Eosinophilic inflammation decreases in subjects with occupational asthma despite persistence of occupational exposure
D. Talini, A. Di Franco, M. Carrara, M. De Santis, M. L. Bartoli, S. Carnevali, P. Paggiaro (Pisa, Italy)
Source: Annual Congress 2002 - Exposure to chemicals
Session: Exposure to chemicals
Session type: Thematic Poster Session
Number: 858
Disease area: Airway diseases
Abstract Prognosis of occupational asthma in subjects with persistent occupational exposure is believed to be poor, despite appropriate treatment. In order to assess the outcome of eosinophilic airway inflammation in subjects with occupational asthma (diagnosed by a positive specific bronchial challenge test) who continued to work, 40 subjects were examined at the diagnosis and after a 6-24 months period of follow-up, when they were still exposed to the specific sensitizer at work. FEV1, PD20FEV1 methacholine, PEF variability and induced sputum were obtained at both examinations. At diagnosis, asthma was evaluated of mild-to-moderate severity, according to GINA guidelines. Sputum eosinophilia (>3%) was observed in 23 (57.5%) subjects at diagnosis, and in 15 (37.7%) subjects at follow-up. Sputum eosinophils percentage significantly decreased at follow-up, while FEV1 (% pred), PD20FEV1 methacholine (mg) did not significantly change (Table, * p <0.05 compared with at diagnosis). PEF variability (Ampl%mean) slightly reduced at follow-up. The decrease in sputum eosinophils was observed both in subjects treated with inhaled corticosteroids (ICS, N=25) and in subjects treated with rescue beta2-agonists (N=15). Therefore, eosinophilic airway inflammation improves in subjects with occupational asthma still exposed at work, independently from treatment with ICS, with only marginal improvement in functional findings. This fact can suggest that prognosis of occupational asthma in these patients is not so poor.
FEV1 (%) PD20FEV1 Ampl%Mean Sputum Eos (%) Diagnosis 89±17] 0.246 17.6±14.8] 4.4 (0-43) Follow-up 88±16] 0.229 12.9±9.4*] 1.3 (0-44)*
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D. Talini, A. Di Franco, M. Carrara, M. De Santis, M. L. Bartoli, S. Carnevali, P. Paggiaro (Pisa, Italy). Eosinophilic inflammation decreases in subjects with occupational asthma despite persistence of occupational exposure. Eur Respir J 2002; 20: Suppl. 38, 858
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