1887

Chapter 9 : Human Berylliosis

MyBook is a cheap paperback edition of the original book and will be sold at uniform, low price.

Preview this chapter:
Zoom in
Zoomout

Human Berylliosis, Page 1 of 2

| /docserver/preview/fulltext/10.1128/9781555817879/9781555812607_Chap09-1.gif /docserver/preview/fulltext/10.1128/9781555817879/9781555812607_Chap09-2.gif

Abstract:

This chapter focuses on the current understanding of beryllium induced chronic beryllium disease (CBD) based on recent insights provided through the investigation of the immune mechanisms responsible for disease development. CBD is a granulomatous disorder that primarily affects the lungs and lymphatics, although skin, liver, heart, and other organs may also be affected. The presenting symptoms of CBD are nonspecific and usually include the insidious onset of a dry, nonproductive cough, dyspnea on exertion, and fatigue. Other symptoms include chest pain, anorexia, weight loss, fever, night sweats, and arthralgias. It has been suggested that this genetic marker be used to potentially exclude individuals from certain workplaces; however, there remain both ethical concerns and appreciation that beryllium sensitization and CBD can occur in individuals who do not possess this genetic susceptibility marker. Studies of T-cell receptor (TCR) repertoire in CD4 T cells from bronchoalveolar lavage (BAL) of CBD patients confirm that these T cells are accumulating in the lung in response to the presence of conventional antigen. Importantly, the DPB1 alleles that mediate presentation of beryllium in culture closely matched those implicated in disease susceptibility, and these studies confirm that the HLA contribution to disease susceptibility is based on the ability of those molecules to bind and present beryllium to T cells. Corticosteroids are the treatment of choice for CBD, with multiple case series’ showing that these drugs alter the clinical course of CBD.

Citation: Fontenot A, Newman L. 2003. Human Berylliosis, p 245-264. In Boros D (ed), Granulomatous Infections and Inflammations. ASM Press, Washington, DC. doi: 10.1128/9781555817879.ch9

Key Concept Ranking

MHC Class II
0.49489316
Major Histocompatibility Complex
0.46307838
Tumor Necrosis Factor alpha
0.45911852
0.49489316
Highlighted Text: Show | Hide
Loading full text...

Full text loading...

Figures

Image of Figure 1
Figure 1

Immunopathogenesis of chronic beryllium disease. Following the inhalation of beryllium, macrophages present beryllium to CD4 T cells, resulting in T-cell activation, proliferation, and cytokine production. The CD4 T cells secrete Th1-type cytokines (IL-2 and IFN-γ), whereas the antigen-presenting cells produce TNF-α and IL-6.

Citation: Fontenot A, Newman L. 2003. Human Berylliosis, p 245-264. In Boros D (ed), Granulomatous Infections and Inflammations. ASM Press, Washington, DC. doi: 10.1128/9781555817879.ch9
Permissions and Reprints Request Permissions
Download as Powerpoint
Image of Figure 2
Figure 2

Modeling of the HLA-DP molecule based on the crystal structure of the DR1 molecule. A top view of the DR1 peptide-binding groove with the α-chain and β-chain is shown. The polymorphicc harged residues at positions 55–56 and 69 are also shown. Despite the appearance from the ribbon structure, minimal portions of these polymorphic residues are exposed on the outside or top of the β-chain.

Citation: Fontenot A, Newman L. 2003. Human Berylliosis, p 245-264. In Boros D (ed), Granulomatous Infections and Inflammations. ASM Press, Washington, DC. doi: 10.1128/9781555817879.ch9
Permissions and Reprints Request Permissions
Download as Powerpoint

