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Law BF, Lin CC, Hettick JM. Human keratinocyte response to 4,4'-methylene diphenyl diisocyanate-glutathione conjugate exposure. Xenobiotica 2024:1-10. [PMID: 39235803 DOI: 10.1080/00498254.2024.2401493] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2024] [Revised: 08/29/2024] [Accepted: 09/03/2024] [Indexed: 09/06/2024]
Abstract
Workplace exposure to diisocyanates like 4,4'-methylene diphenyl diisocyanate can cause occupational asthma (MDI-OA), and the underlying biological pathways are still being researched.Although uncertainty remains, evidence supports the hypothesis that dermal exposure to MDI plays an important role in the development of MDI-OA.Gene expression, proteomics, and informatics tools were utilised to characterise changes in expression of RNA and protein in cultured human HEKa keratinocyte cells following exposure to conjugates of MDI with glutathione (MDI-GSH).RT-qPCR analysis using a panel of 39 candidate primers demonstrated 9 candidate genes upregulated and 30 unchanged.HPLC-MS/MS analysis of HEKa cell lysate identified 18 540 proteins across all samples 60 proteins demonstrate statistically significant differential expression in exposed cells, some of which suggest activation of immune and inflammatory pathways.The results support the hypothesis that dermal exposures have the potential to play an important role in the development of MDI-OA. Furthermore, proteomic and gene expression data suggest multiple immune (adaptive and innate) and inflammatory pathways may be involved in the development of MDI-OA.
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Affiliation(s)
- Brandon F Law
- Allergy and Clinical Immunology Branch, Health Effects Laboratory Division, National Institute for Occupational Safety and Health, Morgantown, WV, USA
| | - Chen-Chung Lin
- Allergy and Clinical Immunology Branch, Health Effects Laboratory Division, National Institute for Occupational Safety and Health, Morgantown, WV, USA
| | - Justin M Hettick
- Allergy and Clinical Immunology Branch, Health Effects Laboratory Division, National Institute for Occupational Safety and Health, Morgantown, WV, USA
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2
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Boster JM, Moore Iii WJ, Stoffel ST, Barber BS, Houle MC, Walter RJ, Morris MJ. Characterizing the Asthma Phenotype of Military Personnel. Mil Med 2024; 189:137-141. [PMID: 39160851 DOI: 10.1093/milmed/usae060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Revised: 01/17/2024] [Accepted: 02/09/2024] [Indexed: 08/21/2024] Open
Abstract
INTRODUCTION Asthma is the most common diagnosis in military personnel who endorse chronic dyspnea. Service members have unique occupational risk factors, and there is concern that airborne exposures in the deployed environment as well as other occupational exposures may contribute to the development of asthma or exacerbate pre-existing disease. Asthma phenotyping with clinical biomarkers such as serum immunoglobulin E (IgE) levels and eosinophil (EOS) counts is useful in defining treatment strategies for the management of asthma. This study sought to characterize the phenotype of medically separated military personnel with career-limiting asthma to define potential management strategies and guide future research evaluating the unexplained prevalence of asthma in this population. MATERIALS AND METHODS A retrospective chart review of active duty service members (ADSM) who underwent fitness for duty evaluation via medical evaluation board between 2005 and 2016 and were separated with a minimum 30% conditional disability rating for asthma was performed. Only ADSM who were diagnosed with asthma by a pulmonologist and had spirometry data available were included in the analysis. Demographics, spirometry data, and laboratory data to include IgE levels, radioallergosorbent panels, and EOS counts were analyzed from the DoD electronic medical record. RESULTS A total of 141 service members were evaluated with a mean age of 42 ± 6.8 years, mean serum EOS count of 300 ± 358 cells/μL, and mean IgE level of 305 ± 363 IU/mL. The patients were further categorized into 4 subgroups based on serum EOS count and IgE level: group A with IgE < 100 IU/mL and EOS < 300 cells/μL (n = 45; 33%), group B with IgE > 100 IU/mL and EOS < 300 cells/μL (n = 44; 32%), group C with IgE < 100 IU/mL and EOS > 300 cells/μL (n = 6; 1%), and group D with IgE > 100 IU/mL, EOS > 300 cells/μL (n = 46; 34%). Among the cohorts, there were no statistically significant differences in demographics, body mass index, spirometry, smoking history, or disability rating. CONCLUSION The majority of ADSM with a defined asthma history do not have concordant elevations in serum IgE and blood EOS suggestive of a Th2-high phenotype. Asthma in this population is heterogeneous, and phenotyping using clinical biomarkers may be useful to define optimal treatment strategies.
