title: Autoantibodies to nervous system-specific proteins are elevated in sera of flight crew members: biomarkers for nervous system injury.
abstract: This descriptive study reports the results of assays performed to detect circulating autoantibodies in a panel of 7 proteins associated with the nervous system (NS) in sera of 12 healthy controls and a group of 34 flight crew members including both pilots and attendants who experienced adverse effects after exposure to air emissions sourced to the ventilation system in their aircrafts and subsequently sought medical attention. The proteins selected represent various types of proteins present in nerve cells that are affected by neuronal degeneration. In the sera samples from flight crew members and healthy controls, immunoglobin (IgG) was measured using Western blotting against neurofilament triplet proteins (NFP), tubulin, microtubule-associated tau proteins (tau), microtubule-associated protein-2 (MAP-2), myelin basic protein (MBP), glial fibrillary acidic protein (GFAP), and glial S100B protein. Significant elevation in levels of circulating IgG-class autoantibodies in flight crew members was found. A symptom-free pilot was sampled before symptoms and then again afterward. This pilot developed clinical problems after flying for 45 h in 10 d. Significant increases in autoantibodies were noted to most of the tested proteins in the serum of this pilot after exposure to air emissions. The levels of autoantibodies rose with worsening of his condition compared to the serum sample collected prior to exposure. After cessation of flying for a year, this pilot's clinical condition improved, and eventually he recovered and his serum autoantibodies against nervous system proteins decreased. The case study with this pilot demonstrates a temporal relationship between exposure to air emissions, clinical condition, and level of serum autoantibodies to nervous system-specific proteins. Overall, these results suggest the possible development of neuronal injury and gliosis in flight crew members anecdotally exposed to cabin air emissions containing organophosphates. Thus, increased circulating serum autoantibodies resulting from neuronal damage may be used as biomarkers for chemical-induced CNS injury.
authors.affiliation: Department of Pharmacology and Cancer Biology, Duke University Medical Center, Durham, North Carolina 27710, USA. donia@duke.edu
authors.forename: Mohamed B
authors.initials: MB
authors.lastname: Abou-Donia
authors.forename: Martha M
authors.initials: MM
authors.lastname: Abou-Donia
authors.forename: Eman M
authors.initials: EM
authors.lastname: ElMasry
authors.forename: Jean A
authors.initials: JA
authors.lastname: Monro
authors.forename: Michel F A
authors.initials: MF
authors.lastname: Mulder
mesh_terms: D000337:Aerospace Medicine; D000395:Air Pollutants, Occupational / Q000009:adverse effects*; D001323:Autoantibodies / Q000097:blood*; D001359:Aviation; D015415:Biomarkers / Q000097:blood; D020378:Confined Spaces; D005904:Glial Fibrillary Acidic Protein / Q000276:immunology; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood; D019570:Inhalation Exposure; D008297:Male; D008869:Microtubule-Associated Proteins / Q000276:immunology; D008875:Middle Aged; D004676:Myelin Basic Protein / Q000276:immunology; D009414:Nerve Growth Factors / Q000276:immunology; D009419:Nerve Tissue Proteins / Q000276:immunology*; D016900:Neurofilament Proteins / Q000276:immunology; D020258:Neurotoxicity Syndromes / Q000097:blood / Q000209:etiology* / Q000276:immunology; D009784:Occupational Diseases; D016273:Occupational Exposure / Q000009:adverse effects; D064568:S100 Calcium Binding Protein beta Subunit; D009418:S100 Proteins / Q000276:immunology; D014404:Tubulin / Q000276:immunology; D016875:tau Proteins / Q000276:immunology
chemical_list: D000395:Air Pollutants, Occupational; D001323:Autoantibodies; D015415:Biomarkers; D005904:Glial Fibrillary Acidic Protein; D007074:Immunoglobulin G; D008869:Microtubule-Associated Proteins; D004676:Myelin Basic Protein; D009414:Nerve Growth Factors; D009419:Nerve Tissue Proteins; D016900:Neurofilament Proteins; D064568:S100 Calcium Binding Protein beta Subunit; D009418:S100 Proteins; C579160:S100B protein, human; D014404:Tubulin; D016875:tau Proteins