References

/content/book/10.1128/9781555817879.chap9
1. Abbas, A. K.,, K. M. Murphy,, and A. Sher. 1996. Functional diversity of helper T lymphocytes. Nature 383: 787 793.
1. Amicosante, M.,, N. Sanarico,, F. Berretta,, J. Arroyo,, G. Lombardi,, R. Lechler,, V. Colizzi,, and C. Saltini. 2001. Beryllium binding to HLA-DP molecule carrying the marker of susceptibility to berylliosis glutamate beta 69. Hum. Immunol. 62: 686 693.
2. Andrews, J. L.,, H. Kazemi,, and H. L. Hardy. 1969. Patterns of lung dysfunction in chronic beryllium disease. Am. Rev. Respir. Dis. 100: 791 800.
3. Aronchick, J. M.,, M. D. Rossman,, and W. T. Miller. 1987. Chronicberyllium disease: diagnosis, radiographic findings, and correlation with pulmonary function tests. Radiology 163: 677 682.
4. Arstila, T. P.,, A. Casrouge,, V. Baron,, J. Even,, J. Kanellopoulos,, and P. Kourilsky. 2000. Diversity of human alpha beta T cell receptors. Science 288: 1135.
5. Bobka, C. A.,, L. A. Stewart,, G. J. Engelken,, L. E. Golitz,, and L. S. Newman. 1997. Comparison of in vivo and in vitro measures of beryllium sensitization. J. Occup. Environ. Med. 39: 540 547.
6. Budinger, L.,, and M. Hertl. 2000. Immunologic mechanisms in hypersensitivity reactions to metal ions: an overview. Allergy 55: 108 115.
7. Chicz, R. M.,, D. F. Graziano,, M. Trucco,, J. L. Strominger,, and J. C. Gorga. 1997. HLADP2: self peptide sequences and binding properties. J. Immunol. 159: 4935 4942.
8. Cullen, M. R.,, J. R. Kominsky,, M. D. Rossman,, M. G. Cherniack,, J. A. Rankin,, J. R. Balmes,, J. A. Kern,, R. P. Daniele,, L. Palmer,, G. P. Naegel, et al. 1987. Chronicberyllium disease in a precious metal refinery. Clinical epidemiologic and immunologic evidence for continuing risk from exposure to low level beryllium fume. Am. Rev. Respir. Dis. 135: 201 208.
9. Daniloff, E. M.,, D. A. Lynch,, B. B. Bartelson,, J. D. Newell, Jr.,, S. M. Bernstein,, and L. S. Newman. 1997. Observer variation and relationship of computed tomography to severity of beryllium disease. Am. J. Respir. Crit. Care Med. 155: 2047 2056.
10. Epstein, P. E.,, J. H. Dauber,, M. D. Rossman,, and R. P. Daniele. 1982. Bronchoalveolar lavage in a patient with chronic berylliosis: evidence for hypersensitivity pneumonitis. Ann. Intern. Med. 97: 213 216.
11. Finch, G. L.,, M. D. Hoover,, F. F. Hahn,, K. J. Nikula,, S. A. Belinsky,, P. J. Haley,, and W. C. Griffith. 1996. Animal models of beryllium-induced lung disease. Environ. Health Perspect. 104S: 973 979.
11a. Fontenot, A. P.,, S. J. Canavera,, L. Gharavi,, L. S. Newman,, and B. L. Kotzin. 2002. Target organ localization of memory CD4 + T cells in patients with chronic beryllium disease. J. Clin. Investig. 110: 1473 1482.
12. Fontenot, A. P.,, M. T. Falta,, B. M. Freed,, L. S. Newman,, and B. L. Kotzin. 1999. Identification of pathogenic T cells in patients with beryllium-induced lung disease. J. Immunol. 163: 1019 1026.
13. Fontenot, A. P.,, B. L. Kotzin,, C. Comment,, and L. S. Newman. 1998. Expansions of T cell subsets expressing particular T cell receptor variable regions in chronic beryllium disease. Am. J. Respir. Cell Mol. Biol. 18: 581 589.
