The toxic oil syndrome: a perspective on immunotoxicological mechanisms

The etiologic agents responsible for the development of autoimmune diseases are generally unknown. Clearly, developing an understanding of causative agents will be essential for the development of strategies for therapy, if not prevention, of these health problems. The immune system is a target of many toxicants, including those obtained through diet. One important example of the immunologic effect of dietary toxins is provided by the toxic oil syndrome (TOS). The intentional denaturation of rapeseed oil with aniline resulted in the production of fatty acid anilides. The unintentional consumption of this adulterated oil in Spain caused a mass poisoning whose effects continue to the present. Among other clinical signs, a majority of TOS patients had characteristics of type 1 hypersensitivities. A smaller number of people developed symptoms of autoimmune diseases including scleroderma. These observations highlight the probability that environmental chemicals may be a major source of etiologic agents for autoimmune disease. In this review, the authors provide an overview of some of the more important features of TOS as they pertain to immunity. The authors also speculate on the immunopathologic mechanisms by which the TOS progressed, with emphasis on oxidative stress as a central byproduct of anilide-induced injury.