Surfactant protein-D and exposure to bioaerosols in wastewater and garbage workers.

PURPOSE: Bioaerosols and their constituents, such as endotoxins, are capable of causing an inflammatory reaction at the level of the lung-blood barrier, which becomes more permeable. Thus, it was hypothesized that occupational exposure to bioaerosols can increase leakage of surfactant protein-D (SP-D), a lung-specific protein, into the bloodstream. METHODS: SP-D was determined by ELISA in 316 wastewater workers, 67 garbage collectors, and 395 control subjects. Exposure was assessed with four interview-based indicators and by preliminary endotoxin measurements using the Limulus amoebocyte lysate assay. Influence of exposure on serum SP-D was assessed by multiple linear regression considering smoking, glomerular function, lung diseases, obesity, and other confounders. RESULTS: Overall, mean exposure levels to endotoxins were below 100 EU/m(3). However, special tasks of wastewater workers caused higher endotoxin exposure. SP-D concentration was slightly increased in this occupational group and associated with the occurrence of splashes and contact to raw sewage. No effect was found in garbage collectors. Smoking increased serum SP-D. No clinically relevant correlation between spirometry results and SP-D concentrations appeared. CONCLUSIONS: These results support the hypothesis that inhalation of bioaerosols, even at low concentrations, has a subclinical effect on the lung-blood barrier, the permeability of which increases without associated spirometric changes.

Occupational exposure of truck drivers to dust and polynuclear aromatic hydrocarbons: a pilot study in Geneva, Switzerland.

The exposure to dust and polynuclear aromatic hydrocarbons (PAH) of 15 truck drivers from Geneva, Switzerland, was measured. The drivers were divided between "long-distance" drivers and "local" drivers and between smokers and nonsmokers and were compared with a control group of 6 office workers who were also divided into smokers and nonsmokers. Dust was measured on 1 workday both by a direct-reading instrument and by sampling. The local drivers showed higher exposure to dust (0.3 mg/m3) and PAH than the long-distance drivers (0.1 mg/m3), who showed no difference with the control group. This observation may be due to the fact that the local drivers spend more time in more polluted areas, such as streets with heavy traffic and construction sites, than do the long-distance drivers. Smoking does not influence exposure to dust and PAH of professional truck drivers, as measured in this study, probably because the ventilation rate of the truck cabins is relatively high even during cold days (11-15 r/h). The distribution of dust concentrations was shown in some cases to be quite different from the expected log-normal distribution. The contribution of diesel exhaust to these exposures could not be estimated since no specific tracer was used. However, the relatively low level of dust exposure dose not support the hypothesis that present day levels of diesel exhaust particulates play a significant role in the excess occurrence of lung cancer observed in professional truck drivers.

Clara cell protein and surfactant protein B in garbage collectors and in wastewater workers exposed to bioaerosols

OBJECTIVES: Inhalation of bioaerosols has been hypothesised to cause "toxic pneumonitis" that should increase lung epithelial permeability at the bronchioloalveolar level. Serum Clara cell protein (CC16) and serum surfactant protein B (SPB) have been proposed as sensitive markers of lung epithelial injury. This study was aimed at looking for increased lung epithelial permeability by determining CC16 and SPB in workers exposed to bioaerosols from wastewater or garbage. METHODS: Subjects (778 wastewater, garbage and control workers; participation 61%) underwent a medical examination, lung function tests [American Thoracic Society (ATS) criteria], and determination of CC16 and SPB. Symptoms of endotoxin exposure and several potential confounders (age, gender, smoking, kidney function, obesity) were looked for. Results were examined with multiple linear or logistic regression. RESULTS: Exposure to bioaerosols increased CC16 concentration in the wastewater workers. No effect of exposure on SPB was found. No clue to work-related respiratory diseases was found. CONCLUSIONS: The increase in CC16 in serum supports the hypothesis that bioaerosols cause subclinical "toxic pneumonitis", even at low exposure. [Authors]

Surfactant protein A, exposure to endotoxin, and asthma in garbage collectors and in wastewater workers.

Endotoxin causes an inflammation at the bronchial and alveolar level. The inflammation-induced increase in permeability of the bronchoalveolar epithelial barrier is supposed to cause a leakage of pneumoproteins. Therefore, their concentrations are expected to increase in the bloodstream.This study aimed at examining the association between occupational exposure to endotoxin and a serum pneumoprotein, surfactant protein A, to look for nonoccupational factors capable of confounding this association, and examine the relation between surfactant protein A and spirometry. There were 369 control subjects, 325 wastewater workers, and 84 garbage collectors in the study. Exposure to endotoxin was assessed through personal sampling and the Limulus amebocytes lysate assay. Surfactant protein A was determined by an in house sandwich enzyme-linked immunosorbent assay (ELISA) in 697 subjects. Clinical and smoking history were ascertained and spirometry carried out according to American Thoracic Society criteria. Multiple linear regression was used for statistical analysis. Exposure was fairly high during some tasks in wastewater workers but did not influence surfactant protein A. Surfactant protein A was lower in asthmatics. Interindividual variability was large. No correlation with spirometry was found. Endotoxin has no effect on surfactant protein A at these endotoxin levels and serum surfactant protein A does not correlate with spirometry. The decreased surfactant protein A secretion in asthmatics requires further study.

