Kazumi Yuasa

Airborne Beta-1,3-Glucan May Be Related to Symptoms in Sick Buildings

Airborne endotoxin and β-1,3-glucan were measured in buildings in which complaints of eye and airway irritation as well as fatigue and skin symptoms had been numerous. The presence of symptoms was evaluated using question naires. Dose-response relationships were found between levels of β-1,3-glucan and eye and throat irritation, dry cough and itching skin. The data suggest that β-1,3-glucan may be responsible for symptoms seen among persons in sick buildings.

Acute pulmonary toxicity of inhaledβ-1,3-glucan and endotoxin

The number of inflammatory cells was studied in lung walls and airways after inhalation of endotoxin or β-1,3-glucan. In the water unsoluble form, β-1,3-glucan caused a delayed response in terms of a decrease in macrophages and lymphocytes in the lung wall, 1 to 7 days after exposure but no invasion of neutrophils into the airways. When solubilized in 0.02 N NaOH, the cell response was the same as that observed after exposure to endotoxin.

Evaluation of the Diagnostic Value of the Measurement of (1→3)-β-D-Glucan in Patients with Pulmonary Aspergillosis

The value of the measurement of (1-->3)-beta-D-glucan, a major and common cell wall constituent of fungi, for diagnosing pulmonary aspergillosis was assessed in comparison with that of conventional examinations. The concentrations of (1-->3)-beta-D-glucan in sera was elevated in 7 out of 8 patients with active aspergillosis, but not in cases without active diseases, except for one sample. Further, the concentrations well reflected the activity of the aspergillosis in each case. Regarding conventional examinations, with the immunodiffusion test it was difficult to detect the present activity of the disease. The radioallergosorbent test was useful for diagnosing bronchopulmonary aspergillosis, but not for other types of aspergillosis. The Aspergillus-specific component, galactomannan, was insensitive and the enzyme-linked immunosorbent assay gave highly variable results. Thus, although the assessment of the specificity of the assay is still necessary, compared with other tests, the assay of (1-->3)-beta-D-glucan has the advantage of diagnosing pulmonary aspergillosis and also of assessing the disease activity.

Bird droppings contain endotoxin and (1-->3)-beta-D-glucan.

Samples of bird droppings were collected and the amount of endotoxin and (1-->3)-beta-D-glucan in these was determined using a specific Limulus assay. All samples contained these agents and calculations on airborne levels demonstrated that doses at risk for inflammation and allergic alveolitis were present. Endotoxin and (1-->3)-beta-D-glucan should be considered in investigations on lung disease induced by bird droppings.

(1→3)-β-D-glucan in patients with pulmonary aspergilloma

To elucidate the role of (1→3)-β-D-glucan in pulmonary aspergilloma, serum concentrations of (1→3)-β-D-glucan were measured repeatedly for as long as 10 months in eight patients. In four patients with inactive disease, concentrations of (1→3)-β-D-glucan were in the normal range.The concentrations of (1→3)-β-D-glucan increased in two patients, although the disease was inactive. This increase might show the earliest stage of the invasive process of the disease. In two other patients with active disease, (1→3)-β-D-glucan increased. Other parameters, such as galactomannan, immunodiffusion and a radio-allergosorbent test, as well as inflammatory m arkers such as C-reactive protein and the leukocyte count, did not show any consistent tendency in regard to the activity of the disease. Thus, a (1→3)-β-D-glucan assay may add valuable data for evaluating the disease activity and understanding the disease process of pulmonary aspergilloma.

胸部感染性疾患におけるヒト免疫グロブリンG-ジエチレントリアミン五酢酸インジウム (111In-DTPA-IgG) シンチグラフィの有用性の検討

The utility of 111In-DTPA-IgG imaging for the detection of intrathoracic lesions was evaluated in 10 patients with the suspicion of inflammatory or infectious diseases. They were intravenously administered 40 or 80 MBq of 111In-DTPA-IgG, and scanned after 24 or 48 hours. Of these, 8 cases, consisted of 4 cases with pneumonia and 2 cases with lung abscess and one case of pulmonary tuberculosis and one of a tuberculous pleuritis, showed true positive results. Others were one false negative case of pneumonia and one true negative case of lung cancer. Overall sensitivity and specificity were 88.9% and 100%, respectively. There were no cases which showed side effects or abnormal laboratory findings caused by the radiopharmaceuticals administered. Thus, 111In-DTPA-IgG imaging is a useful tool for the detection of intrathoracic infectious lesions.