title: Skin as a route of exposure and sensitization in chronic beryllium disease.
abstract: Chronic beryllium disease is an occupational lung disease that begins as a cell-mediated immune response to beryllium. Although respiratory and engineering controls have significantly decreased occupational beryllium exposures over the last decade, the rate of beryllium sensitization has not declined. We hypothesized that skin exposure to beryllium particles would provide an alternative route for sensitization to this metal. We employed optical scanning laser confocal microscopy and size-selected fluorospheres to demonstrate that 0.5- and 1.0- micro m particles, in conjunction with motion, as at the wrist, penetrate the stratum corneum of human skin and reach the epidermis and, occasionally, the dermis. The cutaneous immune response to chemical sensitizers is initiated in the skin, matures in the local lymph node (LN), and releases hapten-specific T cells into the peripheral blood. Topical application of beryllium to C3H mice generated beryllium-specific sensitization that was documented by peripheral blood and LN beryllium lymphocyte proliferation tests (BeLPT) and by changes in LN T-cell activation markers, increased expression of CD44, and decreased CD62L. In a sensitization-challenge treatment paradigm, epicutaneous beryllium increased murine ear thickness following chemical challenge. These data are consistent with development of a hapten-specific, cell-mediated immune response following topical application of beryllium and suggest a mechanistic link between the persistent rate of beryllium worker sensitization and skin exposure to fine and ultrafine beryllium particles.
authors.affiliation: Toxicology and Molecular Biology Branch, Health Effects Laboratory Division, National Institute for Occupational Safety and Health, Morgantown, West Virginia 26505, USA. sft3@cdc.gov
authors.forename: Sally S
authors.initials: SS
authors.lastname: Tinkle
authors.forename: James M
authors.initials: JM
authors.lastname: Antonini
authors.forename: Brenda A
authors.initials: BA
authors.lastname: Rich
authors.forename: Jenny R
authors.initials: JR
authors.lastname: Roberts
authors.forename: Rebecca
authors.initials: R
authors.lastname: Salmen
authors.forename: Karyn
authors.initials: K
authors.lastname: DePree
authors.forename: Eric J
authors.initials: EJ
authors.lastname: Adkins
mesh_terms: D000287:Administration, Topical; D000818:Animals; D001607:Berylliosis / Q000276:immunology / Q000503:physiopathology*; D001608:Beryllium / Q000008:administration & dosage* / Q000633:toxicity*; D046508:Culture Techniques; D004781:Environmental Exposure; D006801:Humans; D018960:Hyaluronan Receptors / Q000096:biosynthesis; D007114:Immunization; D008213:Lymphocyte Activation; D051379:Mice; D008809:Mice, Inbred C3H; D016273:Occupational Exposure; D010316:Particle Size; D010539:Permeability; D012879:Skin Physiological Phenomena
chemical_list: D018960:Hyaluronan Receptors; D001608:Beryllium