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Hu-Wang E, Chelala L, Landeras L, Li H, Husain AN, Strek ME, Chung JH. Pulmonary Alveolar Proteinosis-associated Pulmonary Fibrosis: Evolutional Changes and Radiologic-Pathologic Correlation. Radiol Cardiothorac Imaging 2023; 5:e230040. [PMID: 37908551 PMCID: PMC10613927 DOI: 10.1148/ryct.230040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Revised: 09/06/2023] [Accepted: 09/13/2023] [Indexed: 11/02/2023]
Abstract
Pulmonary alveolar proteinosis (PAP) is a rare disease with frequently favorable outcomes. In a minority of patients with primary or secondary PAP, the disease course may be complicated by pulmonary fibrosis (PF) despite appropriate management. Imaging and histopathologic manifestations of uncomplicated PAP are well-known. In contrast, radiologic-pathologic descriptions of PAP-associated PF (PAP-PF) are limited. The current manuscript presents three cases of PAP-PF, each with serial high-resolution CT imaging demonstrating the longitudinal progression of this unusual complication, with concordant pathologic findings in two patients. Much remains to be known regarding adverse prognostic factors contributing to PAP-PF. Early recognition of radiologic-pathologic manifestations would allow timely diagnosis and management optimization. Keywords: CT, Lung, Inflammation, Pathology © RSNA, 2023.
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Affiliation(s)
| | | | - Luis Landeras
- From the Departments of Cardiopulmonary Imaging (E.H.W., L.C., L.L.,
J.H.C.), Pathology (H.L., A.N.H.), Pulmonary Medicine (M.E.S.), and Radiology
(L.C.), The University of Chicago Medical Center, 5841 S Maryland Ave, Chicago,
IL 60637
| | - Huihua Li
- From the Departments of Cardiopulmonary Imaging (E.H.W., L.C., L.L.,
J.H.C.), Pathology (H.L., A.N.H.), Pulmonary Medicine (M.E.S.), and Radiology
(L.C.), The University of Chicago Medical Center, 5841 S Maryland Ave, Chicago,
IL 60637
| | - Aliya N. Husain
- From the Departments of Cardiopulmonary Imaging (E.H.W., L.C., L.L.,
J.H.C.), Pathology (H.L., A.N.H.), Pulmonary Medicine (M.E.S.), and Radiology
(L.C.), The University of Chicago Medical Center, 5841 S Maryland Ave, Chicago,
IL 60637
| | - Mary E. Strek
- From the Departments of Cardiopulmonary Imaging (E.H.W., L.C., L.L.,
J.H.C.), Pathology (H.L., A.N.H.), Pulmonary Medicine (M.E.S.), and Radiology
(L.C.), The University of Chicago Medical Center, 5841 S Maryland Ave, Chicago,
IL 60637
| | - Jonathan H. Chung
- From the Departments of Cardiopulmonary Imaging (E.H.W., L.C., L.L.,
J.H.C.), Pathology (H.L., A.N.H.), Pulmonary Medicine (M.E.S.), and Radiology
(L.C.), The University of Chicago Medical Center, 5841 S Maryland Ave, Chicago,
IL 60637
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Berthing T, Lard M, Danielsen PH, Abariute L, Barfod KK, Adolfsson K, Knudsen KB, Wolff H, Prinz CN, Vogel U. Pulmonary toxicity and translocation of gallium phosphide nanowires to secondary organs following pulmonary exposure in mice. J Nanobiotechnology 2023; 21:322. [PMID: 37679803 PMCID: PMC10483739 DOI: 10.1186/s12951-023-02049-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Accepted: 08/04/2023] [Indexed: 09/09/2023] Open
Abstract
BACKGROUND III-V semiconductor nanowires are envisioned as being integrated in optoelectronic devices in the near future. However, the perspective of mass production of these nanowires raises concern for human safety due to their asbestos- and carbon nanotube-like properties, including their high aspect ratio shape. Indeed, III-V nanowires have similar dimensions as Mitsui-7 multi-walled carbon nanotubes, which induce lung cancer by inhalation in rats. It is therefore urgent to investigate the toxicological effects following lung exposure to III-V nanowires prior to their use in industrial production, which entails risk of human exposure. Here, female C57BL/6J mice were exposed to 2, 6, and 18 µg (0.12, 0.35 and 1.1 mg/kg bw) of gallium phosphide (III-V) nanowires (99 nm diameter, 3.7 μm length) by intratracheal instillation and the toxicity was investigated 1, 3, 28 days and 3 months after exposure. Mitsui-7 multi-walled carbon nanotubes and carbon black Printex 90 nanoparticles were used as benchmark nanomaterials. RESULTS Gallium phosphide nanowires induced genotoxicity in bronchoalveolar lavage cells and acute inflammation with eosinophilia observable both in bronchoalveolar lavage and lung tissue (1 and 3 days post-exposure). The inflammatory response was comparable to the response following exposure to Mitsui-7 multi-walled carbon nanotubes at similar dose levels. The nanowires underwent partial dissolution in the lung resulting in thinner nanowires, with an estimated in vivo half-life of 3 months. Despite the partial dissolution, nanowires were detected in lung, liver, spleen, kidney, uterus and brain 3 months after exposure. CONCLUSION Pulmonary exposure to gallium phosphide nanowires caused similar toxicological effects as the multi-walled carbon nanotube Mitsui-7.
