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  1. Article ; Online: Effects of inhaled tier-2 diesel engine exhaust on immunotoxicity in a rat model: A hazard identification study. Part II. Immunotoxicology.

    Weatherly, Lisa M / Shane, Hillary L / Baur, Rachel / Lukomska, Ewa / McKinney, Walter / Roberts, Jenny R / Fedan, Jeffrey S / Anderson, Stacey E

    Toxicology reports

    2024  Volume 12, Page(s) 135–147

    Abstract: Diesel exhaust (DE) is an air pollutant containing gaseous compounds and particulate matter. Diesel engines are common on gas extraction and oil sites, leading to complex DE exposure to a broad range of compounds through occupational settings. The US EPA ...

    Abstract Diesel exhaust (DE) is an air pollutant containing gaseous compounds and particulate matter. Diesel engines are common on gas extraction and oil sites, leading to complex DE exposure to a broad range of compounds through occupational settings. The US EPA concluded that short-term exposure to DE leads to allergic inflammatory disorders of the airways. To further evaluate the immunotoxicity of DE, the effects of whole-body inhalation of 0.2 and 1 mg/m
    Language English
    Publishing date 2024-01-15
    Publishing country Ireland
    Document type Journal Article
    ZDB-ID 2805786-7
    ISSN 2214-7500 ; 2214-7500
    ISSN (online) 2214-7500
    ISSN 2214-7500
    DOI 10.1016/j.toxrep.2024.01.004
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  2. Article ; Online: Systemic and immunotoxicity induced by topical application of perfluorohexane sulfonic acid (PFHxS) in a murine model.

    Weatherly, Lisa M / Shane, Hillary L / Jackson, Laurel G / Lukomska, Ewa / Baur, Rachel / Cooper, Madison P / Anderson, Stacey E

    Food and chemical toxicology : an international journal published for the British Industrial Biological Research Association

    2024  Volume 186, Page(s) 114578

    Abstract: Per- and polyfluoroalkyl substances (PFAS) are a large group of stable synthetic surfactants that are incorporated into numerous products for their water and oil resistance and have been associated with adverse health effects. The present study evaluated ...

    Abstract Per- and polyfluoroalkyl substances (PFAS) are a large group of stable synthetic surfactants that are incorporated into numerous products for their water and oil resistance and have been associated with adverse health effects. The present study evaluated the systemic and immunotoxicity of sub-chronic 28- or 10-day dermal exposure of PFHxS (0.625-5% or 15.63-125 mg/kg/dose) in a murine model. Elevated levels of PFHxS were detected in the serum and urine, suggesting that absorption is occurring through the dermal route. Liver weight (% body) significantly increased and spleen weight (% body) significantly decreased with PFHxS exposure, which was supported by histopathological changes. Additionally, PFHxS significantly reduced the humoral immune response and altered immune subsets in the spleen, suggesting immunosuppression. Gene expression changes were observed in the liver, skin, and spleen with genes involved in fatty acid metabolism, necrosis, and inflammation. Immune-cell phenotyping identified significant decreases in B-cells, NK cells, and CD11b
    MeSH term(s) Mice ; Animals ; Disease Models, Animal ; CD8-Positive T-Lymphocytes ; Sulfonic Acids/toxicity ; Fluorocarbons/analysis ; Alkanesulfonic Acids ; Environmental Pollutants
    Chemical Substances perfluorohexanesulfonic acid (355-46-4) ; Sulfonic Acids ; Fluorocarbons ; Alkanesulfonic Acids ; Environmental Pollutants
    Language English
    Publishing date 2024-03-06
    Publishing country England
    Document type Journal Article
    ZDB-ID 782617-5
    ISSN 1873-6351 ; 0278-6915
    ISSN (online) 1873-6351
    ISSN 0278-6915
    DOI 10.1016/j.fct.2024.114578
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  3. Article ; Online: Exposure to the immunomodulatory chemical triclosan differentially impacts immune cell populations in the skin of haired (BALB/c) and hairless (SKH1) mice.

    Baur, Rachel / Shane, Hillary L / Weatherly, Lisa M / Lukomska, Ewa / Kashon, Michael / Anderson, Stacey E

    Toxicology reports

    2022  Volume 9, Page(s) 1766–1776

    Abstract: Workers across every occupational sector have the potential to be exposed to a wide variety of chemicals, and the skin is a primary route of exposure. Furthermore, exposure to certain chemicals has been linked to inflammatory and allergic diseases. Thus, ...

