title: Genetic susceptibility to beryllium: a case-referent study of men and women of working age with sarcoidosis or other chronic lung disease.
abstract: OBJECTIVE
  The study was designed to investigate whether beryllium exposure was related to illness diagnosed as sarcoidosis. Chronic beryllium disease (CBD) and sarcoidosis are clinically and pathologically indistinguishable, with only the presence of beryllium-specific T-lymphocytes identifying CBD. Testing for such cells is not feasible in community studies of sarcoidosis but a second characteristic of CBD, its much greater incidence in those with a glutamic acid residue at position 69 of the HLA-DPB1 gene (Glu69), provides an alternative approach to answering this question.
  
  
  METHODS
  Cases of sarcoidosis aged 18-60 years diagnosed in Alberta, Canada, from 1999 to 2005 were approached through their specialist physician, together with age-matched and sex-matched referents with other chronic lung disease. Referents were grouped into chronic obstructive pulmonary disease (COPD), asthma and other lung disease. Participants completed a telephone questionnaire, including industry-specific questionnaires. DNA was extracted from mailed-in mouthwash samples and genotyped for Glu69. Duration of employment in types of work with independently documented beryllium exposure was calculated.
  
  
  RESULTS
  DNA was extracted for 655 cases (270 Glu69 positive) and 1382 referents (561 positive). No increase in sarcoidosis was seen with either Glu69 or beryllium exposure (none, <10, ≥10 years) as main effects: longer duration in possible beryllium jobs was related to COPD. In Glu69 positive men with exposure ≥10 years, the trend towards increasing rate of COPD was reversed, and a significant interaction of duration of exposure and Glu69 was detected (OR=4.51 95% CI 1.17 to 17.48).
  
  
  CONCLUSIONS
  The gene-environment interaction supports the hypothesis that some cases diagnosed as sarcoidosis result from occupational beryllium exposure.
authors.affiliation: Department of Medicine, University of Alberta, Edmonton, Canada.
authors.forename: Nicola
authors.initials: N
authors.lastname: Cherry
authors.affiliation: Department of Occupational Medicine, University of Alberta, Edmonton, Canada.
authors.forename: Jeremy
authors.initials: J
authors.lastname: Beach
authors.affiliation: Department of Environmental and Occupational Health, Drexel University, Philadelphia, Pennsylvania, USA.
authors.forename: Igor
authors.initials: I
authors.lastname: Burstyn
authors.affiliation: Department of Medical Genetics, University of Calgary, Calgary, Canada ACH Molecular Diagnostic Laboratory, Alberta Health Services, Calgary, Canada.
authors.forename: Jillian
authors.initials: J
authors.lastname: Parboosingh
authors.affiliation: Department of Occupational Medicine, University of Alberta, Edmonton, Canada.
authors.forename: Janine
authors.initials: J
authors.lastname: Schouchen
authors.affiliation: School of Public Health, University of Alberta, Edmonton, Canada.
authors.forename: Ambikaipakan
authors.initials: A
authors.lastname: Senthilselvan
authors.affiliation: Surveillance and Assessment, Alberta Ministry of Health, Edmonton, Canada.
authors.forename: Larry
authors.initials: L
authors.lastname: Svenson
authors.affiliation: ACH Molecular Diagnostic Laboratory, Alberta Health Services, Calgary, Canada.
authors.forename: Jan
authors.initials: J
authors.lastname: Tamminga
authors.affiliation: School of Geography and Earth Sciences, McMaster, Hamilton, Canada.
authors.forename: Niko
authors.initials: N
authors.lastname: Yiannakoulias
mesh_terms: D000293:Adolescent; D000328:Adult; D000416:Alberta; D001249:Asthma / Q000139:chemically induced / Q000235:genetics; D001608:Beryllium / Q000633:toxicity*; D016022:Case-Control Studies; D002908:Chronic Disease; D005260:Female; D059647:Gene-Environment Interaction; D020022:Genetic Predisposition to Disease; D005838:Genotype; D059868:HLA-DP beta-Chains / Q000235:genetics*; D006801:Humans; D008297:Male; D008875:Middle Aged; D016273:Occupational Exposure / Q000009:adverse effects*; D029424:Pulmonary Disease, Chronic Obstructive / Q000139:chemically induced / Q000235:genetics; D017565:Sarcoidosis, Pulmonary / Q000139:chemically induced* / Q000235:genetics*; D011795:Surveys and Questionnaires; D055815:Young Adult
chemical_list: D059868:HLA-DP beta-Chains; C071170:HLA-DPB1 antigen; D001608:Beryllium