Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0393754 (HSA)
 2,996 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A 68-year-old male developed dry cough and exertional dyspnea after handling paint spray containing isocyanates (TDI, MDI) for three months. Initially, the symptoms fluctuated according to whether he was at work or not. He was admitted to our hospital on February 7, 1990, because of progressive worsening of symptoms. In spite of admission to hospital and cessation of exposure to isocyanates, there was no improvement of symptoms. His chest X-ray film showed diffuse small nodular and reticular shadows. Transbronchial lung biopsy revealed thickening of the alveolar walls and formation of Masson's bodies associated with mononuclear cell infiltration in alveolar spaces. High titers of TDI-HSA and MDI-HSA specific IgG antibodies were detected by ELISA, and a high level of serum soluble IL2 receptor was also detected. From these results, we diagnosed hypersensitivity pneumonitis due to exposure to isocyanates. One week administration of prednisolone caused dramatic improvement of his symptoms, chest X-ray findings, and laboratory data. His clinical course and response to prednisolone therapy indicated that long-term steroid administration could not be avoided. The prolonged symptoms and the necessity for long-term steroid therapy are discussed.
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PMID:[A case of hypersensitivity pneumonitis due to isocyanate exposure showing progression even two months after removal of the antigen]. 131 20

Some parameters which might affect RAST results, i.e. incubation length, degree of ligand substitution, and total IgE levels, were examined in a RAST system employing diphenylmethane diisocyanate--human serum albumin (MDI-HSA) conjugates as antigens, both in exposed symptomatic and in non-exposed subjects. The reaction equilibrium was reached after 9 and 18 h. respectively, in the first and the second step of the test. A marked correlation with the degree of ligand substitution was observed, the highest sensitivity being achieved with the lowest (2.9) MDI/HSA molar ratio examined. Higher (up to 50) degrees of substitution resulted in progressively lower levels of radioactivity bound and in a loss of specificity, as confirmed by RAST inhibition experiments. At high levels of ligand substitution, high titers of total serum IgE affected RAST results.
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PMID:RAST-detection of specific IgE in diphenylmethane diisocyanate exposed workers: considerations in performance of the test. 205 11

A 46-year-old man who had worked in a paint processing plast for over 29 years was admitted to our hospital with complaints of nocturnal dyspnea and dry cough. A chest X-ray film showed diffuse granular shadows in bilateral lungs. Pulmonary function tests revealed reduction of diffusing capacity and restrictive impairments. Hypersensitivity pneumonitis (HP) due to isocyanates was speculated from his occupational history and clinical course. Positive skin tests against TDI-HSA and MDI-HSA, precipitating antibody against TDI-HSA, and negative lymphocyte stimulating tests of peripheral blood and bronchoalveolar lavage fluid were also noticed. Environmental provocation test was positive. Histological findings of transbronchial lung biopsy specimens showed diffuse alveolitis and Masson body, but no granulomas. According to these results, the patient was diagnosed as HP due to TDI. Type III allergy of Gell-Coombs seems to participate in this case. The granulomatous lesion is seen less frequently in isocyanate-related HP than in HP induced by organic dusts, which suggests the difference in immunological and histological reactions between both types of HP.
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PMID:[A case of hypersensitivity pneumonitis due to isocyanate (TDI)]. 256 May 2

Evaluation of the immunologic contribution to the pathogenesis of isocyanate lung disease necessitates preparation of isocyanate-protein conjugates to detect anti-isocyanate antibodies. The preparation and characterization of the conjugates were described in the preceding paper in this issue. Sera were obtained from two guinea pigs immunized with 4,4'-diisocyanatodiphenylmethane (MDI) and from three workers with occupational exposure to MDI. By use of Western blot analysis, guinea pig IgG antibodies were best detected by the monomeric component of MDI-guinea pig serum albumin. ELISA additionally indicated that conjugates which contained a high density of hapten detected greater amounts of antibody than did conjugates containing low amounts of hapten. The same procedures were then used to assess the amount of MDI-specific IgG and IgE antibody in sera from symptomatic workers. Effective MDI-HSA antigens were those that were monomeric and had high haptenic content. Highly substituted conjugates of monoisocyanates (phenyl isocyanate and p-tolyl isocyanate) with serum albumins were also effective in detecting antibodies to MDI. These results indicate the importance of the composition of isocyanate conjugate antigens in detecting antibodies to diisocyanates and suggest that standards be developed for preparation and characterization of these diagnostic serologic reagents.
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PMID:Diisocyanate antigens that detect specific antibodies in exposed workers and guinea pigs. 297 45

RAST was performed using both nitrocellulose (NC) and paper discs to compare these solid supports for ability to detect IgE antibodies in sera from two patients with hypersensitivity to the industrial chemical, diphenylmethane-4,4'-diisocyanate (MDI). NC disc had distinct advantages in ease of coupling the hapten-conjugate antigen to discs, and in use of lesser amounts of antigen. With regard to sensitivity, NC discs were better able to distinguish the positive sera from 34 control sera including those with elevated levels of total IgE. In both RAST systems, inhibition studies indicated high specificity of antibodies for MDI, with no reactivity detected toward the serum albumin portion of the MDI-HSA conjugate antigen. However, only in the NC RAST did antibodies from both patients react with p-tolyl isocyanate inhibitor. Based on the above results, NC discs displayed several advantages in RAST and are recommended for routine serological assay of isocyanate-specific antibodies.
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PMID:Nitrocellulose-based RAST to detect IgE antibodies in workers hypersensitive to diphenylmethane-4,4'-diisocyanate. 371 32