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Affiliation(s)
- Joshua M Boster
- Department of Medicine, Pulmonary/Critical Service, Brooke Army Medical Center, JBSA Fort Sam Houston, TX 78234, USA
| | - William J Moore Iii
- Department of Medicine, Pulmonary/Critical Service, Brooke Army Medical Center, JBSA Fort Sam Houston, TX 78234, USA
| | - Steven T Stoffel
- Department of Medicine, Pulmonary/Critical Service, Brooke Army Medical Center, JBSA Fort Sam Houston, TX 78234, USA
| | - Brian S Barber
- Department of Medicine, Pulmonary/Critical Service, Brooke Army Medical Center, JBSA Fort Sam Houston, TX 78234, USA
| | - Mateo C Houle
- Department of Medicine, Pulmonary/Critical Service, Brooke Army Medical Center, JBSA Fort Sam Houston, TX 78234, USA
| | - Robert J Walter
- Department of Medicine, Pulmonary/Critical Service, Brooke Army Medical Center, JBSA Fort Sam Houston, TX 78234, USA
| | - Michael J Morris
- Department of Medicine, Pulmonary/Critical Service, Brooke Army Medical Center, JBSA Fort Sam Houston, TX 78234, USA
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Mwanga HH, Dumas O, Migueres N, Le Moual N, Jeebhay MF. Airway Diseases Related to the Use of Cleaning Agents in Occupational Settings. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY. IN PRACTICE 2024; 12:1974-1986. [PMID: 38432401 DOI: 10.1016/j.jaip.2024.02.036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/23/2023] [Revised: 02/13/2024] [Accepted: 02/19/2024] [Indexed: 03/05/2024]
Abstract
Exposure to disinfectants and cleaning products (DCPs) is now a well-established risk factor for work-related asthma (WRA). However, questions remain on the specific causal agents and pathophysiological mechanisms. Few studies have also reported an association between DCPs and rhinitis or chronic obstructive pulmonary disease. This review discusses the recent evidence pertaining to airway diseases attributable to occupational exposure to DCPs. In contrast to other agents, the incidence of WRA due to DCPs has increased over time. The use of DCPs in spray form has clearly been identified as an added risk factor. The mechanisms for WRA associated with DCPs remain poorly studied; however, both allergic and nonallergic responses have been described, with irritant mechanisms thought to play a major role. An early diagnostic workup based on clinical assessment accompanied by evaluation of lung function and immunological and airway inflammatory markers is important to guide optimal care and exposure avoidance to the implicated agent. Future research should focus on the effects of "green" products, pathophysiological mechanisms, and quantitative exposure assessment including the use of barcode-based methods to identify specific agents. There is an urgent need to strengthen preventive measures and interventions to reduce the burden of airway diseases associated with DCPs.
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Affiliation(s)
- Hussein H Mwanga
- Department of Environmental and Occupational Health, School of Public Health and Social Sciences, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania; Division of Occupational Medicine and Centre for Environmental & Occupational Health Research, School of Public Health, University of Cape Town, Cape Town, South Africa
| | - Orianne Dumas
- Université Paris-Saclay, UVSQ, Univ. Paris-Sud, Inserm, Équipe d'Épidémiologie Respiratoire Intégrative, CESP, Villejuif, France
| | - Nicolas Migueres
- Division of Pulmonology, Department of Chest Diseases, University Hospital of Strasbourg and Fédération de Médecine translationnelle, Strasbourg University, Strasbourg, France; UMR 7357 Laboratoire des sciences de l'ingénieur, de l'informatique et de l'imagerie ICUBE, Strasbourg, France
| | - Nicole Le Moual
- Université Paris-Saclay, UVSQ, Univ. Paris-Sud, Inserm, Équipe d'Épidémiologie Respiratoire Intégrative, CESP, Villejuif, France.
