矽肺86例肺功能分析

测定46例男性与40例女性矽肺患者的肺功能,发现:急进型矽肺患者肺功能改变出现早,有明显通气功能及弥散功能障碍,病程进展缓慢的矽肺患者表现以阻塞性为主的通气功能障碍及弥散功能障碍。在接触矽尘的工人中作 VC、MVV、FEV1及 FEF25～75%等较为敏感的肺功能指标测定,可早期瞭     

Detection, epitope-mapping and function of anti-Fas autoantibody in patients with silicosis

Dysregulation of apoptosis through the Fas-Fas ligand pathway is associated with the onset of autoimmune disease. Since autoantibodies directed against unknown antigens are present in the sera of these patients, sera samples were examined for the presence of autoantibodies directed against the Fas molecule. Using Western blotting and a ProteinChip analysis, autoantibodies against Fas were detected in patients with silicosis, systemic lupus erythematosus (SLE) and systemic sclerosis (SSc), and weakly detected in healthy individuals. Using epitope mapping employing 12-amino-acid polypeptides with the SPOTs system, a minimum of four epitopes and a maximum of 10 epitopes were found. Several amino acid residues involved in binding FasL, such as C66, R87, L90, E93 and H126, were presented within the epitopes. Serum containing a large amount of anti-Fas autoantibody from silicosis patients inhibited the growth of a Fas-expressing human cell line, but did not inhibit the growth of a low Fas-expresser nor a Fas-expresser in which the Fas gene had been silenced by small interference RNA. All epitopes in the intracellular region of Fas were located in the death domain. The possible roles of anti-Fas autoantibody detected in healthy volunteers and patients with silicosis or autoimmune diseases are discussed here.     

检测血液中T-SPOT.TB对矽肺并发结核的诊断价值

目的探讨血T-SPOT.TB用于矽肺并发结核(SCTB)的诊断价值。方法选择SCTB病例62例,根据最终诊断结果分为SCTB组和矽肺(SC)组。使用血T-SPOT.TB、结核菌素皮肤试验(TST)、抗酸杆菌(AFB)、结核抗体(TB-A)试验等4种方法对两组研究对象进行检测,并对比4种检测方法的诊断价值。结果4种方法检测SCTB的敏感度分别为94.4%、52.8%、38.9%、41.7%,其中血T-SPOT.TB检测SCTB的敏感度最高(P0.0001)。4种方法检测SCTB的阴性预测值分别为91.7%、52.8%、48.8%、55.3%,其中血TSPOT.TB检测SCTB的阴性预测值(91.7%)最高(P0.01)。结论血T-SPOT.TB用于SCTB的检测,具有高敏感度、高阴性预测值特点,可用于SCTB疑似病例的诊断。     

中西医结合治疗矽肺的临床观察

目的 :观察中西医结合治疗矽肺的疗效及机制。方法 :70例矽肺患者随机分成 2组 :中西医结合治疗组 4 0例 ,采用口服中药宣肺定喘丸和溶纤丸 ,并静滴复方丹参、维脑路通及双黄连注射液治疗 ;对照组 30例 ,采用口服氨茶碱、抗感染、必要时吸氧等对症治疗。 2组疗程均为 4周 ,观察肺功能变化及总有效率。结果 :中西医结合组总有效率为 95 .0 0 % ,对照组总有效率为 6 6 .6 7% ,2组比较有显著差异 (P<0 .0 1)。中西医结合治疗组治疗后肺活量 (VC)、1秒钟用力呼气容积 (FEV1 )及用力肺活量 (FVC)等均较治疗前及对照组治疗后有明显改善 (P均 <0 .0 5 ) ,临床症状和肺部体征消失时间较对照组显著缩短 (P均 <0 .0 1)。结论 :中西医结合治疗矽肺能改善症状、体征和肺功能 ,提高临床疗效     

Intrapulmonary lymph nodes in South African miners--an autopsy survey

BACKGROUND: Knowledge on intrapulmonary lymph nodes (IPLNs) is still limited. Progress in imaging techniques has enabled easier, more frequent visualization of IPLNs so that a more comprehensive understanding of these nodes is necessary. METHODS: Microscopic slides of lung tissue from 2,337 dust-exposed South African miners autopsied in 1975 were reviewed to identify IPLNs. The prevalence of IPLNs was calculated and histopathological changes in IPLNs and the surrounding lung parenchyma were described. Pathological changes of IPLNs were correlated with those of the surrounding pulmonary parenchyma. RESULTS: IPLNs were found in 86 of the miners (3.7%). Silicotic nodules were seen in IPLNs in 32 of the 86 cases (37.2%), in the majority of which (21/32; 65.6%) the surrounding lung parenchyma was almost normal. CONCLUSION: IPLNs are not uncommon among dust-exposed individuals. Silicotic fibrosis of IPLNs appears to precede pulmonary parenchymal disease.     

