Two-dimensional analysis of elements and mononuclear cells in hard metal lung disease
Two-dimensional analysis of elements and mononuclear cells in hard metal lung disease
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DOI：
10.1164/rccm.200601-134oc
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发表时间：
2007-07-01
影响因子：
24.7
通讯作者：
Gejyo, Fumitake
中科院分区：
文献类型：
--
作者：
Moriyama, Hiroshi;Kobayashi, Masayoshi;Gejyo, Fumitake
理由：硬金属肺病是由接触硬金属引起的，硬金属是一种由碳化钨、钴以及许多其他金属组成的合成化合物。硬金属所致的间质性肺病以巨细胞间质性肺炎为独特特征。硬金属肺病的发病机制尚不清楚。目的：探讨硬金属肺病患者肺活检组织中吸入硬金属及反应性炎症细胞的分布。方法：对17例肺间质性疾病患者和5例对照组进行研究。用电子探针微量分析仪和波长色散光谱仪对元素进行检测和制图。我们用免疫组织化学方法对来自5名患者的组织样本中的单个核细胞进行了抗人CD4、CD8、CD20、CD68和CD163抗体染色，并比较了阳性细胞与硬金属元素的分布。测量结果和主要结果：17例患者中有13例病理诊断为巨细胞间质性肺炎。钨和钴在小叶中心纤维化病变中积聚，但在对照肺中未发现。CD8（+）淋巴细胞和CD163（+）单核-巨噬细胞主要分布在硬金属元素周围的小叶中心纤维化病变中。CD163（+）与钨共定位。在细支气管周围和肺泡壁也可见少量CD8（+）和CD163（+）细胞。结论：巨噬细胞可能通过CID163吞噬吸入的钨，并在硬金属肺病纤维化病变形成过程中发挥重要作用。
Rationale: Hard metal lung disease is caused by exposure to hard metal, a synthetic compound that combines tungsten carbide with cobalt as well as a number of other metals. Interstitial lung disease caused by hard metal is uniquely characterized by giant cell interstitial pneumonia. The pathogenesis of hard metal lung disease is unclear.Objectives: To elucidate the distribution of inhaled hard metal and reactive inflammatory cells in biopsy lung tissue from patients with hard metal lung disease.Methods: Seventeen patients with interstitial lung disease in which tungsten was detected and five control subjects were studied. Detection and mapping of elements were performed with an electron probe microanalyzer equipped with a wavelength dispersive spectrometer. We immunohistochemically stained mononuclear cells in tissue samples available from five patients, with anti-human CD4, CD8, CD20, CD68, and CD163 antibodies, and compared the distribution of positive cells with hard metal elements.Measurements and Main Results: Thirteen of 17 patients were pathologically diagnosed as having giant cell interstitial pneumonia. Tungsten and cobalt were accumulated in the centrilobular fibrotic lesions, but were never found in the control lungs. CD8(+) lymphocytes and CD163(+) monocyte-macrophages were distributed predominantly in centrilobular fibrotic lesions around the hard metal elements. CD163(+) colocalized with tungsten. Small numbers of CD8(+) and CD163(+) cells were also immunohistochemically shown in peribronchiolar areas and alveolar walls.Conclusions: Macrophages may phagocytose inhaled tungsten via CID163 and play an important role in forming the fibrotic lesion of hard metal lung disease with cytotoxic T lymphocytes.