| | - Mohamed F Jeebhay
- Division of Occupational Medicine and Centre for Environmental & Occupational Health Research, School of Public Health, University of Cape Town, Cape Town, South Africa.
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Mohan MK, Thorat K, Puthiyapurayil TP, Sunnapu O, Chandrashekharappa S, Ravula V, Khader R, Sankaranarayanan A, Muhammad H, Vemula PK. Oxime-functionalized anti-insecticide fabric reduces insecticide exposure through dermal and nasal routes, and prevents insecticide-induced neuromuscular-dysfunction and mortality. Nat Commun 2024; 15:4844. [PMID: 38844466 PMCID: PMC11156901 DOI: 10.1038/s41467-024-49167-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Accepted: 05/23/2024] [Indexed: 06/09/2024] Open
Abstract
Farmers from South Asian countries spray insecticides without protective gear, which leads to insecticide exposure through dermal and nasal routes. Acetylcholinesterase plays a crucial role in controlling neuromuscular function. Organophosphate and carbamate insecticides inhibit acetylcholinesterase, which leads to severe neuronal/cognitive dysfunction, breathing disorders, loss of endurance, and death. To address this issue, an Oxime-fabric is developed by covalently attaching silyl-pralidoxime to the cellulose of the fabric. The Oxime-fabric, when stitched as a bodysuit and facemask, efficiently deactivates insecticides (organophosphates and carbamates) upon contact, preventing exposure. The Oxime-fabric prevents insecticide-induced neuronal damage, neuro-muscular dysfunction, and loss of endurance. Furthermore, we observe a 100% survival rate in rats when repeatedly exposed to organophosphate-insecticide through the Oxime-fabric, while no survival is seen when organophosphate-insecticide applied directly or through normal fabric. The Oxime-fabric is washable and reusable for at least 50 cycles, providing an affordable solution to prevent insecticide-induced toxicity and lethality among farmers.
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Affiliation(s)
- Mahendra K Mohan
- Institute for Stem Cell Science and Regenerative Medicine (DBT-inStem), GKVK Post, Bellary Road, Bangalore, 560065, Karnataka, India
| | - Ketan Thorat
- Institute for Stem Cell Science and Regenerative Medicine (DBT-inStem), GKVK Post, Bellary Road, Bangalore, 560065, Karnataka, India
| | - Theja Parassini Puthiyapurayil
- Institute for Stem Cell Science and Regenerative Medicine (DBT-inStem), GKVK Post, Bellary Road, Bangalore, 560065, Karnataka, India
| | | | - Sandeep Chandrashekharappa
- Institute for Stem Cell Science and Regenerative Medicine (DBT-inStem), GKVK Post, Bellary Road, Bangalore, 560065, Karnataka, India
| | - Venkatesh Ravula
- Institute for Stem Cell Science and Regenerative Medicine (DBT-inStem), GKVK Post, Bellary Road, Bangalore, 560065, Karnataka, India
| | - Rajamohammed Khader
- Institute for Stem Cell Science and Regenerative Medicine (DBT-inStem), GKVK Post, Bellary Road, Bangalore, 560065, Karnataka, India
| | - Aravind Sankaranarayanan
- Institute for Stem Cell Science and Regenerative Medicine (DBT-inStem), GKVK Post, Bellary Road, Bangalore, 560065, Karnataka, India
- Tata Institute for Genetics and Society (TIGS), inStem, GKVK Post, Bellary Road, Bangalore, 560065, India
| | - Hadi Muhammad
- Institute for Stem Cell Science and Regenerative Medicine (DBT-inStem), GKVK Post, Bellary Road, Bangalore, 560065, Karnataka, India
| | - Praveen Kumar Vemula
- Institute for Stem Cell Science and Regenerative Medicine (DBT-inStem), GKVK Post, Bellary Road, Bangalore, 560065, Karnataka, India.