Collagen metabolism in experimental lung silicosis. A trimodal behavior of collagenolysis

In spite of several studies, both in vivo and in vitro, the pathogenesis of silicosis remains unclear, mainly in those mechanisms related to fibrogenesis. In this study, we analyzed the concentration, biosynthesis, and degradation of collagen in silica-treated rats 7, 15, 30, 45, and 60 days after instillation. Our results showed a significant increase in collagen content and biosynthesis from the 15th day onward. However, our most remarkable finding was related to collagenolytic activity. In this sense, the silicotic rats presented a trimodal behavior: some animals showed an increased degradation, others had similar values to those of the controls, and others exhibited a decrease of collagenolytic activity. Altogether, these results suggest that collagen deposition in silicotic lungs is due to a rise in biosynthesis and, at least in some animals, to a decrease in degradation. Neverthless, the steps of collagenolysis must be studied in more detail.     

Co-localization of iron binding on silica with p62/sequestosome1 (SQSTM1) in lung granulomas of mice with acute silicosis

The cellular mechanisms involved in the development of silicosis have not been fully elucidated. This study aimed to examine influence of silica-induced lung injury on autophagy. Suspensions of crystalline silica particles were administered transnasally to C57BL/6j mice. Immunohistochemical examination for Fas and p62 protein expression was performed using lung tissue specimens. Two-dimensional and quantitative analysis of silica deposits in the lungs were performed in situ using lung tissue sections by an in-air microparticle induced X-ray emission (in-air micro-PIXE) analysis system, which was based on irrradiation of specimens with a proton ion microbeam. Quantitative analysis showed a significant increase of iron levels on silica particles (assessed as the ratio of Fe relative to Si) on day 56 compared with day 7 (p<0.05). Fas and p62 were expressed by histiocytes in granulomas on day 7, and the expressions persisted for day 56. Fas- and p62-expressing histiocytes were co-localized in granulomas with silica particles that showed an increase of iron levels on silica particles in mouse lungs. Iron complexed with silica induces apoptosis, and may lead to dysregulations of autophagy in histiocytes of granulomas, and these mechanisms may contribute to granuloma development and progression in silicosis.     

Proteomic profiling differences in serum from silicosis and chronic bronchitis patients: a comparative analysis

Background

Silicosis is a severe occupational disease characterized by pulmonary fibrosis, whereas chronic bronchitis (CB) is an acute inflammation of the airways. Differences in the mechanisms of pathogenesis of these diseases are not well understood, therefore we performed proteomic profiling of silicosis and CB patients and, compared the results.

Methods

Two-dimensional gel electrophoresis and MALDI-TOF-MS (matrix assisted laser desorption ionization time of flight mass spectrometry) were used to identify differentially accumulated proteins in stage I of silicosis (SI), stage II of silicosis (SII) and CB. Enzyme linked immunosorbent assay (ELISA) was employed to validate protein expression data.

Results

A total of 28 and 10 proteins were up- and down-regulated in SI, and 21 and 9 proteins were up- and down-regulated SII, compared with CB. Transforming growth factor beta-1 precursor and interferon beta precursor were up-regulated in CB, while interleukin 6, tumor necrosis factor (TNF) and a variant TNF receptor 13B were down-regulated in CB. Additionally, glycoprotein- and apolipoprotein-associated proteins including apolipoprotein A-IV and α-1-B-glycoprotein were up-regulated in CB, indicating an involvement in the pathogenesis of CB but not silicosis. By contrast, HLA-DRB1, medullasin and the proto-oncogene c-Fos were up-regulated in CB.

Conclusions

The immune, metabolism and apolipoprotein-related proteins were identified as playing specific and different roles in silicosis and CB. These proteomic profiling differences would facilitate further studies on the mechanisms underlying silicosis and CB, and may also prove useful to disease diagnosis and treatments.