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Affiliation(s)
- Trine Berthing
- The National Research Centre for the Working Environment, Copenhagen, Denmark
| | - Mercy Lard
- Division of Solid State Physics and NanoLund, Lund University, Lund, 22 100, Sweden
| | | | - Laura Abariute
- Division of Solid State Physics and NanoLund, Lund University, Lund, 22 100, Sweden
- Phase Holographic Imaging PHI AB, Lund, 224 78, Sweden
| | - Kenneth K Barfod
- The National Research Centre for the Working Environment, Copenhagen, Denmark
- Department of Food Science, Microbiology and Fermentation, University of Copenhagen, Copenhagen, Denmark
| | - Karl Adolfsson
- Division of Solid State Physics and NanoLund, Lund University, Lund, 22 100, Sweden
- Axis Communications AB, Lund, 223 69, Sweden
| | - Kristina B Knudsen
- The National Research Centre for the Working Environment, Copenhagen, Denmark
| | - Henrik Wolff
- Finnish Institute of Occupational Health, Helsinki, Finland
- Department of Pathology, University of Helsinki, Helsinki, Finland
| | - Christelle N Prinz
- Division of Solid State Physics and NanoLund, Lund University, Lund, 22 100, Sweden.
| | - Ulla Vogel
- The National Research Centre for the Working Environment, Copenhagen, Denmark.
- National Food Institute, Technical University of Denmark, Kgs. Lyngby, Denmark.
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McLean P, Mueller W, Gosens I, Cassee FR, Rothen-Rutishauser B, Boyles M, Tran L. Establishing relationships between particle-induced in vitro and in vivo inflammation endpoints to better extrapolate between in vitro markers and in vivo fibrosis. Part Fibre Toxicol 2023; 20:5. [PMID: 36759844 PMCID: PMC9909881 DOI: 10.1186/s12989-023-00516-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Accepted: 02/01/2023] [Indexed: 02/11/2023] Open
Abstract
BACKGROUND Toxicity assessment for regulatory purposes is starting to move away from traditional in vivo methods and towards new approach methodologies (NAM) such as high-throughput in vitro models and computational tools. For materials with limited hazard information, utilising quantitative Adverse Outcome Pathways (AOPs) in a testing strategy involving NAM can produce information relevant for risk assessment. The aim of this work was to determine the feasibility of linking in vitro endpoints to in vivo events, and moreover to key events associated with the onset of a chosen adverse outcome to aid in the development of NAM testing strategies. To do this, we focussed on the adverse outcome pathway (AOP) relating to the onset of pulmonary fibrosis. RESULTS We extracted in vivo and in vitro dose-response information for particles known to induce this pulmonary fibrosis (crystalline silica, specifically α-quartz). To test the in vivo-in vitro extrapolation (IVIVE) determined for crystalline silica, cerium dioxide nanoparticles (nano-CeO2) were used as a case study allowing us to evaluate our findings with a less studied substance. The IVIVE methodology outlined in this paper is formed of five steps, which can be more generally summarised into two categories (i) aligning the in vivo and in vitro dosimetry, (ii) comparing the dose-response curves and derivation of conversion factors. CONCLUSION Our analysis shows promising results with regards to correlation of in vitro cytokine secretion to in vivo acute pulmonary inflammation assessed by polymorphonuclear leukocyte influx, most notable is the potential of using IL-6 and IL-1β cytokine secretion from simple in vitro submerged models as a screening tool to assess the likelihood of lung inflammation at an early stage in product development, hence allowing a more targeted investigation using either a smaller, more targeted in vivo study or in the future a more complex in vitro protocol. This paper also highlights the strengths and limitations as well as the current difficulties in performing IVIVE assessment and suggestions for overcoming these issues.