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Doyen V, Gautrin D, Vandenplas O, Malo JL. Comparison of high- and low-molecular-weight sensitizing agents causing occupational asthma: an evidence-based insight. Expert Rev Clin Immunol 2024; 20:635-653. [PMID: 38235552 DOI: 10.1080/1744666x.2024.2306885] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2023] [Accepted: 01/15/2024] [Indexed: 01/19/2024]
Abstract
INTRODUCTION The many substances used at the workplace that can cause sensitizer-induced occupational asthma are conventionally categorized into high-molecular-weight (HMW) agents and low-molecular-weight (LMW) agents, implying implicitly that these two categories of agents are associated with distinct phenotypic profiles and pathophysiological mechanisms. AREAS COVERED The authors conducted an evidence-based review of available data in order to identify the similarities and differences between HMW and LMW sensitizing agents. EXPERT OPINION Compared with LMW agents, HMW agents are associated with a few distinct clinical features (i.e. concomitant work-related rhinitis, incidence of immediate asthmatic reactions and increase in fractional exhaled nitric oxide upon exposure) and risk factors (i.e. atopy and smoking). However, some LMW agents may exhibit 'HMW-like' phenotypic characteristics, indicating that LMW agents are a heterogeneous group of agents and that pooling them into a single group may be misleading. Regardless of the presence of detectable specific IgE antibodies, both HMW and LMW agents are associated with a mixed Th1/Th2 immune response and a predominantly eosinophilic pattern of airway inflammation. Large-scale multicenter studies are needed that use objective diagnostic criteria and assessment of airway inflammatory biomarkers to identify the pathobiological pathways involved in OA caused by the various non-protein agents.
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Affiliation(s)
- Virginie Doyen
- Department of Chest Medicine, Centre Hospitalier Universitaire UCL Namur, Université Catholique de Louvain, Yvoir, Belgium
| | - Denyse Gautrin
- Université de Montréal and Hôpital du Sacré-Cœur de Montréal, Montréal, Canada
| | - Olivier Vandenplas
- Department of Chest Medicine, Centre Hospitalier Universitaire UCL Namur, Université Catholique de Louvain, Yvoir, Belgium
| | - Jean-Luc Malo
- Université de Montréal and Hôpital du Sacré-Cœur de Montréal, Montréal, Canada
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Kleinbeck S, Wolkoff P. Exposure limits for indoor volatile substances concerning the general population: The role of population-based differences in sensory irritation of the eyes and airways for assessment factors. Arch Toxicol 2024; 98:617-662. [PMID: 38243103 PMCID: PMC10861400 DOI: 10.1007/s00204-023-03642-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Accepted: 11/16/2023] [Indexed: 01/21/2024]
Abstract
Assessment factors (AFs) are essential in the derivation of occupational exposure limits (OELs) and indoor air quality guidelines. The factors shall accommodate differences in sensitivity between subgroups, i.e., workers, healthy and sick people, and occupational exposure versus life-long exposure for the general population. Derivation of AFs itself is based on empirical knowledge from human and animal exposure studies with immanent uncertainty in the empirical evidence due to knowledge gaps and experimental reliability. Sensory irritation in the eyes and airways constitute about 30-40% of OELs and is an abundant symptom in non-industrial buildings characterizing the indoor air quality and general health. Intraspecies differences between subgroups of the general population should be quantified for the proposal of more 'empirical' based AFs. In this review, we focus on sensitivity differences in sensory irritation about gender, age, health status, and vulnerability in people, based solely on human exposure studies. Females are more sensitive to sensory irritation than males for few volatile