Identification of metal sensitization in sarcoid-like metal-exposed patients by the MELISA® lymphocyte proliferation test — a pilot study

Fireman, Elizabeth; Shai, Amir Bar; Alcalay, Yifat; Ophir, Noa; Kivity, Shmuel; Stejskal, Věra

doi:10.1186/s12995-016-0101-1

Cited by 29 publications

(23 citation statements)

References 23 publications

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“…Epidemiological evidence on the proportion of chronic beryllium disease misdiagnosed as sarcoidosis is limited to a few case series (188)(189)(190)(191)(192) and one case-referent study (193). Combining beryllium-focused studies of sarcoidosis Overall (I^2 = 94.54%, p = 0.00) Figure 4.…”

Section: Occupational Burden Of Hp (Extrinsic Allergic Alveolitis) Anmentioning

confidence: 99%

The Occupational Burden of Nonmalignant Respiratory Diseases. An Official American Thoracic Society and European Respiratory Society Statement

Blanc¹,

Annesi‐Maesano²,

Balmes³

et al. 2019

Am J Respir Crit Care Med

323

204

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Workplace inhalational hazards remain common worldwide, even though they are ameliorable. Previous American Thoracic Society documents have assessed the contribution of workplace exposures to asthma and chronic obstructive pulmonary disease on a population level, but not to other chronic respiratory diseases. The goal of this document is to report an in-depth literature review and data synthesis of the occupational contribution to the burden of the major nonmalignant respiratory diseases, including airway diseases; interstitial fibrosis; hypersensitivity pneumonitis; other noninfectious granulomatous lung diseases, including sarcoidosis; and selected respiratory infections. Methods: Relevant literature was identified for each respiratory condition. The occupational population attributable fraction (PAF) was estimated for those conditions for which there were sufficient population-based studies to allow pooled estimates. For the other conditions, the occupational burden of disease was estimated on the basis of attribution in case series, incidence rate ratios, or attributable fraction within an exposed group. Results: Workplace exposures contribute substantially to the burden of multiple chronic respiratory diseases, including asthma (PAF, 16%); chronic obstructive pulmonary disease (PAF, 14%); chronic bronchitis (PAF, 13%); idiopathic pulmonary fibrosis (PAF, 26%); hypersensitivity pneumonitis (occupational burden, 19%); other granulomatous diseases, including sarcoidosis (occupational burden, 30%); pulmonary alveolar proteinosis (occupational burden, 29%); tuberculosis (occupational burden, 2.3% in silica-exposed workers and 1% in healthcare workers); and community-acquired pneumonia in working-age adults (PAF, 10%). Conclusions: Workplace exposures contribute to the burden of disease across a range of nonmalignant lung conditions in adults (in addition to the 100% burden for the classic occupational pneumoconioses). This burden has important clinical, research, and policy implications. There is a pressing need to improve clinical recognition and public health awareness of the contribution of occupational factors across a range of nonmalignant respiratory diseases.

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Section: Occupational Burden Of Hp (Extrinsic Allergic Alveolitis) Anmentioning

confidence: 99%

The Occupational Burden of Nonmalignant Respiratory Diseases. An Official American Thoracic Society and European Respiratory Society Statement

Blanc¹,

Annesi‐Maesano²,

Balmes³

et al. 2019

Am J Respir Crit Care Med

323

204

View full text Add to dashboard Cite

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“…This is a memory lymphocyte immunostimulation assay used to identify sensitization toward metals and silica. 136 To induce granulomatous inflammation, silica must be able to react with the immune system. This process is proposed as follows: silica particles are inhaled and reach the alveolar space.…”

Section: Silicamentioning

confidence: 99%

Etiology and Immunopathogenesis of Sarcoidosis: Novel Insights

Beijer

Veltkamp

Meek

et al. 2017

Semin Respir Crit Care Med

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Sarcoidosis is a disorder of unknown etiology. It is a systemic disease, frequently involving the lungs, skin, eyes, and lymph nodes. It is characterized by formation of noncaseating granulomas at the site(s) of disease. Sarcoidosis has a complex disease pathogenesis, with involvement of both the innate and adaptive immune systems. Several innate immune system receptors including NOD-like receptors and Toll-like receptors appear to be involved in the development of sarcoidosis as well as cellular players such as dendritic cells and macrophages. Furthermore, lymphocytes from the adaptive immune system including Th1, Th17, regulatory T cells, and B cells are likely to play a role in the sarcoidosis disease pathogenesis as well. Possibly, genetic susceptibility and exposure to particular etiologic agents including mycobacterial and propionibacterial antigens, metals, and silica can cause sarcoidosis. Besides exogenous triggers, also self-compounds such as serum amyloid A and vimentin, have been found to play a role in the development of sarcoidosis. It is likely that sarcoidosis does not have one single cause but rather is the result of the interplay between different etiologic agents and the immune system in predisposed individuals.

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“…Granulomatous reactions in other organs such as the lungs as the consequence of exposure to inorganic substances, for example beryllium, are well described in the literature, but have to be differentiated from sarcoidosis. As mentioned before, Fireman et al used MELISA testing to identify metal sensitization in sarcoid-like metal-exposed patients with lung disease and to differentiate it from true sarcoidosis (14). Perhaps it could be speculated that a similar phenomenon can take place in tattoos.…”

Section: Discussionmentioning

confidence: 99%

“…, patch tests seem to be unreliable and insufficiently sensitive to show type IV hypersensitivity reactions against Ti. The memory lymphocyte immunostimulation assay (MELISA), a novel lymphocyte stimulation test, is proposed by some authors as an alternative method to prove metal allergy, and has been used to identify and differentiate metal‐induced sarcoid‐like reactions in pulmonary disease . However, this test is not yet approved as a routine method for testing Ti allergy; moreover, it is costly and not easily available in daily dermatological practice.…”

Section: Discussionmentioning

confidence: 99%