    Abstract Workers across every occupational sector have the potential to be exposed to a wide variety of chemicals, and the skin is a primary route of exposure. Furthermore, exposure to certain chemicals has been linked to inflammatory and allergic diseases. Thus, understanding the immune responses to chemical exposures on the skin and the potential for inflammation and sensitization is needed to improve worker safety and health. Responses in the skin microenvironment impact the potential for sensitization; these responses may include proinflammatory cytokines, inflammasome activation, barrier integrity, skin microbiota, and the presence of immune cells. Selection of specific mouse strains to evaluate skin effects, such as haired (BALB/c) or hairless (SKH1) mice, varies dependent on experimental design and needs of a study. However, dermal chemical exposure may impact reactions in the skin differently depending on the strain of mouse. Additionally, there is a need for established methods to evaluate immune responses in the skin. In this study, exposure to the immunomodulatory chemical triclosan was evaluated in two mouse models using immunophenotyping by flow cytometry and gene expression analysis. BALB/c mice exposed to triclosan (2%) had a higher number and frequency of neutrophils and lower number and frequency of dendritic cells in the skin compared to controls. Although these changes were not observed in SKH1 mice, SKH1 mice exposed to triclosan had a higher number and frequency of type 2 innate lymphoid cells in the skin. Taken together, these results demonstrate that exposure to an immunomodulatory chemical, triclosan, differentially impacts immune cell populations in the skin of haired and hairless mice. Additionally, the flow cytometry panel reported in this manuscript, in combination with gene expression analysis, may be useful in future studies to better evaluate the effect of chemical exposures on the skin immune response. These findings may be important to consider during strain selection, experimental design, and result interpretation of chemical exposures on the skin.
    Language English
    Publishing date 2022-09-09
    Publishing country Ireland
    Document type Journal Article
    ZDB-ID 2805786-7
    ISSN 2214-7500 ; 2214-7500
    ISSN (online) 2214-7500
    ISSN 2214-7500
    DOI 10.1016/j.toxrep.2022.09.005
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  4. Article ; Online: Systemic toxicity induced by topical application of perfluoroheptanoic acid (PFHpA), perfluorohexanoic acid (PFHxA), and perfluoropentanoic acid (PFPeA) in a murine model.

    Weatherly, Lisa M / Shane, Hillary L / Lukomska, Ewa / Baur, Rachel / Anderson, Stacey E

    Food and chemical toxicology : an international journal published for the British Industrial Biological Research Association

    2022  Volume 171, Page(s) 113515

    Abstract: Per- and polyfluoroalkyl substances (PFAS) are a class of synthetic structurally diverse chemicals incorporated into industrial and consumer products. PFHpA, PFHxA, and PFPeA are carboxylic PFAS (C7, C6, C5, respectively) labeled as a safer alternative ... ...

    Abstract Per- and polyfluoroalkyl substances (PFAS) are a class of synthetic structurally diverse chemicals incorporated into industrial and consumer products. PFHpA, PFHxA, and PFPeA are carboxylic PFAS (C7, C6, C5, respectively) labeled as a safer alternative to legacy carboxylic PFAS due to their shorter half-life in animals. Although there is a high potential for dermal exposure, these studies are lacking. The present study conducted analyses of serum chemistries, immune phenotyping, gene expression, and histology to evaluate the systemic toxicity of a sub-chronic 28-day dermal exposure of alternative PFAS (1.25-5% or 31.25-125 mg/kg/dose) in a murine model. Liver weight (% body) significantly increased with PFHpA, PFHxA, and PFPeA exposure and histopathological changes were observed in both the liver and skin. Gene expression changes were observed with PPAR isoforms in the liver and skin along with changes in genes involved in steatosis, fatty acid metabolism, necrosis, and inflammation. These findings, along with significant detection levels in serum and urine, support PFAS-induced liver damage and PPARα, δ, and γ involvement in alternative PFAS systemic toxicity and immunological disruption. This demonstrates that these compounds can be absorbed through the skin and brings into question whether these PFAS are a suitable alternative to legacy PFAS.
    MeSH term(s) Mice ; Animals ; Disease Models, Animal ; Alkanesulfonic Acids ; Fluorocarbons/toxicity
    Chemical Substances perfluoropentanoic acid ; perfluorohexanoic acid (ZP34Q2220R) ; perfluoro-n-heptanoic acid (375-85-9) ; Alkanesulfonic Acids ; Fluorocarbons
    Language English
    Publishing date 2022-11-24
    Publishing country England
    Document type Journal Article
    ZDB-ID 782617-5
    ISSN 1873-6351 ; 0278-6915
    ISSN (online) 1873-6351
    ISSN 0278-6915
    DOI 10.1016/j.fct.2022.113515
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  5. Article ; Online: Exposure to the immunomodulatory chemical triclosan differentially impacts immune cell populations in the skin of haired (BALB/c) and hairless (SKH1) mice

