Indium kinetics in an indium exposed worker before and after bilateral lung transplantation.
Emphysema
ITO
Indium
Indium kinetics
Lung transplantation
Pneumoconiosis
Journal
Journal of occupational health
ISSN: 1348-9585
Titre abrégé: J Occup Health
Pays: Australia
ID NLM: 9616320
Informations de publication
Date de publication:
Jan 2020
Jan 2020
Historique:
received:
06
07
2020
revised:
18
08
2020
accepted:
21
08
2020
entrez:
20
9
2020
pubmed:
21
9
2020
medline:
13
5
2021
Statut:
ppublish
Résumé
A male worker with indium-tin oxide (ITO)-induced pneumoconiosis underwent bilateral lung transplantation (LT). Post-LT histopathological investigations of the isolated lungs and hilar lymph nodes were performed and indium concentration in serum (In-S) and serum Krebs von den Lungen-6 (KL-6) were tracked for 122 weeks. He has attained the ultimate treatment goal of > 2-year survival. The main histopathological characteristics were pan-lobular emphysematous change, interstitial fibrosis, and lymphocytic infiltration in the peribronchiolar/perivascular portions, and numerous cholesterol clefts and giant cells containing brown particles. These findings support the conclusion that the lung injury was caused by the inhalation of ITO. Metal element mapping and indium in the isolated lungs revealed that inhaled ITO particles in humans migrate to the lymph nodes. In-S remained at remarkably high levels (≥30 ng/mL) and showed wide fluctuation with bimodality until 46 weeks after LT, but KL-6 remained in the normal range for almost the entire period. The indium concentration in the donor's resection lung at 10 weeks after LT was 143.5 ng/g wet-weight, which was only one one-thousandth of the recipient's lung (161 µg/g wet-weight). After 48 weeks of LT, the recipient's In-S had gradually decreased; the biological half-life was 1.2 years. These results clearly suggest that indium remaining in the recipient's tissues did not adversely influence the transplant donor's lungs. The transplanted donor's lungs were not influenced by indium in the recipient's organs. Bilateral LT is thus an effective treatment option in severe indium lung disease cases.
Sections du résumé
BACKGROUND
BACKGROUND
A male worker with indium-tin oxide (ITO)-induced pneumoconiosis underwent bilateral lung transplantation (LT).
METHODS
METHODS
Post-LT histopathological investigations of the isolated lungs and hilar lymph nodes were performed and indium concentration in serum (In-S) and serum Krebs von den Lungen-6 (KL-6) were tracked for 122 weeks.
RESULTS
RESULTS
He has attained the ultimate treatment goal of > 2-year survival. The main histopathological characteristics were pan-lobular emphysematous change, interstitial fibrosis, and lymphocytic infiltration in the peribronchiolar/perivascular portions, and numerous cholesterol clefts and giant cells containing brown particles. These findings support the conclusion that the lung injury was caused by the inhalation of ITO. Metal element mapping and indium in the isolated lungs revealed that inhaled ITO particles in humans migrate to the lymph nodes. In-S remained at remarkably high levels (≥30 ng/mL) and showed wide fluctuation with bimodality until 46 weeks after LT, but KL-6 remained in the normal range for almost the entire period. The indium concentration in the donor's resection lung at 10 weeks after LT was 143.5 ng/g wet-weight, which was only one one-thousandth of the recipient's lung (161 µg/g wet-weight). After 48 weeks of LT, the recipient's In-S had gradually decreased; the biological half-life was 1.2 years. These results clearly suggest that indium remaining in the recipient's tissues did not adversely influence the transplant donor's lungs.
CONCLUSIONS
CONCLUSIONS
The transplanted donor's lungs were not influenced by indium in the recipient's organs. Bilateral LT is thus an effective treatment option in severe indium lung disease cases.
Identifiants
pubmed: 32951288
doi: 10.1002/1348-9585.12165
pmc: PMC7507028
doi:
Substances chimiques
Air Pollutants, Occupational
0
MUC1 protein, human
0
Mucin-1
0
Tin Compounds
0
indium tin oxide
71243-84-0
Types de publication
Case Reports
Langues
eng
Sous-ensembles de citation
IM
Pagination
e12165Subventions
Organisme : Grants-in-aid for Scientific Research from the Ministry of Education, Culture, Sports, Science and Technology of Japan
ID : 16K09107
Organisme : Grants-in-aid for Scientific Research from the Ministry of Education, Culture, Sports, Science and Technology of Japan
ID : 19H03906
Informations de copyright
© 2020 The Authors. Journal of Occupational Health published by John Wiley & Sons Australia, Ltd on behalf of The Japan Society for Occupational Health.
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