Idiopathic pulmonary fibrosis shows a striking resemblance to dietary glucosinolate induced fibrotic lung disease in farm animals: A mini review.

Abstract

In the late 1970’s idiopathic pulmonary fibrosis (formerly cryptogenic fibrosing alveolitis) appeared as a new clinical entity alongside fibrotic radiographs of known occupational lung diseases. Since then its incidence and mortality has continued to rise without an established cause. Epidemiologists believe an environmental factor to be responsible and suggest biomass fuels, smoking and exposure to air pollution are likely. During that same time period, the veterinary world recognised an acute fatal lung injury and a slower progressive fibrosis in farm animals’ especially healthy older males. They identified the pneumotoxicant to be linked to forage Brassica ingestion and reproduced both conditions in the field by varying exposure level. They described many other features in the farm animals that are also present in IPF, and successfully ended the disease by reducing the dietary intake of forage Brassica to <10% of feed. Their findings show a striking resemblance to IPF, with the male predominance and selective alveolar cell injury along with liver and thyroid disturbances etc. It may also explain the Spanish Toxic Oil Syndrome and its effects. Overall, the intake of Brassica vegetables is unchanged in the human diet apart from seasonal variations; but Brassica exposure has greatly increased in some countries through the progressive replacement of previously used cooking oils by the newer Brassica derived oil seed rape especially in commercially produced food products. We have reviewed the Veterinary data regarding lung injury in the farm animals and its associated features relevant to IPF; alongside our previously published findings on inflammatory mediator changes in medical staff taking Brassica oils. Finally, we have taken a preliminary look at the annual Brassica oil use for cooking and the reported incidence of IPF in 13 different countries where the disease incidence is either stable or changing with time.