Immunology of Mineral Pneumoconioses

"Except for asthma and pulmonary infections, the types of lung disease that have been of immunologic interest the longest are the various mineral pneumoconioses. Because of their chronicity, type of pathology produced, and well-known immunotoxic properties associated with the dusts inciting them, the pneumoconioses have long drawn attention to the possibility that the immune system has not only been modulated but that its effectors have possibly contributed to their pathogenesis. All of the mineral dusts reviewed here have definite immunomodulating properties and act on various cellular and molecular components of the immune system. Further, each has an immunotoxic potential to induce either hypersensitivity (as in the case of beryllium) or other types of immune injury. This article reviews the immunologic aspects of the four major occupational minerals that have an immunologic impact on the lung: asbestos (particularly chrysotile), silica or quartz, beryllium, and coal mine dust.These agents have many things in common, yet each is distinctive. Although the possibility still exists that these mineral particles can adsorb intrinsic tissue antigens or extrinsic organic antigens to their surfaces and initiate immune responses to the adsorbed antigens, only one, beryllium, can act as an antigen itself. Silica is a profound macrophage toxin and thereby exerts many effects on those factors controlled by macrophages. Asbestos has undergone the most immunologic studies resulting in a much dearer picture of how it may contribute to immunopathology. Coal mine dust is the agent about which least is known immunologically, partly because there is no such thing as purified coal mine dust or a standard by which coal mine dust can be defined. Indeed, there are studies that use only the dust from the ground coal itself, whereas other studies use the total dust collected from air samples of a working mine in the belief that other types of dusts (e.g., silica from roof bolt drilling, from sand ground on the rails by cars, and from surface drilling) contribute to the disease (Figs. 1 to 5). This properly is coal mine dust and is poorly characterized. Yet, workers exposed to these dusts share similar reactive characteristics and they may be considered collectively as well as individually."