Airborne endotoxins and humidifier disease

Rylander, Ragnar; Haglind, Per

doi:10.1111/j.1365-2222.1984.tb02197.x

Cited by 111 publications

(47 citation statements)

References 14 publications

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“…Inhalation of air contaminated with gram-negative bacteria results in toxic pneumonitis characterized by fever, chills, and chest tightness, which may be encountered in humidifier disease (38) or during occupational exposures. Lipopolysaccharide (LPS)/endotoxin, a component of the outer membrane of gram-negative bacteria, is one of the primary constituents of organic dust.…”

mentioning

confidence: 99%

ICAM-1 and LFA-1 play critical roles in LPS-induced neutrophil recruitment into the alveolar space

Basit¹,

Reutershan²,

Morris³

et al. 2006

American Journal of Physiology-Lung Cellular and Molecular Phys

114

106

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. ICAM-1 and LFA-1 play critical roles in LPS-induced neutrophil recruitment into the alveolar space. Am J Physiol Lung Cell Mol Physiol 291: L200 -L207, 2006. First published February 3, 2006 doi:10.1152/ajplung.00346.2005.-Neutrophil recruitment into lung constitutes a major response to airborne endotoxins. In many tissues endothelial intercellular adhesion molecule-1 (ICAM-1) interacts with lymphocyte function associated antigen-1 (LFA-1) on neutrophils, and this interaction plays a critical role in neutrophil recruitment. There are conflicting reports about the role of ICAM-1 in neutrophil recruitment into lungs. We studied neutrophil recruitment into alveolar space in a murine model of aerosolized LPSinduced lung inflammation. LPS induces at least a 100-fold increase in neutrophil numbers in alveolar space, as determined by flow cytometry of bronchoalveolar lavage fluid. Neutrophil recruitment was reduced by 54% in ICAM-1 null mice and by 45% in LFA-1 null mice. In wild-type mice treated with anti-ICAM-1 and anti-LFA-1 antibodies, there was 51 and 58% reduction in the neutrophil recruitment, respectively. In chimeric mice, generated by the transplantation of mixtures of bone marrows from LFA-1 null and wild-type mice, the normalized recruitment of LFA-1 null neutrophils was reduced by 60% compared with wild-type neutrophils. Neither the treatment of ICAM-1 null mice with a functionblocking antibody to LFA-1 nor the treatment of LFA-1 null mice with anti-ICAM-1 antibody resulted in further reduction in the recruitment compared with untreated ICAM-1 null and LFA-1 null mice. We conclude that ICAM-1 and LFA-1 play critical roles in the recruitment of neutrophils into the alveolar space in aerosolized LPS-induced lung inflammation, and LFA-1 serves as a ligand of ICAM-1 in the lung.

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mentioning

confidence: 99%

ICAM-1 and LFA-1 play critical roles in LPS-induced neutrophil recruitment into the alveolar space

Basit¹,

Reutershan²,

Morris³

et al. 2006

American Journal of Physiology-Lung Cellular and Molecular Phys

114

106

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“…The reports of bath water fever and humidifier lung demonstrated high concentrations of endotoxin (0. 1-5.0 |Lig/ml) in the causative water (13,14). Endotoxin is an extremely potent agent of lung injury and the inhalation of endotoxin can cause symptomssuch as chills and fever, a decrease in DLC0, an increase in airway hyperresponsiveness, and increases in neutrophils as well as lymphocytes in BALand blood, in a dose-dependent fashion (16,17).…”

Section: Discussionmentioning

confidence: 99%

“…The fact that the onset of symptomsin the present case occurred immediately following the use of the humidifier for the first time favors this notion. It has been suggested that bacterial endotoxin may play a role in humidifier lung (12)(13)(14)(15). The reports of bath water fever and humidifier lung demonstrated high concentrations of endotoxin (0.…”

Section: Discussionmentioning

confidence: 99%

Humidifier Lung: Possible Contribution of Endotoxin-induced Lung Injury.

et al. 2002

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A 56-year-old man was admitted with cough, fever, myalgia, and arthralgia. Chest computed tomography demonstrated bilateral diffuse ground-glass opacities predominantly in the upper lungs. Subpleural non-segmental consolidation was observed in the late phase. Hypersensitivity pneumonitis was suspected, and an environmental provocation test with the incidental use of a home ultrasonic humidifier was positive. Unlike typical hypersensitivity pneumonitis, serum KL-6 levels were normal. Although several microorganisms were isolated from the humidifier water, there was no evidence for immunesensitization. Wedetected high amounts of endotoxin in the humidifier water, which mayhave contributed to the lung injury of this patient.

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“…Humidifier disease has been documented in an occupational setting where airborne endotoxin levels ranged from 130 to 390 ng/m 3 (Rylander & Haglind 1984 …”

Section: Introductionmentioning

confidence: 99%

Estimation of endotoxin inhalation from shower and humidifier exposure reveals potential risk to human health

Anderson

Dixon

Mayfield

2007

Journal of Water and Health

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This paper investigates potential exposure to endotoxin in drinking water through the inhalation of aerosols generated by showers and humidifiers. Adverse health effects attributable to the inhalation of airborne endotoxin in various occupational settings are summarized, as are controlled laboratory inhalation studies. Data from investigations estimating aerosolization of particulate matter by showers and humidifiers provide a basis for similar analyses with endotoxin, which like minerals in water, is nonvolatile. A theoretical assessment of the inhalation of aerosolized endotoxin showed that while the likelihood of an acute response while showering is minimal, the same is not true for humidifiers. Ultrasonic and impeller (cool mist) humidifiers efficiently produce large numbers of respirable particles. It is predicted that airway inflammation can occur if humidifier reservoirs are filled with tap water, sometimes even at typical drinkingwater distribution-system endotoxin concentrations. Higher endotoxin levels occasionally found in drinking water (.1,000 EU/ml) are very likely to induce symptoms such as chills and fever if used as humidifier feed water. While it is unlikely that treated drinking water would contain extremely high endotoxin levels occasionally observed in cyanobacterial blooms (.35,000 EU/ml), the potential for serious acute health consequences exist if used in humidifiers.

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Airborne endotoxins and humidifier disease

Cited by 111 publications

References 14 publications

ICAM-1 and LFA-1 play critical roles in LPS-induced neutrophil recruitment into the alveolar space

ICAM-1 and LFA-1 play critical roles in LPS-induced neutrophil recruitment into the alveolar space

Humidifier Lung: Possible Contribution of Endotoxin-induced Lung Injury.

Estimation of endotoxin inhalation from shower and humidifier exposure reveals potential risk to human health

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