14. Fontenot, A. P.,, L. A. Maier,, S. J. Canavera,, T. B. Hendry-Hofer,, M. Boguniewicz,, E. A. Barker,, L. S. Newman,, and B. L. Kotzin. 2002. Beryllium skin patch testing to analyze T cell stimulation and granulomatous inflammation in the lung. J. Immunol. 168: 3627 3634.
15. Fontenot, A. P.,, L. S. Newman,, and B. L. Kotzin. 2001. Chronicberyllium disease: T cell recognition of a metal presented by HLA-DP. Clin. Immunol. 100: 4 14.
16. Fontenot, A. P.,, M. Torres,, W. H. Marshall,, L. S. Newman,, and B. L. Kotzin. 2000. Beryllium presentation to CD4 + T cells underlies disease susceptibility HLA-DP alleles in chronic beryllium disease. Proc. Natl. Acad. Sci. USA 97: 12717 12722.
17. Freiman, D. G.,, and H. L. Hardy. 1970. Beryllium disease: the relation of pulmonary pathology to the clinical course and prognosis based on a study of 130 cases from the U.S. Beryllium Case Registry. Hum. Pathol. 1: 25 44.
18. Gilchrist, F. C.,, M. Bunce,, P. A. Lympany,, K. I. Welsh,, and R. M. du Bois. 1998. Comprehensive HLA-DP typing using polymerase chain reaction with sequence-specific primers and 95 sequence-specific primer mixes. Tissue Antigens 51: 51 61.
19. Griem, P.,, K. Takahashi,, H. Kalbacher,, and E. Gleichmann. 1995. The antirheumatic drug disodium aurothiomalate inhibits CD4 + T cell recognition of peptides containing two or more cysteine residues. J. Immunol. 155: 1575 1587.
20. Grunewald, J.,, T. Hultman,, A. Bucht,, A. Eklund,, and H. Wigzel. 1995. Restricted usage of T cell receptor V alpha/J alpha gene segments with different nucleotide but identical amino acid sequences in HLA-DR3 + sarcoidosis patients. Mol. Med. 1: 287 296.
21. Grunewald, J.,, C. H. Janson,, A. Eklund,, M. Ohrn,, O. Olerup,, U. Perrson,, and H. Wigzel. 1992. Restricted Vα2.3 gene usage by CD4 + T lymphocytes in bronchoalveolar lavage fluid from sarcoidosis patients correlates with HLA-DR3. Eur. J. Immunol. 22: 129 135.
22. Grunewald, J.,, O. Olerup,, U. Perrson,, M. B. Ohrn,, H. Wigzell,, and A. Eklund. 1994. T-cell receptor variable region gene usage by CD4 + and CD8 + T cells in bronchoalveolar lavage fluid and peripheral blood of sarcoidosis patients. Proc. Natl. Acad. Sci. USA 91: 4965 4969.
23. Haley, P. J. 1991. Mechanisms of granulomatous lung disease from inhaled beryllium: the role of antigenicity in granuloma formation. Toxicol. Pathol. 19: 514 525.
24. Haley, P. J.,, D. S. Swafford,, G. L. Finch,, M. D. Hoover,, B. A. Muggenburg,, and N. F. Johnson. 1997. Immunologic specificity of lymphocyte cell lines from dogs exposed to beryllium oxide. Immunopharmacol. Immunotoxicol. 19: 459 471.
25. Hammer, J.,, F. Gallazzi,, E. Bono,, R. W. Karr,, J. Gueno,, P. Valsasnini,, Z. A. Nagy,, and F. Sinigaglia. 1995. Peptide binding specificity of HLA-DR4 molecules: correlation with rheumatoid arthritis association. J. Exp. Med. 181: 1847 1855.
