Beryllium immunology

An immunologic basis for chronic beryllium disease has been postulated and a hypersensitivity phenomenon demonstrated. Consistent with the concept of chronic berylliosis as a hypersensitivity pulmonary reaction are the following Persons with berylliosis also show delayed cutaneous hypersensitivity reactions to beryllium compounds their peripheral blood lymphocytes undergo blast transformation and release of macrophage inhibition factor after exposure to beryllium in vitro helper/suppressor T-cell ratios are depressed and there is lack of a dose-response relationship in chronic beryllium cases. Hypersensitization may lead to berylliosis in people with relatively low exposures, whereas nonsensitized individuals with higher exposures may have no effects. 

Skin lesions are the most common industrial exposure symptom. Three distinct skin lesions have been noted following exposure to beryllium dermatitis, ulceration, and granulomas. There appears to be an immunological component to chronic beryllium disease, including the dermal responses. 

Cullen MR, KominskyJR, Rossman MD, Cher-NiACK MG, Rankin JA, Balmes JR, Kern JA, Daniels RP, Palmer L, Naegel GP, et al. (1987) Chronic beryllium disease in a precious metal refinery. Clinical epidemiologic and immunologic evidence for continuing risk from exposure to low level beryllium fume. Am Rev Respir Dis 135 201 -208. 

Immunologic Sensitivity to beryllium was investigated among 362 workers at an aluminium smelter in Norway [40 ]. One had abnormal results in two separate blood samples and was sensitized to beryllium. Three others had one abnormal test that was not confirmed by a second test. One of a control group of 31 people had one abnormal and one normal test result. This frequency of beryllium sensitivity is much lower than is found in the beryllium handling industry, which the authors attributed to lower atmospheric concentrations, beryllium speciation effects, or the use of respiratory protective equipment. 

Newman LS, Kieiss K, King TE Jr., et al. Pathologic and immunologic alterations in early stages of beryllium disease. Re-examination of disease definition and natural history. Am Rev Respir Dis 1989 139(6) 1479 1486. 

Newman LS. Immunology, genetics, and epidemiology of beryllium disease. Chest 1996 109(3 suppl) 40S 3S. 

Bama BP, Deodhar SD, Chiang T, et al. Experimental beryUium-induced lung disease. I. Differences in immunologic responses to beryllium compounds in strains 2 and 13 guinea pigs. Int Arch Allergy Appl Immunol 1984 73(l) 42-48. 

Deodhar SD, Barna BP (1991) Immune mechanisms in beryllium lung disease. Clev Clin J Med 58 157-160 Deodhar SD, Barna BP, van Ordstrand HS (1973) A study of the immunologic aspects of chronic berylliosis. Chest 63 309-313... 

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