Beryllium hypersensitivity and chronic beryllium lung disease.
OBJECTIVE
This review aims to present the clinician with a synthesis of recent studies that have enhanced our understanding of the epidemiology and pathogenesis of beryllium hypersensitivity (BeH) and chronic beryllium disease (CBD).


RESULTS
Lower occupational limit levels to beryllium exposure and more stringent preventive measures can decrease the risk for development of BeH and CBD. Beryllium sensitization is determined by a positive beryllium lymphocyte proliferation test (BeLPT). Longitudinal data suggest that BeH progresses to CBD. Together with a comprehensive history the BeLPT may help identify berylliosis in patients erroneously diagnosed to have sarcoidosis. HLA-DPB1-Glu69 marker is associated with increased susceptibility to development of BeH and CBD but poor positive predictive value limits its use; other genetic markers are being investigated. Recent investigations augment our understanding on the role of T-lymphocytes and chemokines in the pathogenesis of beryllium-associated disease. However, the basis for treatment strategies remains scarce.


CONCLUSIONS
Our enhanced understanding of beryllium-associated lung disease potentially provides a window to unraveling other granulomatous diseases. However, even more questions beg to be elucidated and additional efforts are needed to translate this body of knowledge into better prevention and treatment.
Santo Tomas
Linus H
LH
Division of Pulmonary and Critical Care Medicine, Medical College of Wisconsin, 9200 W. Wisconsin Avenue, Milwaukee, WI 53226, USA. lsantot@mcw.edu
D000395:Air Pollutants, Occupational / Q000009:adverse effects; D001607:Berylliosis / Q000453:epidemiology / Q000209:etiology* / Q000517:prevention & control; D001608:Beryllium / Q000009:adverse effects*; D002908:Chronic Disease; D018450:Disease Progression; D006801:Humans; D012130:Respiratory Hypersensitivity / Q000453:epidemiology / Q000209:etiology* / Q000517:prevention & control; D012307:Risk Factors
D000395:Air Pollutants, Occupational; D001608:Beryllium