Summary
A group of 182 workers exposed to diisocyanates (varnishers, carpenters, producers of polyurethane resins and expanded plastic) were examined to study the immunogenic capacity of these substances. The skin tests, particularly the intradermal tests, revealed reactions of the immediate, accelerated and/or delayed types due to the presence of IgE and IgG, in addition to responses of the cellular type. This was confirmed by passive transfer in guinea-pigs and man and immunohaematological tests such as passive haemagglutination and lymphocyte transformation. In 4 cases it was possible to demonstrate thermoresistant, homocytotropic immunoglobulins, that were not dependent on complement and behaved like reagins (i.e. short-term anaphylactic IgG). Exposure tests were performed on 45 cases; the results are analyzed and compared with those of the skin tests. It is concluded that both these groups of tests are of value in investigating the aetiopathogenesis of the pathology of the isocyanates: the skin tests for initial screening, and then the exposure tests for resolving doubtful diagnoses. Cross-reactions were also demonstrated between toluenediisocyanate and methylene-diisocyanate. Two phases could be considered in the pathogenesis; in the first phase, signs of inflammation appeared at the primary sites of contact with the irritant, then the ability of the diisocyanates to form a conjugate with organic proteins results in the production of a complete antigen and consequent sensitization of the exposed person. The appearance of symptoms naturally depends on subsequent exposure and the immunogenic capacity of the patient: the response is mainly of the reagin type in atopic patients and of type 3 in non-atopic patients.
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Avery S. B., Stetson D. M., Pan P. M., Mathews K. P.: Immunological Investigations of Individuals with Toluene-Diisocyanate Asthma — Clin. exp. Immunol.4, 585, 1969.
Bruckner H. C., Avery S. B., Stetson D. M.: Clinical and Immunological Appraisal of Workers Exposed to Diisocyanates — Arch. environm. Hlth16, 619, 1968.
Bryant D. H., Burns M. W., Lazarus L.: New Type of Allergic Asthma Due to IgG ‘Reaginic’ Antibody — Brit. med. J.4, 589, 1973.
Cirla A. M., Aresini G., Briatico G., Inzoli S., Nava C., Zedda S.: Valutazione dei criteri di diagnosi nell’asma professionale da isocianati — Med. d. Lavoro. (In Press).
Cirla A. M., Zedda S., Nava C.: Pathologie respiratoire dans l’emploi des vernis aux isocyanates dans l’industrie des meubles — In: Atti del I Congr. Intern. Medico nell’industria chimica. Ludwigshafen, 1972; p. 330.
Csizmas L.: Preparation of Formalinized Erythrocytes — Proc. Soc. exp. Biol. (N. Y.)157, 159, 1960.
Du Bois A. B., Tothelo J. H., Jr.: A New Method for Measuring Airway Resistance in Man Using a Body Plethysmograph; Values in Normal Subjects and in Patients with Respiratory Diseases — J. clin. Invest.35, 327, 1956.
Gaffuri E., Brugnane F.: Patologia respiratoria da diisocianati in verniciatori — Med. d. Lavoro62, 151, 1971.
Girard J. P., Rosa N. R., Kunz M. L., Kobayashi S., Arbesman C. E.:In Vitro Lymphocyte Transformation in Atopic Patients Induced by Antigens — J. Allergy39, 65, 1967.
Henson P. M., Cochrane C. A.: Antigen-Antibodies Complexes Platelets and Increased Vascular Permeability. Cellular and Humoral Mechanisms in Anaphylaxis and Allergy — Movat H. Z. Ed., Basel, 1969; p. 129.
Konzen R. B., Craft B. F., Schell L. D.: Human Response to Low Concentrations of p,p-Diphenylmethane Diisocyanate (MDI) — Amer. industr. Hyg. Ass. J.27, 121, 1966.
Ovary Z.: Immediate Reactions in the Skin of Experimental Animal Provoked by Antibody-Antigen Interaction — Progr. Allergy5, 459, 1958.
Parish W. E.: Short-Term Anaphylactic IgG Antibodies in Human Sera — Lancet1, 2, 1970.
Parish W. E., Pepys J.: Allergic Reactions in the Lung — In:Gell P. G. H., Coombs R. R. A. (Eds): Clinical Aspects of Immunology. Blackwell, Oxford, 1968; p. 390.
Pepys J.: Skin Test in Diagnosis — In:Gell P. G. H., Coombs R. R. A. (Eds): Clinical Aspects of Immunology. Blackwell, Oxford, 1968; p. 332.
Pepys J.: Immunopathology of Allergic Lung Disease — Clin. Allergy3, 1, 1973.
Pepys J., Hargraves F. E., Ghan M., Mc Carthy D. S.: Inhibitory Effects of Disodium Chromoglycate (Intal) on Allergens Inhalation Tests — Lancet1, 134, 1968.
Pepys J., Pickering C. A. C., Breslin B. X. A., Terry D. Y.: Asthma Due to Inhaled Chemical Agents: Tolylene Diisocyanate — Clin. Allergy2, 225, 1972.
Pepys J., Turner Warwick M., Dawson P. L., Hinson K. F. W.: Arthus (Type III) Skin Test Reaction in Man — In:Rose B., Richter M., Schon A., Frankland A. W. (Eds)): Clinical and Immunological Features. Excerpta Medica Foundation, Amsterdam, 1968; p. 221.
Reilly D. A.: A Field Method for Determining 2,4-Tolylene Diisocyanate Vapour in Air — Analyst88, 732, 1963.
Reilly D. A.: Test Paper Method for the Determination of TDI Vapour in Air — Analyst93, 178, 1968.
Scadding J. G.: Antigen-Antibody Reactions in Bronchopulmonary Disease — J. roy. Coll. Phycns Lond.2, 35, 1967.
Scheel L. L., Killens R., Josephson A.: Immunochemical Aspects of Toluene Diisocyanate Toxicity — Amer. industr. Hyg. Ass. J.25, 179, 1964.
Scherman W. B.: Hypersensitivity Mechanisms and Management — W. B. Saunders, Philadelphia, 1968.
Taylor G.: Immune Response to Tolylene Diisocyanate (TDI) Exposure in Man — Proc. roy. Soc. Med.63, 379, 1970.
Zedda S., Cardani A., Cirla A. M., Nava C.: Asma da isocianati — Riv. Ist. vaccinogeno e dei Consorzi prov. antitubercolari (Milano)22, 178, 1972.
Zedda S., Sartorelli E.: Variability of Plethysmographic Measurements of Airways Resistances during the Day in Normal Subjects and Patients — Respiration28, 158, 1971.
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Nava, C., Arbosti, G., Briatico-Vangosa, G. et al. Pathology produced by isocyanates: Methods of immunological investigation. La Ricerca Clin. Lab. 5, 135–145 (1975). https://doi.org/10.1007/BF02910122
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DOI: https://doi.org/10.1007/BF02910122