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Affiliation(s)
- Polly McLean
- Institute of Occupational Medicine (IOM), Edinburgh, UK.
| | - William Mueller
- grid.410343.10000 0001 2224 0230Institute of Occupational Medicine (IOM), Edinburgh, UK
| | - Ilse Gosens
- grid.31147.300000 0001 2208 0118National Institute for Public Health and the Environment – RIVM, Bilthoven, The Netherlands
| | - Flemming R. Cassee
- grid.31147.300000 0001 2208 0118National Institute for Public Health and the Environment – RIVM, Bilthoven, The Netherlands ,grid.5477.10000000120346234Institute for Risk Assessment Sciences, Utrecht University, Utrecht, The Netherlands
| | - Barbara Rothen-Rutishauser
- grid.8534.a0000 0004 0478 1713Adolphe Merkle Institute, University of Fribourg, Chemin des Verdiers 4, 1700 Fribourg, Switzerland
| | - Matthew Boyles
- grid.410343.10000 0001 2224 0230Institute of Occupational Medicine (IOM), Edinburgh, UK
| | - Lang Tran
- grid.410343.10000 0001 2224 0230Institute of Occupational Medicine (IOM), Edinburgh, UK
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Roach K, Roberts J. A comprehensive summary of disease variants implicated in metal allergy. JOURNAL OF TOXICOLOGY AND ENVIRONMENTAL HEALTH. PART B, CRITICAL REVIEWS 2022; 25:279-341. [PMID: 35975293 PMCID: PMC9968405 DOI: 10.1080/10937404.2022.2104981] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Allergic disease represents one of the most prominent global public health crises of the 21st century. Although many different substances are known to produce hypersensitivity responses, metals constitute one of the major classes of allergens responsible for a disproportionately large segment of the total burden of disease associated with allergy. Some of the most prevalent forms of metal allergy - including allergic contact dermatitis - are well-recognized; however, to our knowledge, a comprehensive review of the many unique disease variants implicated in human cases of metal allergy is not available within the current scientific literature. Consequently, the main goal in composing this review was to (1) generate an up-to-date reference document containing this information to assist in the efforts of lab researchers, clinicians, regulatory toxicologists, industrial hygienists, and other scientists concerned with metal allergy and (2) identify knowledge gaps related to disease. Accordingly, an extensive review of the scientific literature was performed - from which, hundreds of publications describing cases of metal-specific allergic responses in human patients were identified, collected, and analyzed. The information obtained from these articles was then used to compile an exhaustive list of distinctive dermal/ocular, respiratory, gastrointestinal, and systemic hypersensitivity responses associated with metal allergy. Each of these disease variants is discussed briefly within this review, wherein specific metals implicated in each response type are identified, underlying immunological mechanisms are summarized, and major clinical presentations of each reaction are described.Abbreviations: ACD: allergic contact dermatitis, AHR: airway hyperreactivity, ASIA: autoimmune/ autoinflammatory syndrome induced by adjuvants, BAL: bronchoalveolar lavage, CBD: chronic beryllium disease, CTCL: cutaneous T-cell lymphoma, CTL: cytotoxic T-Lymphocyte, DRESS: drug reaction with eosinophilia and systemic symptoms, GERD: gastro-esophageal reflux disease, GI: gastrointestinal, GIP: giant cell interstitial pneumonia, GM-CSF: granulocyte macrophage-colony stimulating factor, HMLD: hard metal lung disease, HMW: high molecular weight, IBS: irritable bowel syndrome, Ig: immunoglobulin, IL: interleukin, LMW: low molecular weight, PAP: pulmonary alveolar proteinosis, PPE: personal protective equipment, PRR: pathogen recognition receptor, SLE: systemic lupus erythematosus, SNAS: systemic nickel allergy syndrome, Th: helper T-cell, UC: ulcerative colitis, UV: ultraviolet.
