Skin as a route of exposure and sensitization in chronic beryllium disease.
BACKGROUND Beryllium compounds can cause acute and chronic lung injury in humans. Although models of chronic granulomatous lung disease have been established in various animal species, a murine model of beryllium-induced chronic lung disease has not been established. EXPERIMENTAL DESIGN Beryllium was introduced intratracheally either as a soluble salt (BeSO4) or in particulate form (BeO). Various preimmunization protocols were used to enhance immune-mediated pulmonary changes. Cells obtained by bronchoalveolar lavage (BAL) were analyzed using flow cytometry, and the observations correlated with in vitro immune responses and with lung histopathology. RESULTS Histologic changes were consistently found in mice preimmunized with BeSO4.4H2O plus syngeneic serum. Addition of complete or incomplete Freund's adjuvant to the preimmunization protocol was not necessary to induce granulomatous changes. BAL showed a significant increase in lymphocytes at 2, 4, and 8 weeks after intratracheal BeSO4. Approximately one-third of BAL lymphocytes expressed the gamma/delta T lymphocyte receptor at 2 weeks; at 4 weeks the lymphocytes were predominantly Thy1+, L3T4+ (CD4+) and expressed only the alpha/beta T lymphocyte receptor. Only BAL lymphocytes from mice preimmunized with BeSO4/serum and challenged with BeSO4/serum showed significant in vitro proliferation in response to BeSO4. Macrophage activation antigens (Mac-2, Mac-3) were expressed only during the acute inflammatory phase (2 weeks) whereas increased expression of a monocyte/macrophage antigen (Mac-1) remained elevated beyond the inflammatory period in some instances. Attempts to induce similar lesions in BALB/c and C57BL6/J mice were unsuccessful. Genetic differences at the H-2 major histocompatibility complex gene complex may account for the differential responses to BeSO4 among various mouse strains. A single exposure to BeO also induced histopathologic changes in the lung which correlated with BAL cellularity, but these changes were only observed 8 months after exposure and did not proceed to frank granulomas. CONCLUSIONS A murine model of granulomatous lung disease may prove useful in understanding the genetic and immunologic factors that determine the response to beryllium. The animal model may also have implications for pulmonary sarcoidosis, a disease of unknown cause(s), whose disease manifestations and BAL profiles are difficult to distinguish clinically and pathologically from chronic beryllium disease.