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Are high- and low-molecular-weight sensitizing agents associated with different clinical phenotypes of occupational asthma?
O. Vandenplas, J. Godet, L. Hurdubaea, C. Rifflart, H. Suojalehto, M. Wiszniewska, X. Munoz, J. Sastre, P. Klusackova, V. Moore, R. Merget, D. Talini, C. Svanes, P. Mason, M. dell'Omo, P. Cullinan, G. Moscato, S. Quirce, J. Hoyle, DL. Sherson, P....
Language English Country Denmark
Document type Journal Article, Multicenter Study, Research Support, Non-U.S. Gov't
Grant support
European Academy of Allergy and Clinical Immunology - International
Fondation Mont-Godinne - International
Fondation Louvain - International
CIBER de Enfermedades Respiratorias [CIBERES] - International
Instituto de Salud Carlos III - International
Ministry of Economy and Competitiveness - International
PubMed
29956349
DOI
10.1111/all.13542
Knihovny.cz E-resources
- MeSH
- Allergens chemistry immunology MeSH
- Biomarkers MeSH
- Adult MeSH
- Immunization MeSH
- Middle Aged MeSH
- Humans MeSH
- Molecular Weight MeSH
- Odds Ratio MeSH
- Leukocyte Count MeSH
- Occupational Exposure adverse effects MeSH
- Asthma, Occupational blood diagnosis etiology MeSH
- Respiratory Function Tests MeSH
- Retrospective Studies MeSH
- Check Tag
- Adult MeSH
- Middle Aged MeSH
- Humans MeSH
- Male MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Multicenter Study MeSH
- Research Support, Non-U.S. Gov't MeSH
BACKGROUND: High-molecular-weight (HMW) proteins and low-molecular-weight (LMW) chemicals can cause occupational asthma (OA) although few studies have thoroughly compared the clinical, physiological, and inflammatory patterns associated with these different types of agents. The aim of this study was to determine whether OA induced by HMW and LMW agents shows distinct phenotypic profiles. METHODS: Clinical and functional characteristics, and markers of airway inflammation were analyzed in an international, multicenter, retrospective cohort of subjects with OA ascertained by a positive inhalation challenge response to HMW (n = 544) and LMW (n = 635) agents. RESULTS: Multivariate logistic regression analysis showed significant associations between OA caused by HMW agents and work-related rhinitis (OR [95% CI]: 4.79 [3.28-7.12]), conjunctivitis (2.13 [1.52-2.98]), atopy (1.49 [1.09-2.05]), and early asthmatic reactions (2.86 [1.98-4.16]). By contrast, OA due to LMW agents was associated with chest tightness at work (2.22 [1.59-3.03]), daily sputum (1.69 [1.19-2.38]), and late asthmatic reactions (1.52 [1.09-2.08]). Furthermore, OA caused by HMW agents showed a higher risk of airflow limitation (1.76 [1.07-2.91]), whereas OA due to LMW agents exhibited a higher risk of severe exacerbations (1.32 [1.01-1.69]). There were no differences between the two types of agents in the baseline sputum inflammatory profiles, but OA caused by HMW agents showed higher baseline blood eosinophilia and a greater postchallenge increase in fractional nitric oxide. CONCLUSION: This large cohort study describes distinct phenotypic profiles in OA caused by HMW and LMW agents. There is a need to further explore differences in underlying pathophysiological pathways and outcome after environmental interventions.
Cardio Thoracic and Vascular Department University of Pisa Pisa Italy
Department of Allergy Fundacion Jimenez Dıaz and CIBER de Enfermedades Respiratorias Madrid Spain
Department of Allergy Hospital La Paz Institute for Health Research Madrid Spain
Department of Occupational Medicine 1st Faculty of Medicine Charles University Prague Czech Republic
Department of Occupational Medicine Haukeland University Hospital Bergen Norway
Department of Pulmonary Medicine and Occupational Medicine Odense University Hospital Odense Denmark
Department of Respiratory Medicine North Manchester General Hospital Manchester UK
Occcupational Medicine Finnish Institute of Occupational Health Helsinki Finland
Occupational Lung Disease Unit Birmingham Heartlands Hospital Birmingham UK
Pôle de Santé Publique Strasbourg University Strasbourg France
Unit of Occupational Medicine and Public Health University of Padova Padova Italy
References provided by Crossref.org
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