substances. Older people appear less sensitive than younger ones. However, impaired defense mechanisms may increase vulnerability in the long term. Empirical evidence of sensory irritation in children is rare and limited to children down to the age of six years. Studies of the nervous system in children compared to adults suggest a higher sensitivity in children; however, some defense mechanisms are more efficient in children than in adults. Usually, exposure studies are performed with healthy subjects. Exposure studies with sick people are not representative due to the deselection of subjects with moderate or severe eye or airway diseases, which likely underestimates the sensitivity of the group of people with diseases. Psychological characterization like personality factors shows that concentrations of volatile substances far below their sensory irritation thresholds may influence the sensitivity, in part biased by odor perception. Thus, the protection of people with extreme personality traits is not feasible by an AF and other mitigation strategies are required. The available empirical evidence comprising age, lifestyle, and health supports an AF of not greater than up to 2 for sensory irritation. Further, general AFs are discouraged for derivation, rather substance-specific derivation of AFs is recommended based on the risk assessment of empirical data, deposition in the airways depending on the substance's water solubility and compensating for knowledge and experimental gaps. Modeling of sensory irritation would be a better 'empirical' starting point for derivation of AFs for children, older, and sick people, as human exposure studies are not possible (due to ethical reasons) or not generalizable (due to self-selection). Dedicated AFs may be derived for environments where dry air, high room temperature, and visually demanding tasks aggravate the eyes or airways than for places in which the workload is balanced, while indoor playgrounds might need other AFs due to physical workload and affected groups of the general population.
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Affiliation(s)
- Stefan Kleinbeck
- Leibniz Research Centre for Working Environment and Human Factors, Dortmund, Germany.
| | - Peder Wolkoff
- National Research Centre for the Working Environment, Copenhagen, Denmark
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Beigoli S, Amin F, Kazemi Rad H, Rezaee R, Boskabady MH. Occupational respiratory disorders in Iran: a review of prevalence and inducers. Front Med (Lausanne) 2024; 11:1310040. [PMID: 38390570 PMCID: PMC10881831 DOI: 10.3389/fmed.2024.1310040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Accepted: 01/19/2024] [Indexed: 02/24/2024] Open
Abstract
The link between occupational respiratory diseases (ORD) and exposure to harmful factors that are present in the workplace has been well shown. Factors such as physical activity, age and duration of occupational exposure playing important roles in ORD severity, should be identified in the workplace, their effects on workers health should be studied, and ultimately, exposure to them must be minimized. We carried out a literature review by searching PubMed, Scopus, and Web of Science databases to retrieve studies published from 1999 until the end of April 2023 reporting the prevalence and inducers of ORD in Iran. In Iranian workers, several ORD such as interstitial lung disease, silicosis, occupational asthma, pulmonary inflammatory diseases, chronic obstructive pulmonary diseases, and lung cancers have been reported. It was indicated that ORD mainly occur due to repeated and prolonged exposure to noxious agents in the workplace. We also extracted the prevalence of ORD in different regions of Iran from the retrieved reports. Based on our literature review, the prevalence of ORD among Iranian workers highlights the importance of regular assessment of the risk of exposure to noxious agents in the workplace to develop measures for preventing potential adverse effects.
