Toluene diisocyanate (TDI) is known as one of causes of occupational asthma and hypersensitivity pneumonitis. To investigate the stimulatory effect on bronchial epithelial cells in response to TDI, the authors examined production of cytokines by the bronchial epithelial cell line BEAS-2B and intercellular signal transduction stimulated by TDI-human serum albumin (HSA) conjugate. The production of interleukin (IL)-8, granulocyte-macrophage colony-stimulating factor (GM-CSF), and regulated on activation normal T cell expressed and secreted (RANTES) from the bronchial epithelial cells were augmented by the TDI-HSA conjugate. Extracellular signal-regulated kinase (Erk) 1/2 and p38 mitogen-activated protein kinase (MAPK) were phosphorylated by the TDI-HSA conjugate. AG1478, SB203580, and dexamethasone prevented augmentation of these cytokine production. TDI-HSA conjugate did not augment release of epidermal growth factor (EGF) ligands from BEAS-2B. These results suggest that TDI directly induces production of proinflammatory cytokines and chemokines through p38 MAPK and EGF receptor (EGFR)-Erk pathway without an autocrine mechanism. Thus, TDI was shown to have a stimulatory effect on bronchial epithelial cells, suggesting the potent role of bronchial epithelial cells in TDI-induced asthma.
We present the case of a 71‐year‐old Japanese man suffering from severe dyspnea who showed abnormal left ventricular motion in cardiac echogram with ST‐T elevation in electrocardiogram, which at first was misdiagnosed as an acute myocardial infarction. Coronary angiography showed neither coronary obstructions nor spasms. The symptoms were transient and the patient soon recovered. We speculate that it is a specific type of atypical stunned myocardium caused by the great stress of severe pulmonary dysfunction.
We present the case of a 71-year-old Japanese man suffering from severe dyspnea who showed abnormal left ventricular motion in cardiac echogram with ST-T elevation in electrocardiogram, which at first was misdiagnosed as an acute myocardial infarction. Coronary angiography showed neither coronary obstructions nor spasms. The symptoms were transient and the patient soon recovered. We speculate that it is a specific type of atypical stunned myocardium caused by the great stress of severe pulmonary dysfunction.
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