Metal-Induced Diffuse Lung Disease

Abstract

The number of metals that are associated with the development of diffuse parenchymal lung disease continues to expand. In addition to lung fibrosis, inhalation of metal particulates can induce a wide range of lung pathology, including reactive airways disease and cancer. This article focuses on diffuse parenchymal diseases resulting from the inhalation of beryllium and cobalt. More is known regarding the immunopathogenesis of beryllium-induced disease than is known for disease induced by any other metal. Chronic beryllium disease (CBD) is a granulomatous lung disorder caused by beryllium exposure in the workplace and is characterized by the accumulation of beryllium-specific CD4 (+) T cells in the bronchoalveolar lavage. Genetic susceptibility markers associated with increased risk have been identified for both CBD and hard metal lung disease. The mechanism for the genetic susceptibility of CBD lies in the ability of certain human leukocyte antigen (HLA)-DP molecules to bind and present beryllium to pathogenic CD4 (+) T cells. Whether the same is true for hard metal lung disease is unknown. In contrast, no HLA allelic association has been identified in nickel allergic subjects. The study of metal-induced lung disease allows the investigation of the relationship between environmental exposure and genetic susceptibility. These studies will enhance our understanding of the immunopathogenesis of metal-induced disease and how exposure to these metals results in irreversible lung fibrosis.

Evaluating Measuring Techniques for Occupational Exposure during Additive Manufacturing of Metals: A Pilot Study

“…) and may induce cancer (Wild et al. ) as well as lung complications (Fontenot and Amicosante ; Rehfisch et al. ).…”

Structural Basis of Chronic Beryllium Disease: Linking Allergic Hypersensitivity and Autoimmunity

“…For example, despite the numerous checkpoints, T cells can become activated in some individuals by MHC bound to self-peptides, causing serious tissue-specific autoimmune diseases such as type-1 diabetes, rheumatoid arthritis and multiple sclerosis. Furthermore, T cell mediated allergic hypersensitivities involve a wide variety of non-peptide environmental chemicals that include metal cations, as well as plant, industrial and pharmaceutical organic compounds (Fontenot and Amicosante, 2008; Louis-Dit-Sully and Schamel, 2014; Pichler et al, 2006; Thierse et al, 2005). Most evidence indicates that these agents must become associated with a self MHC-peptide complex in order to elicit a T cell response, but how they bind to the complex and how the TCR recognizes their presence is largely unknown.…”

Chemical Pneumonitis and Acute Lung Injury Caused by Inhalation of Nickel Fumes

“…Respiratory effects arising in full-time welders include bronchitis, siderosis, asthma, and a possible increase in the incidence of lung cancer (1)(2)(3)(4)(5). Although the most frequent acute respiratory complaint of welders is metal fume fever, some reports have also described interstitial pneumonia and acute lung injury induced by inhalation of metal fumes (1,6). Nickel fumes inhalation can cause bronchial asthma and pulmonary infiltrates with eosinophilia syndrome; however acute lung injury is very rare (7,8).…”