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Recent evidence suggests that the alveolar macrophage-derived cytokines tumor necrosis factor-alpha (TNF-alpha), interleukin-1 beta (IL-1 beta), and interleukin-6 (IL-6) play important roles in granulomatous diseases. Our objective was to quantify the mRNA for these cytokines in beryllium disease, a human granulomatous disease of known etiology. We hypothesized that alveolar macrophages and bronchoalveolar lavage fluid from patients with beryllium disease and sarcoidosis would express increased levels of mRNA and proteins, respectively, for TNF-alpha, IL-1 beta, and IL-6 compared with those of normal individuals. We performed bronchoalveolar lavage and used a quantitative polymerase chain reaction to determine alveolar macrophage-derived cytokine gene expression. We determined lavage fluid cytokine levels by enzyme-linked immunosorbent assay. In patients with beryllium disease (n = 23), we observed elevated macrophage mRNA expression for TNF-alpha and IL-6 when compared with that of normal subjects (n = 7). Sarcoidosis patients (n = 6) also had increased expression for TNF-alpha and IL-6 compared with that of normal volunteers. IL-1 beta expression was similar in all three groups. In patients with beryllium disease (n = 39), lavage fluid TNF-alpha concentration was higher than that of 16 normal subjects. Lavage fluid IL-1 beta and IL-6 levels did not differ among the groups. This is the first report of macrophage cytokine expression in beryllium disease. These novel findings suggest that macrophage expression of TNF-alpha and IL-6 may be important in the human granulomatous inflammatory response.

OBJECTIVE:Subjects exposed to laboratory animals are at a heightened risk of developing respiratory and allergic diseases. These diseases can be prevented by simple measures such as the use of personal protective equipment. We report here the primary findings of the Laboratory Animals and Respiratory Allergies Study regarding the prevalence of allergic diseases among laboratory animal workers, the routine use of preventive measures in laboratories and animal facilities, and the need for prevention programs.METHODS:Animal handlers and non-animal handlers from 2 Brazilian universities (University of São Paulo and State University of Campinas) answered specific questionnaires to assess work conditions and symptoms. These subjects also underwent spirometry, a bronchial challenge test with mannitol, and skin prick tests for 11 common allergens and 5 occupational allergens (rat, mouse, guinea pig, hamster, and rabbit).RESULTS:Four hundred fifty-five animal handlers (32±10 years old [mean±SD], 209 men) and 387 non-animal handlers (33±11 years old, 121 men) were evaluated. Sensitization to occupational allergens was higher among animal handlers (16%) than non-animal handlers (3%, p<0.01). Accessibility to personal protective equipment was measured at 85% (median, considering 73 workplaces of the animal handler group). Nineteen percent of the animal handlers indicated that they wear a respirator at all times while handling animals or working in the animal room, and only 25% of the animal handlers had received an orientation about animal-induced allergies, asthma, or rhinitis.CONCLUSION:In conclusion, our data indicate that preventive programs are necessary. We suggest providing individual advice to workers associated with institutional programs to promote a safer work environment.

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TU could be an important occupational allergen in greenhouse workers showing allergic symptomatology. There is no crossreactivity between this mite and the house dust mite D. pteronyssinus.

Objetivo: Descrever características demográficas e clínicas de fumantes que procuraram atendimentoem centro especializado na cessação de tabagismo. Métodos: Foram analisadas, retrospectivamente,as informações disponíveis em ficha clínica padronizada preenchida no momento do primeiro atendimento, de fumantes que procuraram o Ambulatório de Apoio ao Tabagista do Centro de Saúde Escola daFaculdade de Medicina de Ribeirão Preto da Universidade de São Paulo, no período de 18 meses.Resultados: O serviço foi procurado no período por 186 fumantes (135 mulheres), com idade de 50±12anos. A maioria (59%) veio encaminhada de outros ambulatórios médicos, e o consumo apenas decigarros industrializados foi relatado por 96%. A idade de início do consumo regular de cigarros foi de18±7 anos. Experiências prévias frustradas de abandono foram relatadas por 83% dos fumantes, e onúmero médio de tentativas efetuadas foi de 3±2. A maioria dos atendidos (66%) exibia dependência ànicotina de grau alto ou muito alto, com escore médio do teste de Fargeström de 6±2. Co-morbidadesfísicas foram relatadas em 62% e psiquiátricas em 24% dos casos, particularmente depressão (17%).Conclusões: Os dados obtidos servem como embasamento de algumas necessidades a serem supridas por novos serviços de cessação do tabagismo a serem instalados em municípios de porte médiodo Brasil e exterior.