    Baur, Rachel / Shane, Hillary L. / Weatherly, Lisa M. / Lukomska, Ewa / Kashon, Michael / Anderson, Stacey E.

    Toxicology Reports. 2022, v. 9 p.1766-1776

    2022  

    Abstract: Workers across every occupational sector have the potential to be exposed to a wide variety of chemicals, and the skin is a primary route of exposure. Furthermore, exposure to certain chemicals has been linked to inflammatory and allergic diseases. Thus, ...

    Abstract Workers across every occupational sector have the potential to be exposed to a wide variety of chemicals, and the skin is a primary route of exposure. Furthermore, exposure to certain chemicals has been linked to inflammatory and allergic diseases. Thus, understanding the immune responses to chemical exposures on the skin and the potential for inflammation and sensitization is needed to improve worker safety and health. Responses in the skin microenvironment impact the potential for sensitization; these responses may include proinflammatory cytokines, inflammasome activation, barrier integrity, skin microbiota, and the presence of immune cells. Selection of specific mouse strains to evaluate skin effects, such as haired (BALB/c) or hairless (SKH1) mice, varies dependent on experimental design and needs of a study. However, dermal chemical exposure may impact reactions in the skin differently depending on the strain of mouse. Additionally, there is a need for established methods to evaluate immune responses in the skin. In this study, exposure to the immunomodulatory chemical triclosan was evaluated in two mouse models using immunophenotyping by flow cytometry and gene expression analysis. BALB/c mice exposed to triclosan (2%) had a higher number and frequency of neutrophils and lower number and frequency of dendritic cells in the skin compared to controls. Although these changes were not observed in SKH1 mice, SKH1 mice exposed to triclosan had a higher number and frequency of type 2 innate lymphoid cells in the skin. Taken together, these results demonstrate that exposure to an immunomodulatory chemical, triclosan, differentially impacts immune cell populations in the skin of haired and hairless mice. Additionally, the flow cytometry panel reported in this manuscript, in combination with gene expression analysis, may be useful in future studies to better evaluate the effect of chemical exposures on the skin immune response. These findings may be important to consider during strain selection, experimental design, and result interpretation of chemical exposures on the skin.
    Keywords cytokines ; experimental design ; exposure pathways ; flow cytometry ; gene expression ; immune response ; immunophenotyping ; inflammasomes ; inflammation ; mice ; microorganisms ; neutrophils ; occupational health and safety ; toxicology ; triclosan ; Skin ; Dendritic cells ; ILC2s
    Language English
    Size p. 1766-1776.
    Publishing place Elsevier B.V.
    Document type Article ; Online
    Note Use and reproduction
    ZDB-ID 2805786-7
    ISSN 2214-7500
    ISSN 2214-7500
    DOI 10.1016/j.toxrep.2022.09.005
    Database NAL-Catalogue (AGRICOLA)

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  6. Article: Systemic toxicity induced by topical application of heptafluorobutyric acid (PFBA) in a murine model

    Weatherly, Lisa M. / Shane, Hillary L. / Lukomska, Ewa / Baur, Rachel / Anderson, Stacey E.

    Food and chemical toxicology. 2021 Oct., v. 156

    2021  

    Abstract: Heptafluorobutyric acid (PFBA) is a synthetic chemical belonging to the per- and polyfluoroalkyl substances (PFAS) group that includes over 5000 chemicals incorporated into numerous products. PFBA is a short-chain PFAS (C4) labeled as a safer alternative ...

