A Pilot Study Assessing the Ability of 5-Aminosalicylic Acid to Modulate the Immune Response in Chronic Beryllium Disease

Chronic beryllium disease is a granulomatous lung disease, characterized by the accumulation of macrophages and beryllium-specific CD4+ T-cells that proliferate and produce T-helper cell type 1 cytokines. Previous studies indicate that beryllium-mediated oxidative stress enhances cytokine response in chronic beryllium disease CD4+ T-cells. 5-Aminosalicylic acid (5-ASA) is currently used to treat inflammatory bowel disease and has both antioxidant and antiinflammatory actions. We hypothesized that 5-ASA therapy may be a beneficial therapy in chronic beryllium disease. An investigator-initiated, randomized, double-blind, placebo-controlled 5-ASA trial was undertaken. Patients with chronic beryllium disease were randomized 3:1 to receive 5-ASA (500-mg capsules) four times daily (n = 13) or placebo capsules (n = 5), for 6 weeks. Primary study endpoints included changes in beryllium lymphocyte proliferation test responses in peripheral blood mononuclear cells and bronchoalveolar lavage cells. Secondary endpoin...