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

Abstract

There are few studies available about how the workers‘ characteristics may influence the pattern of response to sensitizing agents in subjects with occupational asthma (OA) confirmed by a positive specific challenge test (SIC) with low molecular weight (LMW) agents or high molecular weight (HMW) agents. Early response has been more frequently found in females, atopics, smokers, subjects with higher FEV1 and PD20, and in subjects with longer asthma duration. Informations about the role of the type/level of airway inflammation are not reported.
74 subjects with OA were studied by SIC, 48 exposed to LMW agents and 26 exposed to HMW agents. Characteristics of subjects (age, sex, smoking habit, atopy, duration of symptoms and exposure, latency, type of response, sputum eosinophilia and functional data) were compared between two groups.

	n.	Duration Exposure	Duration Latency	FEV1%	PD20FEV1 (GM)	Eosin %	Early/Dual/Late (%)
LMW	48	20.1±13.1*	13.9±12.7*	89.2±16.0*	0.22	0.95*	33.3/31.3/35.4*
HMW	26	15.2±7.7	9.7±5.7	93.5±14.8	0.18	6.8	69.2/23.1/7.7

*p<0.01 LMW vs HMW

Subdividing subjects by type of response, immediate reactions (early +dual response) were common in subjects exposed to HMW agents (p=0.009), and in subjects with higher sputum eosinophilia (p=0.04). Univariate regression showed an association among immediate response and HMW and sputum eosinophilia. Multiple regression analysis confirmed that the immediate response was associated with HMW sensitization.
Molecular weight of occupational agent causing OA and consequently sputum eosinophilia, as airway inflammation marker, seems to predict the type of response to the SIC.

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D. Talini, F. Novelli, E. Bacci, M. L. Bartoli, S. Cianchetti, A. Di Franco, F. L. Dente, M. De Santis, P. Paggiaro (Pisa, Italy). Comparison between airway response to high versus low molecular weight agents in occupational asthma. Eur Respir J 2010; 36: Suppl. 54, 1468

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