26. Harden, P. N.,, C. Geddes,, P. A. Rowe,, J. H. McIlroy,, M. Boulton-Jones,, R. S. Rodger,, B. J. Junor,, J. D. Briggs,, J. M. Connell,, and A. G. Jardine. 1995. Polymorphisms in angiotensin-converting-enzyme gene and progression of IgA nephropathy. Lancet 345: 1540 1542.
27. Hardy, H. L.,, and I. R. Tabershaw. 1946. Delayed chemical pneumonitis in workers exposed to beryllium compounds. J. Ind. Hyg. Toxicol. 28: 197 211.
28. Inoue, Y.,, E. Barker,, E. Daniloff,, N. Kohno,, K. Hiwada,, and L. S. Newman. 1997. Pulmonary epithelial cell injury and alveolar-capillary permeability in berylliosis. Am. J. Respir. Crit. Care Med. 156: 109 115.
29. Inoue, Y.,, T. E. King, Jr.,, S. S. Tinkle,, K. Dockstader,, and L. S. Newman. 1996. Human mast cell basic fibroblast growth factor in pulmonary fibrotic disorders. Am. J. Pathol. 149: 2037 2054.
30. Jones-Williams, W.,, and D. Kelland. 1986. New aid for diagnosing chronic beryllium disease (CBD): laser ion mass analysis (LIMA). J. Clin. Pathol. 39: 900 901.
31. Jones-Williams, W.,, and E. R. Wallach. 1989. Laser microprobe mass spectrometry (LAMMS) analysis of beryllium, sarcoidosis, and other granulomatous diseases. Sarcoidosis 6: 111 117.
32. Kelleher, P. C.,, J. W. Martyny,, M. M. Mroz,, L. A. Maier,, A. J. Ruttenber,, D. A. Young,, and L. S. Newman. 2001. Beryllium particulate exposure and disease relations in a beryllium machining plant. J. Occup. Environ. Med. 43: 238 249.
33. Kreiss, K.,, F. Miller,, L. S. Newman,, E. A. Ojo-Amaize,, M. D. Rossman,, and C. Saltini. 1994. Chronic beryllium disease—from the workplace to cellular immunology, molecular immunogenetics, and back. Clin. Immunol. Immunopathol. 71: 123 129.
34. Kreiss, K.,, M. M. Mroz,, L. S. Newman,, J. Martyny,, and B. Zhen. 1996. Machining risk of beryllium disease and sensitization with median exposures below 2 g/m3. Am. J. Ind. Med. 30: 16 25.
35. Kreiss, K.,, M. M. Mroz,, B. Zhen,, J. W. Martyny,, and L. S. Newman. 1993. Epidemiology of beryllium sensitization and disease in nuclear workers. Am. Rev. Respir. Dis. 148: 985 991.
36. Kreiss, K.,, L. S. Newman,, M. Mroz,, and P. A. Campbell. 1989. Screening blood test identifies subclinical beryllium disease. J. Occup. Med. 31: 603 608.
37. Kreiss, K.,, S. Wasserman,, M. M. Mroz,, and L. S. Newman. 1993. Beryllium disease screening in the ceramics industry: blood test performance and exposure-disease relations. J. Occup. Med. 35: 267 274.
38. Kriebel, D.,, J. D. Brain,, N. L. Sprince,, and H. Kazemi. 1988. The pulmonary toxicity of beryllium. Am. Rev. Respir. Dis. 137: 464 473.
39. Lombardi, G.,, C. Germain,, J. Uren,, M. T. Fiorillo,, R. M. du Bois,, W. Jones-Williams,, C. Saltini,, R. Sorrentino,, and R. Lechler. 2001. HLA-DP allele-specific T cell responses to beryllium account for DP-associated susceptibility to chronic beryllium disease. J. Immunol. 166: 3549 3555.
40. Maier, L. A.,, M. V. Raynolds,, D. A. Young,, E. A. Barker,, and L. S. Newman. 1999. Angiotensin-1 converting enzyme polymorphisms in chronic beryllium disease. Am. J. Respir. Crit. Care Med. 159: 1342 1350.