    Abstract Heptafluorobutyric acid (PFBA) is a synthetic chemical belonging to the per- and polyfluoroalkyl substances (PFAS) group that includes over 5000 chemicals incorporated into numerous products. PFBA is a short-chain PFAS (C4) labeled as a safer alternative to legacy PFAS which have been linked to numerous health effects. Despite the high potential for dermal exposure, occupationally and environmentally, dermal exposure studies are lacking. Using a murine model, this study analyzed serum chemistries, histology, immune phenotyping, and gene expression to evaluate the systemic toxicity of sub-chronic dermal PFBA 15-day (15% v/v or 375 mg/kg/dose) or 28-day (3.75–7.5% v/v or 93.8–187.5 mg/kg/dose) exposures. PFBA exposure produced significant increases in liver and kidney weights and altered serum chemistries (all exposure levels). Immune-cell phenotyping identified significant increases in draining lymph node B-cells (15%) and CD11b + cells (3.75–15%) and skin T-cells (3.75–15%) and neutrophils (7.5–15%). Histopathological and gene expression changes were observed in both the liver and skin after dermal PFBA exposure. The findings indicate PFBA induces liver toxicity and alterations of PPAR target genes, suggesting a role of a PPAR pathway. These results demonstrate that sustained dermal exposure to PFBA induces systemic effects and raise concerns of short-chain PFAS being promoted as safer alternatives.
    Keywords T-lymphocytes ; animal models ; blood serum ; dermal exposure ; gene expression ; hepatotoxicity ; histology ; histopathology ; kidneys ; liver ; lymph nodes ; neutrophils ; peroxisome proliferator-activated receptors ; phenotype ; topical application ; toxicology
    Language English
    Dates of publication 2021-10
    Publishing place Elsevier Ltd
    Document type Article
    ZDB-ID 782617-5
    ISSN 1873-6351 ; 0278-6915
    ISSN (online) 1873-6351
    ISSN 0278-6915
    DOI 10.1016/j.fct.2021.112528
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  7. Article ; Online: Prior Exposure to Ortho-Phthalaldehyde Augments IgE-Mediated Immune Responses to Didecyldimethylammonium Chloride: Potential for 2 Commonly Used Antimicrobials to Synergistically Enhance Allergic Disease.

    Shane, Hillary L / Lukomska, Ewa / Weatherly, Lisa / Baur, Rachel / Anderson, Stacey E

    Toxicological sciences : an official journal of the Society of Toxicology

    2021  Volume 178, Issue 1, Page(s) 127–137

    Abstract: Health-care workers have an increased incidence of allergic disease compared with the general public and are exposed to a variety of high-level disinfectants. Although exposure to these agents has been associated with allergic disease, findings between ... ...

    Abstract Health-care workers have an increased incidence of allergic disease compared with the general public and are exposed to a variety of high-level disinfectants. Although exposure to these agents has been associated with allergic disease, findings between epidemiology and animal studies often conflict respecting immunological mechanisms. Therefore, we hypothesized that previous exposure to a representative IgE-mediated sensitizer (ortho-phthalaldehyde [OPA]) alters immune responses to a representative T-cell-mediated sensitizer (didecyldimethlyammonium chloride [DDAC]). Here, BALB/c mice were topically exposed to OPA (0.5%) for 3 days, rested, then topically exposed to DDAC (0.0625%, 0.125%, and 0.25%) for 14 days. Coexposure resulted in phenotypic changes in draining lymph node (dLN) cells, including a decreased frequency of CD8+ T cells and increased frequency and number of B cells compared with DDAC-only treated mice. The coexposed mice also had enhanced Th2 responses, including significant alterations in: dLN Il4 (increased), B-cell activation (increased), CD8+ T-cell activation (decreased), and local and systemic IgE production (increased). These changes were not observed if mice were exposed to DDAC prior to OPA. Exposure to OPA alone shows Th2 skewing, indicated by increased activation of skin type 2 innate lymphoid cells, increased frequency and activation of draining lymph node B cells, and increased levels of type 2 cytokines. These findings suggest that the OPA-induced immune environment may alter the response to DDAC, resulting in increased IgE-mediated immune responses. This data may partially explain the discordance between epidemiological and laboratory studies regarding disinfectants and provide insight into the potential immunological implications of mixed chemical exposures.
    MeSH term(s) Animals ; B-Lymphocytes/drug effects ; CD8-Positive T-Lymphocytes/drug effects ; Cytokines ; Disinfectants/toxicity ; Immunity, Innate ; Immunoglobulin E/immunology ; Mice ; Mice, Inbred BALB C ; Quaternary Ammonium Compounds/toxicity ; o-Phthalaldehyde/toxicity
    Chemical Substances Cytokines ; Disinfectants ; Quaternary Ammonium Compounds ; Immunoglobulin E (37341-29-0) ; o-Phthalaldehyde (643-79-8) ; didecyldimethylammonium (Z7F472XQPA)
    Keywords covid19
    Language English
    Publishing date 2021-02-06
    Publishing country United States
    Document type Journal Article ; Research Support, N.I.H., Extramural
    ZDB-ID 1420885-4
    ISSN 1096-0929 ; 1096-6080
    ISSN (online) 1096-0929
    ISSN 1096-6080
    DOI 10.1093/toxsci/kfaa112
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  8. Article ; Online: Exposure to the anti-microbial chemical triclosan disrupts keratinocyte function and skin integrity in a model of reconstructed human epidermis.