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Affiliation(s)
- Ka Roach
- Allergy and Clinical Immunology Branch (ACIB), National Institute of Occupational Safety and Health (NIOSH), Morgantown, WV, USA
| | - Jr Roberts
- Allergy and Clinical Immunology Branch (ACIB), National Institute of Occupational Safety and Health (NIOSH), Morgantown, WV, USA
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Bomhard EM. The toxicology of gallium oxide in comparison with gallium arsenide and indium oxide. ENVIRONMENTAL TOXICOLOGY AND PHARMACOLOGY 2020; 80:103437. [PMID: 32565349 DOI: 10.1016/j.etap.2020.103437] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/26/2020] [Revised: 06/15/2020] [Accepted: 06/17/2020] [Indexed: 06/11/2023]
Abstract
Gallium arsenide (GaAs) and indium oxide (In2O3) are used in electronic industries at high and increasing tonnages since decades. Gallium oxide (Ga2O3) is an emerging wide-bandgap transparent conductive oxide with as yet little industrial use. Since GaAs has received critical attention due to the arsenic ion, it seemed reasonable to compare its toxicology with the respective endpoints of Ga2O3 and In2O3 toxicology in order to find out if and to what extent arsenic contributes. In addition, the toxicology of Ga2O3 has not yet been adequately reviewed, Therefore, this review provides the first evaluation of all available toxicity data on Ga2O3. The acute toxicity of all three compounds is rather low. Subchronic inhalation studies in rats and mice revealed persistent pulmonary alveolar proteinosis (PAP) and/or alveolar histiocytic infiltrates down to the lowest tested concentration in rats and mice, i.e. 0.16 mg Ga2O3/m3. These are also the predominant effects after GaAs and In2O3 exposure at similarly low levels, i.e. 0.1 mg/m3 each. Subchronic Ga2O3 exposure caused a minimal microcytic anemia with erythrocytosis in rats (at 6.4 mg/m3 and greater) and mice (at 32 and 64 mg/m3), a decrease in epididymal sperm motility and concentration as well as testicular degeneration at 64 mg/m3. At comparable concentrations the hematological effects and male fertility of GaAs were much stronger. The stronger effects of GaAs are due to its better solubility and presumed higher bioavailability. The database for In2O3 is too small and subchronic testing was at very low levels to allow conclusive judgements if blood/blood forming or degrading and male fertility organs/tissues would also be targets.
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Affiliation(s)
- Ernst M Bomhard
- REACh ChemConsult GmbH, Strehlener Str. 14, D-01069 Dresden, Germany.
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Kim SH, Jeon S, Lee DK, Lee S, Jeong J, Kim JS, Cho WS. The early onset and persistent worsening pulmonary alveolar proteinosis in rats by indium oxide nanoparticles. Nanotoxicology 2019; 14:468-478. [PMID: 31775551 DOI: 10.1080/17435390.2019.1694184] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Workplace inhalation exposure to indium compounds has been reported to produce 'indium lung disease' characterized by pulmonary alveolar proteinosis (PAP), granulomas, and pulmonary fibrosis. However, there is little information about the pulmonary toxicity of nano-sized indium oxide (In2O3), which is widely used in various applications such as liquid crystal displays. In this study, we evaluated the time-course and dose-dependent lung injuries by In2O3 nanoparticles (NPs) after a single intratracheal instillation to rats. In2O3 NPs were instilled to female Wistar rats at 7.5, 30, and 90 cm2/rat and lung injuries were evaluated at day 1, 3, 7, 14, 30, 90, and 180 after a single intratracheal instillation. Treatment of In2O3 NPs induced worsening diverse pathological changes including PAP, persistent neutrophilic inflammation, type II cell hyperplasia, foamy macrophages, and granulomas in a time- and dose-dependent manner. PAP was induced from day 3 and worsened throughout the study. The concentrations of interleukin-1β, tumor necrosis factor-α, and monocyte chemoattractant protein-1 in bronchoalveolar lavage fluid (BALF) showed dose- and time-dependent increases and the levels of these inflammatory mediators are consistent with the data of inflammatory cells in BALF and progressive lung damages by In2O3 NPs. This study suggests that a single inhalation exposure to In2O3 NPs can produce worsening lung damages such as PAP, chronic active inflammation, infiltration of foamy macrophages, and granulomas. The early onset and persistent PAP even at the very low dose (7.5 cm2/rat) implies that the re-evaluation of occupational recommended exposure limit for In2O3 NPs is urgently needed to protect workers.
