International conference on byssinosis. Mechanisms of disease induction.

From this work and other published data there are at least three distinct compounds that have been shown to be capable of inducing symptoms of byssinosis. There is an aminopolysaccharide-protein complex in cotton plant bracts that acts by causing histamine release in the human lung and also causes necrosis of bronchiolar epithelium. There is endotoxin or endotoxin-like material present in cotton plant bracts that acts by a mechanism other than by causing histamine release. This can induce histologic features of chronic bronchitis over a period of time. There is a polyphenol compound whose action is unlikely to be via complement activation, even though higher titers of antibody to it are present in byssinotic compared with nonbyssinotic subjects. It is postulated that such a compound is held in the lungs by antibody and exerts its effect on the pulmonary vasculature, altering capillary resistance. It also produces pathologic change as might be expected from its ability to precipitate proteins and activate complement.