41. Maier, L. A.,, R. T. Sawyer,, R. A. Bauer,, L. A. Kittle,, P. Lympany,, D. McGrath,, R. Dubois,, E. Daniloff,, C. S. Rose,, and L. S. Newman. 2001. High beryllium-stimulated TNF-alpha is associated with the −308 TNF-alpha promoter polymorphism and with clinical severity in chronic beryllium disease. Am. J. Respir. Crit. Care Med. 164: 1192 1199.
42. Marian, A. J.,, Q. T. Yu,, R. Workman,, G. Greve,, and R. Roberts. 1993. Angiotensinconverting enzyme polymorphism in hypertrophic cardiomyopathy and sudden cardiac death. Lancet 342: 1085 1086.
43. Marrack, P.,, and J. Kappler. 1987. The T cell receptor. Science 238: 1073 1078.
44. Marshall, E. 1999. Beryllium screening raises ethical issues. Science 285: 178 179.
45. Mroz, M. M.,, K. Kreiss,, D. C. Lezotte,, P. A. Campbell,, and L. S. Newman. 1991. Reexamination of the blood lymphocyte transformation test in the diagnosis of chronic beryllium disease. J. Allergy Clin. Immunol. 88: 54 60.
46. Nepom, G. T. 1998. Major histocompatibility complex-directed susceptibility to rheumatoid arthritis. Adv. Immunol. 68: 315 332.
47. Newman, L. S. 1993. To Be2 + or not to Be2 +: immunogenetics and occupational exposure. Science 262: 197 198.
48. Newman, L. S.,, C. Bobka,, B. Schumacher,, E. Daniloff,, B. Zhen,, M. Mroz,, and T. E. King, Jr. 1994. Compartmentalized immune response reflects clinical severity of beryllium disease. Am. J. Respir. Crit. Care Med. 150: 135 142.
49. Newman, L. S.,, D. L. Buschman,, J. D. Newell, Jr., and D. A. Lynch. 1994. Beryllium disease: assessment with CT. Radiology 190: 835 840.
50. Newman, L. S.,, K. Kreiss,, T. E. King, Jr.,, S. Seay,, and P. A. Campbell. 1989. Pathologic and immunologicalterations in early stages of beryllium disease: re-examination of disease definition and natural history. Am. Rev. Respir. Dis. 139: 1479 1486.
51. Newman, L. S.,, J. Lloyd,, and E. Daniloff. 1996. The natural history of beryllium sensitization and chronic beryllium disease. Environ. Health Perspect. 104: 937S 943S.
52. Newman, L. S.,, L. A. Maier,, and B. Nemery,. 1998. Interstitial lung disorders due to beryllium and cobalt, p. 367 392. In M. I. Schwarz, and T. E. King, Jr., (ed), Interstitial Lung Disease, 3rd ed. B.C. Decker Inc., Hamilton, Ontario, Canada.
53. Newman, L. S.,, R. Orton,, and K. Kreiss. 1992. Serum angiotensin converting enzyme activity in chronic beryllium disease. Am. Rev. Respir. Dis. 146: 39 42.
54. Newman, L. S.,, C. S. Rose,, and L. A. Maier. 1997. Sarcoidosis. N. Engl. J. Med. 336: 1224 1234.
55. Nikula, K. J.,, D. S. Swafford,, M. D. Hoover,, M. D. Tohulka,, and G. L. Finch. 1997. Chronicgranulomatous pneumonia and lymphocyticresponses induced by inhaled beryllium metal in A/J and C3H/HeJ mice. Toxicol. Pathol. 25: 2 12.
55a. O'Garra, A. 1998. Cytokines induce the development of functionally heterogeneous T helper cell subsets. Immunity 8: 275 283.
56. Pappas, G. P.,, and L. S. Newman. 1993. Early pulmonary physiologicabnormalities in beryllium disease. Am. Rev. Respir. Dis. 148: 661 666.
57. Penzotti, J. E.,, G. T. Nepom,, and T. P. Lybrand. 1997. Use of T cell receptor/HLADRB1* 04 molecular modeling to predict site-specific interactions for the DR shared epitope associated with rheumatoid arthritis. Arthritis Rheum. 40: 1316 1326.