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Affiliation(s)
- Sung-Hyun Kim
- Lab of Toxicology, Department of Medicinal Biotechnology, College of Health Sciences, Dong-A University, Busan, Republic of Korea
| | - Soyeon Jeon
- Lab of Toxicology, Department of Medicinal Biotechnology, College of Health Sciences, Dong-A University, Busan, Republic of Korea
| | - Dong-Keun Lee
- Lab of Toxicology, Department of Medicinal Biotechnology, College of Health Sciences, Dong-A University, Busan, Republic of Korea
| | - Seonghan Lee
- Lab of Toxicology, Department of Medicinal Biotechnology, College of Health Sciences, Dong-A University, Busan, Republic of Korea
| | - Jiyoung Jeong
- Lab of Toxicology, Department of Medicinal Biotechnology, College of Health Sciences, Dong-A University, Busan, Republic of Korea
| | - Jong Sung Kim
- Department of Community Health and Epidemiology, Dalhousie University, Halifax, Canada
| | - Wan-Seob Cho
- Lab of Toxicology, Department of Medicinal Biotechnology, College of Health Sciences, Dong-A University, Busan, Republic of Korea
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Bomhard EM. The toxicology of indium oxide. ENVIRONMENTAL TOXICOLOGY AND PHARMACOLOGY 2018; 58:250-258. [PMID: 29448164 DOI: 10.1016/j.etap.2018.02.003] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/02/2018] [Accepted: 02/05/2018] [Indexed: 06/08/2023]
Abstract
Indium oxide (In2O3) is a technologically important semiconductor essentially used, doped with tin oxide, to form indium tin oxide (ITO). It is poorly soluble in all so far tested physiologic media. After repeated inhalation, In2O3 particles accumulate in the lungs. Their mobilization can cause significant systemic exposure over long periods of time. An increasing number of cases of severe lung effects (characterized by pulmonary alveolar proteinosis, emphysema and/or interstitial fibrosis) in workers of the ITO industry warrants a review of the toxicological hazards also of In2O3. The database on acute and chronic toxicity/carcinogenicity/genotoxicity/reproductive toxicity as well skin/eye irritation and sensitization is very limited or even lacking. Short-term and subchronic inhalation studies in rats and mice revealed persistent alveolar proteinosis, inflammation and early indicators of fibrosis in the lungs down to concentrations of 1 mg/m3. Epidemiological and medical surveillance studies, serum/blood indium levels in workers as well as data on the exposure to airborne indium concentrations indicate a need for measures to reduce exposure at In2O3 workplaces.
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Affiliation(s)
- Ernst M Bomhard
- REAChChemConsult GmbH, Strehlener Str. 14, D-01069 Dresden, Germany.
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Abstract
The lung is constantly exposed to a large volume of inhaled air that may contain toxicant xenobiotics. With the possibility of exposure to a variety of respiratory toxicants from airborne pollutants in our environment during the course of daily activities, in occupational settings, the use of aerosol sprays for household products, and the development of inhalant bronchial therapies, pulmonary toxicology has become an important subspecialty of toxicology. The lung is susceptible to injury following hematogenous exposure to toxicants. Susceptibility to injury and the type of response following exposure to air- or blood-borne toxicants is largely dependent on the physiochemical characteristics and concentration of the toxicant, duration of exposure, site/tissue specific sensitivity, and the integrity of the defense mechanisms of the lung. In this chapter, nonneoplastic and neoplastic spontaneous lesions and those that develop in the lungs of rats following exposure to toxicants by various routes, but primarily by inhalation, are discussed in detail which provides insight into our understanding of how human lungs respond to toxic chemicals. In addition, the gross and microscopic anatomy of the rat lung is also discussed some detail. Although inhalation is the primary route of exposure in experimental studies, in the past, many studies used intratracheal instillation or direct injection of known carcinogens into the lung. These experiments often resulted in the development of squamous cell carcinomas even though they are very rare as a naturally occurring neoplasm. Instillation of chemicals or particles into the trachea or pleura or direct injection into the lung results in lesions or responses that may not be as relevant to understanding the mechanism of pulmonary carcinogenesis as inhalation of materials under more normal conditions. There remain, however, many areas where our understanding of the response of the lung to toxic chemicals is incomplete.
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