotal pathogenic role exerted by interleukin-1beta has been recently reported. CASE PRESENTATION We treated with anti-interleukin 1 beta targeted antibody canakinumab a 67 year old man with asbestosis and long lasting systemic autoimmune features. A dramatic improvement in clinical manifestations was observed at 1 week after the first injection, with complete clinical remission at 4 months. CONCLUSION This case suggests new perspectives for the treatment of asbestosis and its systemic features.
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Affiliation(s)
- Laura Niccoli
- Consultant in Rheumatology, Rheumatology Division, Hospital of Prato, Prato, Italy.
| | - Emanuele Cassarà
- Consultant in Rheumatology, Rheumatology Division, Hospital of Prato, Prato, Italy.
| | - Olga Kaloudi
- Consultant in Rheumatology, Rheumatology Division, Hospital of Prato, Prato, Italy.
| | - Carlotta Nannini
- Consultant in Rheumatology, Rheumatology Division, Hospital of Prato, Prato, Italy.
| | - Micaela Romagnoli
- Consultant in Pneumology, Pneumologie et Addictologie CHU Arnaud de Villeneuve 191, Av. du Doyen Gaston Giraud, 34295, Montpellier, France.
| | - Fabrizio Cantini
- Consultant in Rheumatology, Rheumatology Division, Hospital of Prato, Prato, Italy.
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Shoulder ring complaints as a rare first symptom of malignant pleural mesothelioma. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2015; 852:5-10. [PMID: 25724794 DOI: 10.1007/5584_2015_113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/16/2023]
Abstract
The prevalence of malignant pleural mesothelioma is often encountered in the areas highly exposed to asbestos. The aim of this paper was a retrospective analysis of shoulder pain as a rare, first symptom of pleural mesothelioma, which constitutes an interdisciplinary diagnostic problem concerning both orthopedics and pulmonology. The research was based on a retrospective review of the patients' medical records. The considered period of time included the years 2006-2012. The study group included a total of 49 patients. Seven patients (14.3%) presented a complain of shoulder pain, as the first symptom of mesothelioma. The remaining 42 mesothelioma patients, without this symptom, constituted a reference group. The intensity of shoulder pain was, on average, 4/10 on an analog scale. A concomitant limitation of mobility was observed in five out of the seven subjects. In one case, limitation of motion and dysfunction of the shoulder joint were at an advanced stage. Neuralgia of upper limbs was found in two cases. We conclude that shoulder pain may be a manifesting symptom of malignant pleural mesothelioma. The neoplasm appears to have a pleiotropic effect on human body, reflected in different ways of its primary manifestation which may also include the motor system.
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Parks CG, Miller FW, Pollard KM, Selmi C, Germolec D, Joyce K, Rose NR, Humble MC. Expert panel workshop consensus statement on the role of the environment in the development of autoimmune disease. Int J Mol Sci 2014; 15:14269-97. [PMID: 25196523 PMCID: PMC4159850 DOI: 10.3390/ijms150814269] [Citation(s) in RCA: 71] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2014] [Revised: 07/31/2014] [Accepted: 08/04/2014] [Indexed: 12/20/2022] Open
Abstract
Autoimmune diseases include 80 or more complex disorders characterized by self-reactive, pathologic immune responses in which genetic susceptibility is largely insufficient to determine disease onset. In September 2010, the National Institute of Environmental Health Sciences (NIEHS) organized an expert panel workshop to evaluate the role of environmental factors in autoimmune diseases, and the state of the science regarding relevant mechanisms, animal models, and human studies. The objective of the workshop was to analyze the existing data to identify conclusions that could be drawn regarding environmental exposures and autoimmunity and to identify critical knowledge gaps and areas of uncertainty for future study. This consensus document summarizes key findings from published workshop monographs on areas in which “confident” and “likely” assessments were made, with recommendations for further research. Transcribed notes and slides were reviewed to synthesize an overview on exposure assessment and questions addressed by interdisciplinary panels. Critical advances in the field of autoimmune disease research have been made in the past decade. Collaborative translational and interdisciplinary research is needed to elucidate the role of environmental factors in autoimmune diseases. A focus on exposure assessment methodology is needed to improve the effectiveness of human studies, and more experimental studies are needed to focus on causal mechanisms underlying observed associations of environmental factors with autoimmune disease in humans.
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Affiliation(s)
- Christine G Parks
- Epidemiology Branch, National Institute of Environmental Health Sciences (NIEHS), National Institutes of Health (NIH), Research Triangle Park, NC 27709, USA.
| | | | - Kenneth Michael Pollard
- Department of Molecular and Experimental Medicine, the Scripps Research Institute, La Jolla, CA 92037, USA.
| | - Carlo Selmi
- Division of Rheumatology, Allergy and Clinical Immunology, University of California, Davis, CA 95616, USA.
| | - Dori Germolec
- National Toxicology Program, NIEHS, NIH, Morrisville, NC 27560, USA.
| | - Kelly Joyce
- Department of History and Politics, Drexel University, Philadelphia, PA 19104, USA.
| | - Noel R Rose
- John Hopkins Center for Autoimmune Disease Research, Bloomberg School of Public Health, Baltimore, MD 21205, USA.
| | - Michael C Humble
- Division of Extramural Research and Training, NIEHS, NIH, Research Triangle Park, NC 27709, USA.
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