Toenail dust collected from podiatrist's nail drills was examined for size, endotoxin content and ability to stimulate release of interleukin 8 (IL-8) from macrophages and lung epithelial cells in vitro. The size distribution revealed a large number of particles in the size ranges that would deposit in the nose, airways and lung periphery. Endotoxin was readily measurable in aqueous extracts of the nail particles and a soluble component of the nail dust particles was able to stimulate substantial release of IL-8 from epithelial cells. Suspensions of toenail particles were tested for ability to stimulate IL-8 release from monocyte-derived macrophages; treatment with polymyxin B to remove endotoxin had no effect. We conclude that podiatrists who routinely carry out nail drilling could be inhaling particles that can deposit throughout the respiratory tract, where they could contribute to inflammation by stimulating release of IL-8 from cells via the particles themselves and via endotoxin
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