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Affiliation(s)
- Sima Beigoli
- Applied Biomedical Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
- Department of Physiology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Fatemeh Amin
- Physiology-Pharmacology Research Center, Research Institute of Basic Medical Sciences, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
- Department of Physiology and Pharmacology, School of Medicine, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
| | - Hamideh Kazemi Rad
- Department of Physiology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Ramin Rezaee
- Applied Biomedical Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
- International UNESCO Center for Health-Related Basic Sciences and Human Nutrition, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mohammad Hossein Boskabady
- Applied Biomedical Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
- Department of Physiology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
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Affiliation(s)
- Giselle Mosnaim
- From the Division of Allergy and Immunology, Department of Medicine, NorthShore University HealthSystem, Evanston, IL
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Alhadlaq HW, Ateeq A, Shayea AMF, Gasana J. Occupational Asthma Prevalence among Migrant Workers Attending Shuaiba Industrial Medical Center in Kuwait. Healthcare (Basel) 2023; 11:2021. [PMID: 37510462 PMCID: PMC10379107 DOI: 10.3390/healthcare11142021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2023] [Revised: 07/11/2023] [Accepted: 07/12/2023] [Indexed: 07/30/2023] Open
Abstract
Specific work environments, such as exposure to chemicals emitted during industrial processes, are related to occupational asthma. From 1985 to 2012, Kuwait was expected to have the highest asthma prevalence rate among Middle East nations, at 15%. This cross-sectional study was conducted using secondary data from occupational health physicians' records in the Shuaiba Industrial Medical Center (SIMC) extracted and analyzed using SPSS. Chi-square test and logistic regression were used to check the association between risk factors and bronchial asthma (BA). The data sample size was 3478 in 2018 and 3807 in 2019. In 2018, BA had a significant relationship with age categories, work year groups, and determinants of fitness. Migrant workers above 51 years of age had a high risk of developing BA (p-value = 0.012). There was a high risk of developing BA in workers who worked > 21 years (p-value < 0.001) and in workers who worked between 11 and 20 years (p-value = 0.042). Overweight workers had a risk of developing BA (p-value = 0.042). In 2019, BA had an associated relationship with age categories and determinants of fitness. Workers above 51 years of age had about a 39% risk of developing BA (p-value = 0.009). Otherwise, the BMI, working year groups, marital status, and smoking status had no association with BA. In conclusion, BA is prevalent among migrant workers at the SIMC. Long hours, low income, and a lack of PPE are just a few of the issues that migrant workers have been exposed to, raising their risk of poor health.
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Affiliation(s)
- Hussah Waleed Alhadlaq
- Department of Environmental and Occupational Health, College of Public Health, Kuwait University, Safat 13110, Kuwait
| | - Alanoud Ateeq
- Shuaiba Medical Industrial Center, Occupational Health Department, Ministry of Health, Ahmadi 47005, Kuwait
| | - Abdulaziz M F Shayea
- Departments of Occupational Therapy, Faculty of Allied Health Science, Kuwait University, Kuwait City 12037, Kuwait
- Departments of Molecular Biology, Faculty of Graduate Studies, Kuwait University, Kuwait City 12037, Kuwait
| | - Janvier Gasana
- Department of Environmental and Occupational Health, College of Public Health, Kuwait University, Safat 13110, Kuwait
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McConnachie G, Johnson P. Total Reactive Isocyanate Group (TRIG) Measurement: A Commentary. Ann Work Expo Health 2023; 67:553-558. [PMID: 36866423 PMCID: PMC10243925 DOI: 10.1093/annweh/wxad007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Accepted: 02/24/2023] [Indexed: 03/04/2023] Open
Abstract
Exposure to airborne isocyanates has, for decades, been a leading cause of occupational asthma. As respiratory sensitizers, isocyanates can induce allergic respiratory diseases with symptoms persisting even without further exposure. As this cause of occupational asthma is recognized it should be almost entirely preventable. In several countries isocyanates are assigned occupational exposure limits based on the total of reactive isocyanate groups (TRIG). The measurement of TRIG has some significant advantages over the measurement of individual isocyanate compounds. This exposure metric is explicit, simplifying calculations, and comparisons across published data. It reduces the risk of underestimating exposure by 'missing' important isocyanate compounds that may be present but are not the target analytes. It allows for quantification of exposure to complex mixtures of isocyanates, di-isocyanates monomers, prepolymers, polyisocyanates, oligomers, and/or intermediate forms. This is becoming increasingly important as more complex isocyanate products are being used in the workplace. There are many methods and techniques for measuring air concentrations/potential exposure to isocyanates. Several established methods have been standardized and published as International Organization for Standardization (ISO) methods. While some may be applied directly for determination of TRIG, others (developed for determination of individual isocyanates), require modification. This commentary aims to highlight the relative merits and limitations of those methods capable of determining TRIG and also considers potential future developments.