58. Potolicchio, I.,, A. Festucci,, P. Hausler,, and R. Sorrentino. 1999. HLA-DP molecules bind cobalt: a possible explanation for the genetic association with hard metal disease. Eur. J. Immunol. 29: 2140 2147.
59. Potolicchio, I.,, G. Mosconi,, A. Forni,, B. Nemery,, P. Seghizzi,, and R. Sorrentino. 1997. Susceptibility to hard metal lung disease is strongly associated with the presence of glutamate 69 in HLA-DP beta chain. Eur. J. Immunol. 27: 2741 2743.
60. Raynolds, M. V.,, M. R. Bristow,, E. W. Bush,, W. T. Abraham,, B. D. Lowes,, L. S. Zisman,, C. S. Taft,, and M. B. Perryman. 1993. Angiotensin-converting enzyme DD genotype in patients with ischaemicor idiopathicdilated cardiomyopathy. Lancet 342: 1073 1075.
61. Richeldi, L.,, K. Kreiss,, M. M. Mroz,, B. Zhen,, P. Tartoni,, and C. Saltini. 1997. Interaction of genetic and exposure factors in the prevalence of berylliosis. Am. J. Ind. Med. 32: 337 340.
62. Richeldi, L.,, R. Sorrentino,, and C. Saltini. 1993. HLA-DPB1 glutamate 69: a genetic marker of beryllium disease. Science 262: 242 244.
63. Romagnoli, P.,, A. M. Labhardt,, and F. Sinigaglia. 1991. Selective interaction of Ni with an MHC-bound peptide. EMBO J. 10: 1303 1306.
64. Rossman, M. D.,, J. A. Kern,, J. A. Elais,, M. R. Cullen,, P. E. Epstein,, O. P. Preuss,, T. N. Markham,, and R. P. Daniele. 1988. Proliferative response of bronchoalveolar lymphocytes to beryllium. Ann. Intern. Med. 108: 687 693.
65. Rossman, M. D.,, J. Stubbs,, C. W. Lee,, E. Argyris,, E. Magira,, and D. Monos. 2002. Human leukocyte antigen class II amino acid epitopes: susceptibility and progression markers for beryllium hypersensitivity. Am. J. Respir. Crit. Care Med. 165: 788 794.
66. Saltini, C.,, M. Amicosante,, A. Franchi,, G. Lombardi,, and L. Richeldi. 1998. Immunoge neticbasis of environmental lung disease: lessons from the berylliosis model. Eur. Respir. J. 12: 1463 1475.
67. Saltini, C.,, M. Kirby,, B. C. Trapnell,, N. Tamura,, and R. G. Crystal. 1990. Biased accumulation of T lymphocytes with "memory"-type CD45 leukocyte common antigen gene expression on the epithelial surface of the human lung. J. Exp. Med. 171: 1123 1140.
68. Saltini, C.,, K. Winestock,, M. Kirby,, P. Pinkston,, and R. G. Crystal. 1989. Maintenance of alveolitis in patients with chronic beryllium disease by beryllium-specific helper T cells. N. Engl. J. Med. 320: 1103 1109.
69. Schwartz, B. D., 1995. The major histocompatibility complex, p. 94 113. In R. R. Rich,, T. A. Fleisher,, B. D. Schwartz,, W. T. Shearer,, and W. esur (ed), Clinical Immunology: Principles and Practice, 1st ed. Mosby, St. Louis, Mo.
70. Sinigaglia, F. 1994. The molecular basis of metal recognition by T cells. J. Invest. Dermatol. 102: 398 401.
71. Sinigaglia, F.,, D. Scheidegger,, G. Garotta,, R. Scheffer,, M. Pletscher,, and A. Lanzavecchia. 1985. Isolation and characterization of Ni-specific T cell clones from patients with Ni-contact dermatitis. J. Immunol. 135: 3929 3932.