    Baur, Rachel / Kashon, Michael / Lukomska, Ewa / Weatherly, Lisa M / Shane, Hillary L / Anderson, Stacey E

    Journal of immunotoxicology

    2021  Volume 20, Issue 1, Page(s) 1–11

    Abstract: Triclosan is an anti-microbial chemical incorporated into products that are applied to the skin of healthcare workers. Exposure to triclosan has previously been shown to be associated with allergic disease in humans and impact the immune responses in ... ...

    Abstract Triclosan is an anti-microbial chemical incorporated into products that are applied to the skin of healthcare workers. Exposure to triclosan has previously been shown to be associated with allergic disease in humans and impact the immune responses in animal models. Additionally, studies have shown that exposure to triclosan dermally activates the NLRP3 inflammasome and disrupts the skin barrier integrity in mice. The skin is the largest organ of the body and plays an important role as a physical barrier and regulator of the immune system. Alterations in the barrier and immune regulatory functions of the skin have been demonstrated to increase the risk of sensitization and development of allergic disease. In this study, the impact of triclosan exposure on the skin barrier and keratinocyte function was investigated using a model of reconstructed human epidermis. The apical surface of reconstructed human epidermis was exposed to triclosan (0.05-0.2%) once for 6, 24, or 48 h or daily for 5 consecutive days. Exposure to triclosan increased epidermal permeability and altered the expression of genes involved in formation of the skin barrier. Additionally, exposure to triclosan altered the expression patterns of several cytokines and growth factors. Together, these results suggest that exposure to triclosan impacts skin barrier integrity and function of human keratinocytes and suggests that these alterations may impact immune regulation.
    MeSH term(s) Humans ; Mice ; Animals ; Triclosan/toxicity ; Keratinocytes ; Epidermis/metabolism ; Skin ; Cytokines/metabolism ; Hypersensitivity ; Cell Differentiation
    Chemical Substances Triclosan (4NM5039Y5X) ; Cytokines
    Language English
    Publishing date 2021-04-12
    Publishing country England
    Document type Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't ; Research Support, U.S. Gov't, P.H.S.
    ZDB-ID 2205064-4
    ISSN 1547-6901 ; 1547-691X
    ISSN (online) 1547-6901
    ISSN 1547-691X
    DOI 10.1080/1547691X.2022.2148781
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  9. Article ; Online: Systemic toxicity induced by topical application of heptafluorobutyric acid (PFBA) in a murine model.

    Weatherly, Lisa M / Shane, Hillary L / Lukomska, Ewa / Baur, Rachel / Anderson, Stacey E

    Food and chemical toxicology : an international journal published for the British Industrial Biological Research Association

    2021  Volume 156, Page(s) 112528

    Abstract: Heptafluorobutyric acid (PFBA) is a synthetic chemical belonging to the per- and polyfluoroalkyl substances (PFAS) group that includes over 5000 chemicals incorporated into numerous products. PFBA is a short-chain PFAS (C4) labeled as a safer alternative ...

