Metal-Induced Pulmonary Fibrosis

Abstract

Purpose of review: The incidence of pulmonary fibrosis is increasing worldwide and may, in part, be due to occupational and environmental exposures. Secondary fibrotic interstitial lung diseases may be mistaken for idiopathic pulmonary fibrosis with important implications for both disease management and prognosis. The purpose of this review is to shed light on possible underlying causes of interstitial pulmonary fibrosis and to encourage dialogue on the importance of acquiring a thorough patient history of occupational and environmental exposures. Recent findings: A recent appreciation for various occupational and environmental metals inducing both antigen-specific immune reactions in the lung and nonspecific “innate” immune system responses has emerged and with it a growing awareness of the potential hazards to the lung caused by low-level metal exposures. Advancements in the contrast and quality of High Resolution CT scans and identification of histopathological patterns of interstitial pulmonary fibrosis have improved clinical diagnostics, and recent findings indicate specific hotspots of pulmonary fibrosis within the US. Increased prevalence of lung disease in these areas appears to be linked to occupational/environmental metal exposure and ethnic susceptibility/vulnerability. Summary: A systematic overview of possible occupational and environmental metals causing interstitial pulmonary fibrosis and a detailed evaluation of vulnerable/susceptible populations may facilitate a broader understanding of potential underlying causes and highlight risks of disease predisposition.

Serum-borne factors alter cerebrovascular endothelial microRNA expression following particulate matter exposure near an abandoned uranium mine on the Navajo Nation

“…a-i Significantly altered (p < 0.05) microRNAs in FA and CAPs-exposed mouse serum contaminant metal mixtures, including uranium (U), arsenic (As) and vanadium (V) [4][5][6]. Metals-based exposure has been implicated in several adverse health effects, including pulmonary and cardiovascular diseases, neurological disorders and cancer [53][54][55][56]. Recent epidemiological evidence from the area has suggested cognitive deficits in Navajo children compared to the national average [57].…”

Movement Disorders and Dementia in a Woman With Chronic Aluminium Toxicity: Video-MRI Imaging

“…Aluminium encephalopathy results from the interaction of aluminium with the CNS to produce inflammation, degeneration, and demyelination [ 1 2 3 4 5 6 7 8 9 10 11 ]. Although many neurotoxins such as lead, mercury, aluminum, copper, zinc, recreational drugs, alcohol, and tobacco are present in our environment, only a few of them cause pathognomonic neurologic syndromes [ 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 ].…”

“…Aluminium encephalopathy results from the interaction of aluminium with the CNS to produce inflammation, degeneration, and demyelination [ 1 2 3 4 5 6 7 8 9 10 11 ]. Although many neurotoxins such as lead, mercury, aluminum, copper, zinc, recreational drugs, alcohol, and tobacco are present in our environment, only a few of them cause pathognomonic neurologic syndromes [ 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 ]. Most of their manifestations can mimic psychiatric, metabolic, inflammatory, neoplastic and degenerative diseases of the nervous system (table 2 submitted as supplementary file 2) [ 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 ].…”

“…Intention tremor, dysmetria, dysdiadochokinesia and ataxia have also been reported [ 6 7 8 9 10 ]. We report a 55-year-old woman, who presented with these abnormal movement disorders, cerebellar ataxia, pyramidal signs, and dementia consistent with an encephalopathy caused by aluminum toxicity and highlight bilateral blepharospasm, polyminimyoclonus and dystonic posturing of the hand as novel features [ 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 ].…”

The Role of Occupational and Environmental Exposures in the Pathogenesis of Idiopathic Pulmonary Fibrosis: A Narrative Literature Review

“…In a recent, comprehensive literature review, Assad et al [44] evaluated clinical and mechanistic studies to try and determine the role of metals in the development of pulmonary fibrosis. The authors found that occupational and environmental exposure to numerous metals appeared to show an association with pulmonary fibrosis, including aluminium, arsenic, cadmium, copper, molybdenum, tungsten and colbalt, uranium and vanadium.…”