Two workers are presented who were exposed to diphenylmethane diisocyanate (MDI) while coating pipes with a polyurethane foam. After a latent period of exposure, worker A developed immediate-onset asthma and worker B developed a clinical picture of hypersensitivity pneumonitis for which he was hospitalized. The antibody response of these workers to a conjugate of MDI with human serum albumin (MDI-HSA) was measured by gel precipitation, total antibody binding of 125I MDI-HSA, and specific IgG and IgE antibody by polystyrene-tube radioimmunoassay (PTRAI). Worker B had precipitating antibody to MDI-HSA by double immunodiffusion in gel. Both workers had high levels of IgG antibody specific for MDI-HSA which had some cross-reactivity with a conjugate or toluene diisocyanate and HSA. Total serum antibody binding of 125I MDI-HSA was 15 microgram/ml in worker A and 900 microgram/ml in worker B. Both workers had serum IgE antibody specific for MDI-HSA as measured by two PTRIA techniques. These results indicate that a marked immunologic response to MDI is possible in exposed workers and that hypersensitivity pneumonitis can occur subsequent to the inhalation of a low-molecular-weight chemical in the industrail setting.
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PMID:Immunoglobulin E-mediated asthma and hypersensitivity pneumonitis with precipitating anti-hapten antibodies due to diphenylmethane diisocyanate (MDI) exposure. 624 52

Serum samples obtained from hemodialysis patients with immediate-type hypersensitivity reactions and hemodialysis patients with no reactions were analyzed for antibody activity against hapten-protein complexes prepared from PA and MDI. These chemicals, used in preparation of plastics, have been shown to be associated with immunologically mediated disease in other studies. IgE and IgG antibodies against P-HSA and MDI-HSA were detected in several sera, but symptomatic patients could not be differentiated from asymptomatic patients by antibody levels. Antibodies capable of agglutinating or hemolyzing P-E were also detected in some sera from hemodialysis patients. These studies demonstrate that although no clinical disease has yet been correlated with these antibodies, sufficient exposure of hemodialysis patients to protein-reactive chemicals occurs to elicit an immunologic response against hapten-protein or hapten-cells. Such antibodies may have immunopathogenetic significance in subjects systemically exposed to fluids which have been in contact with plastics.
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PMID:Antibodies in hemodialysis patients against hapten-protein and hapten-erythrocytes. 740 Jun 67

Two workers (23 and 28 years old) developed rhinitis and bronchial asthma after occupational contact with the isocyanate MDI. Positive skin prick test results for MDI-HSA and IgE antibodies to all isocyanate-HSA conjugates were obtained in both cases, and the inhalation challenge test with MDI produced immediate and late asthmatic reactions. In the patch test and the stimulation assay of peripheral mononuclear blood cells, a specific sensitization to the diamine MDA (in both cases) and to further amines (in one case), as well as to hydrolysates of the respective diisocyanates, was seen, which appears to be independent of the IgE response to isocyanate-HSA conjugates. Our results offer evidence of IgE-mediated, as well as lymphocyte, responses induced by exposures to isocyanate products over several months or years.
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PMID:Humoral and cellular immune responses in asthmatic isocyanate workers: report of two cases. 873 20

A 51-year-old man who had been working for 10 years with polyurethane paint containing isocyanate (MDI) was admitted to our hospital with complaints of fever and exertional dyspnea. Fine crackles were heard in both bases, and the patient had clubbed fingers. A chest X-ray film and computed tomograms of the lungs revealed patchy infiltrative shadows in both lung fields and subpleural honeycombing associated with irregular linear areas. Examination of bronchoalveolar lavage fluid showed increased T lymphocytes and a decreased CD 4/8 ratio. Specimens obtained by transbronchial lung biopsy revealed lymphoplasmacytic infiltration into the thickened alveolar walls, macrophage accumulation, and micro-epithelioid cell granulomas in the alveolar sacs. Hypersensitivity pneumonitis was suspected although the causative antigen was not identified because the results of short-term environmental provocation tests were negative in the patient's home and workplace. After discharge, the patient continued working as a paint sprayer. His acute symptoms recurred 1 month after exposure to isocyanate. Similar episodes occurred on two separate occasions. In addition, the patient tested positive for antibody to MDI-HSA in bronchoalveolar fluid. From the above observations, the patient was given a diagnosis of chronic hypersensitivity pneumonitis due to isocyanate (MDI). This condition is extremely rare. Furthermore, it is interesting that acute symptoms recurred 1 month after environmental exposure to the causative antigen.
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PMID:[Chronic hypersensitivity pneumonitis due to isocyanate in a patient presenting with acute symptoms 1 month after environmental exposure]. 980 16