72. Stern, L. J.,, J. H. Brown,, T. S. Jardetzky,, J. C. Gorga,, R. G. Urban,, J. L. Strominger,, and D. C. Wiley. 1994. Crystal structure of the human class II MHC protein HLA-DR1 complexed with an influenza virus peptide. Nature 368: 215 221.
73. Sterner, J. H.,, and M. Eisenbud. 1951. Epidemiology of beryllium intoxication. Arch. Industr. Hyg. Occ. Med. 4: 123 151.
74. Stoeckle, J. D.,, H. L. Hardy,, and A. L. Weber. 1969. Chronicberyllium disease. Longterm follow-up of sixty cases and selective review of the literature. Am. J. Med. 46: 545 561.
75. Stratmann, T.,, V. Apostolopoulos,, V. Mallet-Designe,, A. L. Corper,, C. A. Scott,, I. A. Wilson,, A. S. Kang,, and L. Teyton. 2000. The I-Ag7 MHC class II molecule linked to murine diabetes is a promiscuous peptide binder. J. Immunol. 165: 3214 3225.
76. Striebich, C. C.,, M. T. Falta,, Y. Wang,, J. Bill,, and B. L. Kotzin. 1998. Selective accumulation of related CD4 + T cell clones in the synovial fluid of patients with rheumatoid arthritis. J. Immunol. 161: 4428 4436.
76. Tinkle, S. S.,, L. A. Kittle,, and L. S. Newman. 1999. Partial IL-10 inhibition of the cellmediated immune response in chronic beryllium disease. J. Immunol. 163: 2747 2753.
77. Tinkle, S. S.,, L. A. Kittle,, B. A. Schumacher,, and L. S. Newman. 1997. Beryllium induces IL-2 and IFN-γ in berylliosis. J. Immunol. 158: 518 526.
78. Tinkle, S. S.,, and L. S. Newman. 1997. Beryllium-stimulated release of tumor necrosis factor-alpha, interleukin-6, and their soluble receptors in chronic beryllium disease. Am. J. Respir. Crit. Care Med. 156: 1884 1891.
79. Todd, J. A.,, H. Acha-Orbea,, J. I. Bell,, N. Chao,, Z. Fronek,, C. O. Jacob,, M. McDermott,, A. A. Sinha,, L. Timmerman,, L. Steinman, et al. 1988. A molecular basis for MHC class II-associated autoimmunity. Science 240: 1003 1009.
80. Wang, Z.,, P. S. White,, M. Petrovic,, O. L. Tatum,, L. S. Newman,, L. A. Maier,, and B. L. Marrone. 1999. Differential susceptibilities to chronic beryllium disease contributed by different Glu69 HLA-DPB1 and -DPA1 alleles. J. Immunol. 163: 1647 1653.
81. Yoshida, T.,, S. Shima,, K. Nagaoka,, H. Taniwaki,, A. Wada,, H. Kurita,, and K. Morita. 1997. A study on the beryllium lymphocyte transformation test and the beryllium levels in working environment. Ind. Health 35: 374 379.

Tables

Generic image for table
Table 1

Industries that utilize beryllium

Citation: Fontenot A, Newman L. 2003. Human Berylliosis, p 245-264. In Boros D (ed), Granulomatous Infections and Inflammations. ASM Press, Washington, DC. doi: 10.1128/9781555817879.ch9
Generic image for table
Table 2

DP β-chain amino acid sequences of beryllium-presenting and nonpresenting alleles

Citation: Fontenot A, Newman L. 2003. Human Berylliosis, p 245-264. In Boros D (ed), Granulomatous Infections and Inflammations. ASM Press, Washington, DC. doi: 10.1128/9781555817879.ch9

This is a required field
Please enter a valid email address
Please check the format of the address you have entered.
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error