Exposure to bioaerosols, respiratory health and lung-specific proteins: a prospective study in garbage and wastewater workers.

Objectives To prospectively assess respiratory health in wastewater workers and garbage collectors over 5 years. Methods Exposure, respiratory symptoms and conditions, spirometry and lung-specific proteins were assessed yearly in a cohort of 304 controls, 247 wastewater workers and 52 garbage collectors. Results were analysed with random coefficient models and linear regression taking into account several potential confounders. Results Symptoms, spirometry and lung-specific proteins were not affected by occupational exposure. Conclusions In this population no effects of occupational exposure to bioaerosols were found, probably because of good working conditions.

The modern holy shroud.

Testimonies disclosed that a 44-year-old pedestrian was struck head-on by a truck while she was roaming on the motorway; at the time of collision, the truck was travelling at a speed of about 90 km/h. In the second phase of the collision, the pedestrian was projected about 100 m before her body was run over by the truck and then by a car. The autopsy revealed extensive mutilations, making it impossible to verify the testimonies of witnesses to the collision as regards the pedestrian's position at the moment of the first impact. However, the reports produced by the technical expert and the forensic pathologist were able to confirm the testimonies, based on an impact zone on the front panel of the cab of the truck, where part of the pedestrian's face was reproduced like a "modern holy shroud".

Alveolar epithelial CNGA1 channels mediate cGMP-stimulated, amiloride-insensitive, lung liquid absorption.

Impairment of lung liquid absorption can lead to severe respiratory symptoms, such as those observed in pulmonary oedema. In the adult lung, liquid absorption is driven by cation transport through two pathways: a well-established amiloride-sensitive Na(+) channel (ENaC) and, more controversially, an amiloride-insensitive channel that may belong to the cyclic nucleotide-gated (CNG) channel family. Here, we show robust CNGA1 (but not CNGA2 or CNGA3) channel expression principally in rat alveolar type I cells; CNGA3 was expressed in ciliated airway epithelial cells. Using a rat in situ lung liquid clearance assay, CNG channel activation with 1 mM 8Br-cGMP resulted in an approximate 1.8-fold stimulation of lung liquid absorption. There was no stimulation by 8Br-cGMP when applied in the presence of either 100 μM L: -cis-diltiazem or 100 nM pseudechetoxin (PsTx), a specific inhibitor of CNGA1 channels. Channel specificity of PsTx and amiloride was confirmed by patch clamp experiments showing that CNGA1 channels in HEK 293 cells were not inhibited by 100 μM amiloride and that recombinant αβγ-ENaC were not inhibited by 100 nM PsTx. Importantly, 8Br-cGMP stimulated lung liquid absorption in situ, even in the presence of 50 μM amiloride. Furthermore, neither L: -cis-diltiazem nor PsTx affected the β(2)-adrenoceptor agonist-stimulated lung liquid absorption, but, as expected, amiloride completely ablated it. Thus, transport through alveolar CNGA1 channels, located in type I cells, underlies the amiloride-insensitive component of lung liquid reabsorption. Furthermore, our in situ data highlight the potential of CNGA1 as a novel therapeutic target for the treatment of diseases characterised by lung liquid overload.

Ethanol among randomly controlled drivers

Objectives: Ethanol is well-known to impair driving ability. The major aim of this study was to evaluate the number of drivers driving under the influence of ethanol in a population of randomly controlled drivers. Methods: 1016 drivers were randomly controlled at 27 different locations in Western Switzerland from October 2006 to April 2008. Drivers were controlled for alcohol consumption with a breathalyzer according to the Swiss Road traffic law. If the result was equal or higher than an equivalent of a blood alcohol concentration of 0.8 g/kg, a blood sample was taken; otherwise, a saliva sample was obtained. Blood and saliva were analysed for ethanol by Head-space gas chromatography coupled with a FID detector. Results: Among the controlled drivers, men (69%) predominated over female (31%). The mean age was 41 (range: 16 90). For 968 drivers (95.3%) ethanol was not detected in blood or saliva. These drivers were not under the influence of ethanol. Ethanol was detected in saliva or blood of 48 drivers (4.7%). Among these drivers, blood alcohol concentration (BAC) was above the legal limit of 0.8 g/kg (serious offence) in 14 cases (1.4% of the total population). BAC were in the range of 0.91 to 2.43 g/kg (mean: 1.32 g/kg, median: 1.11 g/kg). Among these 14 cases, men (13 cases, 93%) were over represented. No ethanol was found in the population of truck drivers (17 cases). 986 drivers were car drivers and 46 of them have drunk ethanol (5%). 13 bikers were controlled and 2 of them have drunk ethanol (15%). Conclusion: Driving under the influence of ethanol concerned about 5% of a population of randomly controlled drivers, and 1,4% of the drivers had a blood alcohol concentration higer than 0.8 g/kg (legale limit for a serious offence).

