Abstract
BackgroundPulmonary alveolar proteinosis (PAP) is a rare disease occurred by idiopathic (autoimmune) or secondary to particle inhalation. The in-air microparticle induced X-ray emission (in-air micro-PIXE) system performs elemental analysis of materials by irradiation with a proton microbeam, and allows visualization of the spatial distribution and quantitation of various elements with very low background noise. The aim of this study was to assess the secondary PAP due to inhalation of harmful particles by employing in-air micro-PIXE analysis for particles and intracellular iron in parafin-embedded lung tissue specimens obtained from a PAP patient comparing with normal lung tissue from a non-PAP patient. The iron inside alveolar macrophages was stained with Berlin blue, and its distribution was compared with that on micro-PIXE images.ResultsThe elements composing particles and their locations in the PAP specimens could be identified by in-air micro-PIXE analysis, with magnesium (Mg), aluminum (Al), silicon (Si), phosphorus (P), sulfur (S), scandium (Sc), potassium (K), calcium (Ca), titanium (Ti), chromium (Cr), copper (Cu), manganase (Mn), iron (Fe), and zinc (Zn) being detected. Si was the major component of the particles. Serial sections stained by Berlin blue revealed accumulation of sideromacrophages that had phagocytosed the particles. The intracellular iron content of alveolar macrophage from the surfactant-rich area in PAP was higher than normal lung tissue in control lung by both in-air micro-PIXE analysis and Berlin blue staining.ConclusionThe present study demonstrated the efficacy of in-air micro-PIXE for analyzing the distribution and composition of lung particles. The intracellular iron content of single cells was determined by simultaneous two-dimensional and elemental analysis of paraffin-embedded lung tissue sections. The results suggest that secondary PAP is associated with exposure to inhaled particles and accumulation of iron in alveolar macrophages.
Highlights
Pulmonary alveolar proteinosis (PAP) is a rare disease occurred by idiopathic or secondary to particle inhalation
The aim of this study was to assess the secondary PAP due to inhalation of harmful particles by employing in-air microparticle induced X-ray emission analysis for particles and intracellular iron in lung tissue specimens combined with Berlin blue staining for iron
Tissues were subjected to in-air micro-PIXE analysis and Berlin blue staining for iron
Summary
Pulmonary alveolar proteinosis (PAP) is a rare disease occurred by idiopathic (autoimmune) or secondary to particle inhalation. Pulmonary alveolar proteinosis is a rare disease characterized by dense accumulation of surfactant and phospholipids in the alveoli and distal airways [1]. Progression of this disease leads to respiratory failure [2]. The aim of this study was to assess the secondary PAP due to inhalation of harmful particles by employing in-air microparticle induced X-ray emission (in-air micro-PIXE) analysis for particles and intracellular iron in lung tissue specimens combined with Berlin blue staining for iron
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