Immunoreactivity to metal and silica associates with sarcoidosis in Dutch patients
Immunoreactivity to metal and silica associates with sarcoidosis in Dutch patients
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DOI：
10.1186/s12931-020-01409-w
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发表时间：
2020-06-08
影响因子：
5.8
通讯作者：
Veltkamp, M.
中科院分区：
文献类型：
--
作者：
Beijer, E.;Meek, B.;Veltkamp, M.
背景金属或二氧化硅参与结节病的发病机制已被一些病例报告和特定的流行病学研究所提出。然而，在一组结节病患者和非结节病对照组中，尚未研究过职业暴露和免疫反应的结合。方法在256例结节病患者和73例对照组阻塞性睡眠呼吸暂停患者中，使用由完整职业史组成的问卷评估金属和二氧化硅暴露，随后将其与工作暴露矩阵联系起来。接下来，免疫反应铝，铍，锆和二氧化硅测定33结节病和19个对照组患者使用淋巴细胞增殖试验。结果在结节病组中，83/256例（32.4%）有金属或二氧化硅的职业暴露，而对照组为24.7%（p = 0.21）。与对照组相比，检测的结节病患者对金属或二氧化硅表现出免疫反应性的百分比显著更高（分别为21.2%和0%，p = 0.039）。结论仅在结节病患者中发现对二氧化硅和金属的免疫反应性，支持这些抗原可能参与结节病患者的一个独特亚群的发病机制的假设。这表明在寻找结节病患者的致病因子时，除了铍之外，锆、铝和二氧化硅也值得临床研究。
Background Involvement of metals or silica in the pathogenesis of sarcoidosis has been suggested by several case reports and specific epidemiological studies. However, the combination of occupational exposure and an immunological reaction has not been studied before in a group of sarcoidosis patients and non-sarcoidosis controls. Methods In 256 sarcoidosis patients and 73 control patients with obstructive sleep apnea, exposure to metal and silica was assessed using a questionnaire consisting of a complete occupational history subsequently linked to job-exposure matrices. Next, immunoreactivity to aluminium, beryllium, zirconium and silica was determined in 33 sarcoidosis and 19 control patients using a lymphocyte proliferation test. Results In sarcoidosis, 83 out 256 patients (32.4%) had occupational exposure to metals or silica, compared to 24.7% in the control group (p = 0.21). A significantly higher percentage of the sarcoidosis patients tested showed immunoreactivity to metals or silica compared to the control group (21.2 and 0% respectively,p = 0.039). Conclusions Immunoreactivity to silica and metals was only found in sarcoidosis patients, supporting the hypothesis that these antigens may be involved in the pathogenesis of a distinct subgroup of sarcoidosis patients. This indicates that when searching for causative agents in sarcoidosis patients, besides beryllium, also zirconium, aluminium and silica deserve clinical investigation.