Sensing the environment : a role for the mouse olfactory subsystems

Summary : Four distinct olfactory subsystems compose the mouse olfactory system, the main olfactory epithelium (MOE), the septal organ of Masera (SO), the vomeronasal organ (VNO) and the Grueneberg ganglion (GG). They are implicated in the sensory modalities of the animal and they evolved to analyse and discriminate molecules carrying chemical messages, such as odorants and pheromones. In this thesis, the VNO, principally implicated in pheromonal communications as well as the GG, which had no function attributed until this work, were investigated from their morphology to their physiological functions, using an array of biochemical and physiological methods. First, the roles of a particular protein, the CNGA4 ion channel, were investigated in the VNO. In the MOE, CNGA4 is expressed as a modulatory channel subunit implicated in odour discrimination and adaptation. Interestingly, this calcium channel is the unique member of the cyclic nucleotide-gated (CNG) family to be expressed in the VNO and up to this work its functions remained unknown. Using a combination of transgenic and knockout mice, as well as histological and physiological approaches, we have characterized CNGA4 expression in the VNO. A strong expression in immature neurons was found as well as in the microvilli of mature neurons (putative site of chemodetection). Interestingly and confirming its dual localisation, the genetic invalidation of the CNGA4 channel has, as consequences, a strong impairment in vomeronasal maturation as well as deficit in pheromone sensing. Thus the CNGA4 channel appears to be a multifunctional protein in the mouse VNO playing essential role(s) in this organ. During the second part of the work, the morphology of the most recently described olfactory subsystem, the Grueneberg ganglion, was investigated in detail. Interestingly we found that glial cells and ciliated neurons compose this olfactory ganglion. This particular morphological aspect was similar to the olfactory AWC neurons from C. elegans which was used for further comparisons. Thus as for AWC neurons, we found that GG neurons are sensitive to temperature changes and are able to detect highly volatile molecules. Indeed, the presence of alarm pheromones (APs) secreted by stressed mice, elicit strong cellular responses, as well as a GG dependent behavioural changes. Investigations on the signaling elements present in GG neurons revealed that, as for AWC neurons, or pGC-D expressing neurons from the MOE, proteins participating in a cGMP pathway were found in GG neurons such as pGC-G and CNGA3 channels. These two proteins might be implicated in chemosensing as well as in thermosensing, two apparent properties of this organ. In this thesis, the multisensory modalities of two mouse olfactory subsystems were described and are related to a high degree of complexity required for the animal to sense its environment

Alveolar epithelial CNGA1 channels mediate cGMP-stimulated, amiloride-insensitive, lung liquid absorption.

Impairment of lung liquid absorption can lead to severe respiratory symptoms, such as those observed in pulmonary oedema. In the adult lung, liquid absorption is driven by cation transport through two pathways: a well-established amiloride-sensitive Na(+) channel (ENaC) and, more controversially, an amiloride-insensitive channel that may belong to the cyclic nucleotide-gated (CNG) channel family. Here, we show robust CNGA1 (but not CNGA2 or CNGA3) channel expression principally in rat alveolar type I cells; CNGA3 was expressed in ciliated airway epithelial cells. Using a rat in situ lung liquid clearance assay, CNG channel activation with 1 mM 8Br-cGMP resulted in an approximate 1.8-fold stimulation of lung liquid absorption. There was no stimulation by 8Br-cGMP when applied in the presence of either 100 μM L: -cis-diltiazem or 100 nM pseudechetoxin (PsTx), a specific inhibitor of CNGA1 channels. Channel specificity of PsTx and amiloride was confirmed by patch clamp experiments showing that CNGA1 channels in HEK 293 cells were not inhibited by 100 μM amiloride and that recombinant αβγ-ENaC were not inhibited by 100 nM PsTx. Importantly, 8Br-cGMP stimulated lung liquid absorption in situ, even in the presence of 50 μM amiloride. Furthermore, neither L: -cis-diltiazem nor PsTx affected the β(2)-adrenoceptor agonist-stimulated lung liquid absorption, but, as expected, amiloride completely ablated it. Thus, transport through alveolar CNGA1 channels, located in type I cells, underlies the amiloride-insensitive component of lung liquid reabsorption. Furthermore, our in situ data highlight the potential of CNGA1 as a novel therapeutic target for the treatment of diseases characterised by lung liquid overload.

