title: Airway isocyanate-adducts in asthma induced by exposure to hexamethylene diisocyanate.
abstract: OBJECTIVE
  The clinical features, airway histology, and detection of hexamethylene diisocyanate (HDI) protein adducts in endobronchial biopsies from a patient with HDI asthma are described.
  
  
  METHODS
  Isocyanate asthma was diagnosed by history, methacholine challenge, and workplace HDI challenge. Bronchoscopy was performed 24 h after challenge and immunohistochemical staining was performed.
  
  
  RESULTS
  Airway biopsies obtained at bronchoscopy demonstrated inflammatory changes typical for asthma, including increased airway eosinophils and T cells. Immunohistochemical staining with specific anti-HDI antibodies demonstrated the presence and localization of HDI adducts in human bronchial biopsies.
  
  
  CONCLUSIONS
  These studies confirm epithelial exposure to HDI following workplace challenge and demonstrate the feasibility of detecting and localizing isocyanate adducts in human lung tissue. Identifying and characterizing the airway macromolecules to which isocyanates bind in vivo are probably crucial to the understanding of how isocyanates cause sensitization and asthma. The ability to detect isocyanate adducts may also help characterize isocyanate exposure patterns and exposure-disease relationships.
authors.affiliation: Department of Internal Medicine, Yale University School of Medicine, New Haven, Connecticut, USA.
authors.forename: C A
authors.initials: CA
authors.lastname: Redlich
authors.forename: M H
authors.initials: MH
authors.lastname: Karol
authors.forename: C
authors.initials: C
authors.lastname: Graham
authors.forename: R J
authors.initials: RJ
authors.lastname: Homer
authors.forename: C T
authors.initials: CT
authors.lastname: Holm
authors.forename: J A
authors.initials: JA
authors.lastname: Wirth
authors.forename: M R
authors.initials: MR
authors.lastname: Cullen
mesh_terms: D000328:Adult; D000395:Air Pollutants, Occupational / Q000009:adverse effects*; D001249:Asthma / Q000139:chemically induced* / Q000276:immunology / Q000473:pathology; D001706:Biopsy; D001980:Bronchi / Q000276:immunology / Q000473:pathology; D003485:Cyanates / Q000009:adverse effects*; D004848:Epithelium / Q000276:immunology; D006801:Humans; D007073:Immunoglobulin E / Q000032:analysis; D017953:Isocyanates; D008297:Male; D009784:Occupational Diseases / Q000139:chemically induced* / Q000175:diagnosis / Q000276:immunology / Q000473:pathology; D016273:Occupational Exposure / Q000009:adverse effects*
chemical_list: D000395:Air Pollutants, Occupational; D003485:Cyanates; D017953:Isocyanates; C015262:1,6-hexamethylene diisocyanate; D007073:Immunoglobulin E