    Abstract Heptafluorobutyric acid (PFBA) is a synthetic chemical belonging to the per- and polyfluoroalkyl substances (PFAS) group that includes over 5000 chemicals incorporated into numerous products. PFBA is a short-chain PFAS (C4) labeled as a safer alternative to legacy PFAS which have been linked to numerous health effects. Despite the high potential for dermal exposure, occupationally and environmentally, dermal exposure studies are lacking. Using a murine model, this study analyzed serum chemistries, histology, immune phenotyping, and gene expression to evaluate the systemic toxicity of sub-chronic dermal PFBA 15-day (15% v/v or 375 mg/kg/dose) or 28-day (3.75-7.5% v/v or 93.8-187.5 mg/kg/dose) exposures. PFBA exposure produced significant increases in liver and kidney weights and altered serum chemistries (all exposure levels). Immune-cell phenotyping identified significant increases in draining lymph node B-cells (15%) and CD11b + cells (3.75-15%) and skin T-cells (3.75-15%) and neutrophils (7.5-15%). Histopathological and gene expression changes were observed in both the liver and skin after dermal PFBA exposure. The findings indicate PFBA induces liver toxicity and alterations of PPAR target genes, suggesting a role of a PPAR pathway. These results demonstrate that sustained dermal exposure to PFBA induces systemic effects and raise concerns of short-chain PFAS being promoted as safer alternatives.
    MeSH term(s) Administration, Topical ; Animals ; Chemical and Drug Induced Liver Injury ; Environmental Pollutants/toxicity ; Female ; Fluorocarbons/toxicity ; Indicators and Reagents/toxicity ; Mice
    Chemical Substances Environmental Pollutants ; Fluorocarbons ; Indicators and Reagents ; perfluorobutyric acid (375-22-4)
    Language English
    Publishing date 2021-08-30
    Publishing country England
    Document type Journal Article
    ZDB-ID 782617-5
    ISSN 1873-6351 ; 0278-6915
    ISSN (online) 1873-6351
    ISSN 0278-6915
    DOI 10.1016/j.fct.2021.112528
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  10. Article ; Online: Biological effects of inhaled crude oil. VI. Immunotoxicity.

    Weatherly, Lisa M / Shane, Hillary L / Baur, Rachel / Lukomska, Ewa / Roberts, Jenny R / Fedan, Jeffrey S / Anderson, Stacey E

    Toxicology and applied pharmacology

    2022  Volume 449, Page(s) 116100

    Abstract: Crude oil is an unrefined petroleum product that is a mixture of hydrocarbons and other organic material. Studies on the individual components of crude oil and crude oil exposure itself suggest it has immunomodulatory potential. As investigations of the ... ...

    Abstract Crude oil is an unrefined petroleum product that is a mixture of hydrocarbons and other organic material. Studies on the individual components of crude oil and crude oil exposure itself suggest it has immunomodulatory potential. As investigations of the immunotoxicity of crude oil focus mainly on ingestion and dermal exposure, the effects of whole-body inhalation of 300 ppm crude oil vapor [COV; acute inhalation exposure: (6 h × 1 d); or a 28 d sub-chronic exposure (6 h/d × 4 d/wk. × 4 wks)] was investigated 1, 28, and 90 d post-exposure in Sprague-Dawley rats. Acute exposure increased bronchoalveolar lavage (BAL) fluid cellularity, CD4+ and CD8+ cells, and absolute and percent CDllb+ cells only at 1 d post-exposure; additionally, NK cell activity was suppressed. Sub-chronic exposure resulted in a decreased frequency of CD4+ T-cells at 1 d post-exposure and an increased number and frequency of B-cells at 28 d post-exposure in the lung-associated lymph nodes. A significant increase in the number and frequency of B-cells was observed in the spleen at 1 d post-exposure; however, NK cell activity was suppressed at this time point. No effect on cellularity was identified in the BALF. No change in the IgM response to sheep red blood cells was observed. The findings indicate that crude oil inhalation exposure resulted in alterations in cellularity of phenotypic subsets that may impair immune function in rats.
    MeSH term(s) Animals ; Bronchoalveolar Lavage Fluid ; Inhalation Exposure/adverse effects ; Lung ; Petroleum/toxicity ; Rats ; Rats, Sprague-Dawley ; Sheep
    Chemical Substances Petroleum
    Language English
    Publishing date 2022-06-06
    Publishing country United States
    Document type Journal Article ; Research Support, U.S. Gov't, P.H.S.
    ZDB-ID 204477-8
    ISSN 1096-0333 ; 0041-008X
    ISSN (online) 1096-0333
    ISSN 0041-008X
    DOI 10.1016/j.taap.2022.116100
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