Sensing pheromones : a role for the CNGA4 and TRPC2 proteins

Chez les mammifères, les phéromones sont des molécules clés dans la régulation des comportements sociaux au sein d'une espèce. Chez la souris, la détection de ces molécules se fait dans l'organe voméronasal (VNO] et implique le canal TRPC2 afin de dépolariser les neurones. Des différences de comportement entre des souris Trpc2-/- et des souris sans VNO suggèrent l'implication d'une autre protéine effectrice dans la voie de signalisation des phéromones. L'hypothèse étant que cette protéine formerait un canal hétéromérique avec TRPC2. CNGA4 est une protéine sans fonction connue dans le VNO des rongeurs. Elle appartient à la famille des protéines CNG qui joue un rôle important dans différentes voies de signalisation comme la vision ou l'olfaction. Etant donné sa présence dans le VNO, son rôle inconnu dans cet organe et son rôle important dans de nombreuses voies de signalisation, nous avons décidé d'étudier CNGA4 afin de connaître sa localisation, ses propriétés ou encore sa structure. Nous avons découvert que CNGA4 est exprimée dans les axons, les neurones immatures ainsi que sur les microvillosités des neurones de VNO. A l'aide de souris portant une version non fonctionnelle de CNGA4, nous avons pu montrer que cette protéine joue un rôle majeur dans la voie de signalisation des phéromones. Ainsi, les neurones du VNO portant une version non fonctionnelle de CNGA4 répondent moins fréquemment aux phéromones et par conséquent les phéromones activent également moins de neurones dans le bulbe olfactif accessoire, premier relais du VNO avec le cortex. Cette détection défaillante se traduit par une absence d'agressivité des souris mutantes ainsi que par une incapacité de ces souris à discriminer le sexe de leur conspécifique. Etant donné les propriétés similaires de CNGA4 et de TRPC2, nous avons supposé que les deux protéines pourraient interagir. Cette hypothèse a été confortée par l'observation que CNGA4 n'est plus exprimée dans les microvillosités du VNO des souris Trpc2-/-. A l'aide d'expériences d'expression hétérologue, nous avons pu observer que les deux protéines interagissent et forment un canal activé par un analogue du diacylglycérol suggérant que ce canal est fonctionnel. Ces résultats indiquent que CNGA4 formerait un canal hétéromérique avec TRPC2 et aurait dans ce canal une fonction modulatrice. Des expériences complémentaires sont nécessaires afin de connaître le rôle de chacune de ces protéines dans la voie de signalisation des phéromones. Sensing pheromones: a role for the CNGA4 and TRPC2 proteins Mammalian pheromones are key chemical signals in the regulation of intraspecies social behaviors. Detection of these pheromones, which takes place in sensory neurons of the vomeronasal organ (VNO), implies the activation of the transient receptor potential canonical channel 2 (TRPC2) as the final effector. Interestingly, discrepancies between Trpc2 /- mice and mice lacking a VNO suggest the implication of another protein in the pheromone signaling pathway. This protein could either form a heteromeric channel with TRPC2 or a separate homomeric ion channel. The cyclic nucleotide-gated channel subunit CNGA4 is also expressed in the rodent VNO but its role and properties in this organ remain unknown. CNGA4 belongs to the CNG channel family which is playing an important role in different sensory pathways such as in light and odorant detection. We thus decided to study the role of the CNGA4 protein in the mouse VNO. We found CNGA4 to be expressed in axons, dendrites and in the sensory microvilli. Using mice bearing a non-functional form of CNGA4 we further demonstrated the importance of the CNGA4 protein for the pheromone signaling pathway as neurons from mutant mice were responding less frequently to chemosensory cues. As a result, mutant mice displayed a non-aggressive behavior and an impaired sexual discrimination ability. Based on the CNGA4 localization and its role in the pheromone signaling pathway we hypothesized a possible interaction between CNGA4 and TRPC2 forming a heteromeric channel. First evidences for this interaction came from the absence of CNGA4 expression in the sensory microvilli of Trpc2-/- mice. Second, using transfected HEK cells as an expression system we could observe that CNGA4 and TRPC2 interact and translocate to the plasma membrane. Perfusion of a DAG analogue on co-transfected HEK cells resulted in a strong calcium entry suggesting that the two proteins form a functional channel. These results might suggest a modulatory role for CNGA4 in a heteromeric TRPC2+CNGA4 ion channel. Further experiments will give more insights on the combined role of these transduction ion channels in pheromone detection.