Bronchial Response to High and Low Molecular Weight Occupational Inhalant Allergens
10.4168/aair.2020.12.1.164
- Author:
Lipińska-Ojrzanowska AGNIESZKA
1
;
Nowakowska-Świrta EWA
;
Wiszniewska MARTA
;
Walusiak-Skorupa JOLANTA
Author Information
1. Department of Occupational Diseases and Environmental Health, Nofer Institute of Occupational Medicine, Lodz, Poland. Ewa.Nowakowska-Swirta@imp.lodz.pl
- Publication Type:Randomized Controlled Trial
- Keywords:
Occupational asthma;
prognosis;
bronchial hyperreactivity;
allergens;
asthma;
immunoglobulin E
- MeSH:
Allergens;
Asthma;
Asthma, Occupational;
Bronchial Hyperreactivity;
Humans;
Immunoglobulin E;
Inhalation;
Methacholine Chloride;
Molecular Weight;
Occupational Exposure;
Prognosis
- From:Allergy, Asthma & Immunology Research
2020;12(1):164-170
- CountryRepublic of Korea
- Language:English
-
Abstract:
PURPOSE: Occupational asthma may be induced by high- or low-molecular weight allergens (HMWA or LMWA, respectively). The study was conducted to compare the pattern of bronchial response in 200 HMWA-induced asthmatics (n = 130) and LMWA-induced asthmatics (n = 70). METHODS: The study participants underwent a single-blind, placebo-controlled specific inhalation challenge (SIC) with workplace allergens, accompanied by evaluation of non-specific bronchial hyperresponsiveness (NSBHR) with methacholine before and after the SIC. RESULTS: A single early bronchial response more frequently occurred in HMWA-induced asthmatics than in LMWA-induced asthmatics (86.2% vs. 20%). An isolated late bronchial response or atypical patterns were more frequently observed in LMWA-induced asthmatics than in LMWA-induced asthmatics (45.7% vs. 3.8% or 34.3% vs. 10%, respectively). Baseline NSBHR before SIC was more often detected in LMWA-induced asthmatics than in HMWA-induced asthmatics (81.4% vs. 54.6%), and the median value of the provocation concentration of methacholine was relevantly lower in these patients before and after SIC. A significant 3-fold increase in NSBHR after SIC was observed more often in LMWA-induced asthmatics than in HMWA-induced asthmatics (82.8% vs. 66.1%). In addition, compared to LMWA-induced asthmatics, HMWA-induced asthmatics were older, were more frequently active smokers, showed lower level of NSBHR, and more frequently continued their work in harmful occupational exposure. CONCLUSIONS: The results of this study suggest that HMWA-induced asthmatics may have milder clinical courses and that there is a possibility of job continuation despite asthma exacerbation requiring medical surveillance.
