Source: Annual Congress 2010 - Occupational asthma
Disease area: Airway diseases

Abstract

Introduction: The role of IgG₄ in baker´s asthma is controversial. In different studies wheat flour specific IgG₄ (spIgG₄) was suggested either as an exposure marker, a sensitizing or a protective antibody. We hypothesized that those discrepancies could be due to differences in the study design.
Aims: To assess the effect of the study design on the appraisal of the role of spIgG₄ in baker´s asthma.
Methods: We used two different populations. A cross-sectional population consisted of 239 bakery workers from whom information on chest and nose and eyes work-related (WR) symptoms and exposure was collected and wheat flour specific IgE (spIgE) level was measured by RAST. A clinic population corresponded to 63 bakers from the same supermarket in-store bakeries who attend our clinic reporting WR symptoms and with a spIgE result ≥ to 2% from whom diagnostic and exposure information was collected. Sera spIgG₄ were measured using an in-house ELISA. SpIgG₄ concentrations‘ values in the top quartile were considered ‘high‘.
Results: In the cross-sectional population those with high spIgG₄ had been working for longer (4.3 vs 6.2yrs, p=0.01), but rates of high spIgG₄ were not statistically different between those with and without WR symptoms (30.3% vs 23.2%, p=0.28). In contrast, in the clinic population spIgG₄ levels were significantly higher in those diagnosed with occupational asthma (OA) due to flour in comparison with those without OA or occupational rhinitis (p=0.02).
Conclusions: Study design seems to have an effect on the apparent role of spIgG₄ antibodies assessment. It is likely that this issue will be clarified only through prospective, longitudinal study.

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Citations should be made in the following way:
S. Gómez-Ollés, S. Thomas, A. Ratneswaren, J. Harris, H. Jeal, A. Brant, P. Cullinan, M. Jones (London, United Kingdom). The role of the study design in elucidating the functions of wheat flour IgG₄ in baker´s asthma. Eur Respir J 2010; 36: Suppl. 54, 1469

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