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Affiliation(s)
- Glen McConnachie
- Health and Safety Executive Science and Research Centre, Harpur Hill, Buxton, DerbyshireSK17 9JN, UK
| | - Paul Johnson
- Health and Safety Executive Science and Research Centre, Harpur Hill, Buxton, DerbyshireSK17 9JN, UK
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Ronsmans S, Le Moual N, Dumas O. Update on irritant-induced occupational asthma. Curr Opin Allergy Clin Immunol 2023; 23:63-69. [PMID: 36729951 DOI: 10.1097/aci.0000000000000884] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
PURPOSE OF REVIEW In this narrative review, we aim to highlight novel research findings on both acute/subacute irritant-induced asthma (IIA) and chronic exposure IIA (also called 'low dose' IIA). RECENT FINDINGS Novel case series showed that acute and subacute IIA cases had similar causal agents (e.g., acid or base aerosols/fumes, dusts, mixtures) but had occurred in different circumstances (accidents vs. regular work). Acute and subacute IIA cases had similar clinical characteristics but poorer short-term outcomes than sensitizer-induced occupational asthma patients. Novel large epidemiological studies reported associations between chronic occupational exposure to irritants and current adult-onset asthma and poor asthma control, and with a specific asthma endotype characterized by neutrophilic inflammation and oxidative stress. Recent studies reconfirmed the association of the use of disinfectants and cleaning products (especially sprays) with IIA. A role for genetic susceptibility has been suggested. SUMMARY Recent literature provided further understanding of both acute/subacute and chronic exposure IIA, in terms of causes, possible mechanisms, and consequences such as poor asthma control. Research is needed to clarify several aspects of IIA, including its frequency (still likely underestimated), modulating factors, and mechanisms. Research aiming at improving irritant exposure assessment, including intensity/duration, and determining relevant exposure windows would be welcome.
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Affiliation(s)
- Steven Ronsmans
- KU Leuven, Centre for Environment and Health, Department of Public Health and Primary Care, Leuven, Belgium
| | - Nicole Le Moual
- Université Paris-Saclay, UVSQ, Univ. Paris-Sud, Inserm, Équipe d'Épidémiologie respiratoire intégrative, CESP, 94807, Villejuif, France
| | - Orianne Dumas
- Université Paris-Saclay, UVSQ, Univ. Paris-Sud, Inserm, Équipe d'Épidémiologie respiratoire intégrative, CESP, 94807, Villejuif, France
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Dalbøge A, Albert Kolstad H, Ulrik CS, Sherson DL, Meyer HW, Ebbehøj N, Sigsgaard T, Zock JP, Baur X, Schlünssen V. The Relationship Between Potential Occupational Sensitizing Exposures and Asthma: An Overview of Systematic Reviews. Ann Work Expo Health 2023; 67:163-181. [PMID: 36472234 DOI: 10.1093/annweh/wxac074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Accepted: 10/05/2022] [Indexed: 12/12/2022] Open
Abstract
OBJECTIVES The aim was to identify, appraise, and synthesize the scientific evidence of the relationship between potential occupational sensitizing exposures and the development of asthma based on systematic reviews. METHODS The study was conducted as an overview of systematic reviews. A systematic literature search was conducted for systematic reviews published up to 9 February 2020. Eligibility study criteria included persons in or above the working age, potential occupational sensitizing exposures, and outcomes defined as asthma. Potential occupational sensitizing exposures were divided into 23 main groups comprising both subgroups and specific exposures. Two reviewers independently selected studies, extracted study data, assessed study quality, and evaluated confidence in study results and level of evidence of the relationship between potential occupational sensitizing exposures and asthma. RESULTS Twenty-seven systematic reviews were included covering 1242 studies and 486 potential occupational sensitizing exposures. Overall confidence in study results was rated high in three systematic reviews, moderate in seven reviews, and low in 17 reviews. Strong evidence for the main group of wood dusts and moderate evidence for main groups of mites and fish was found. For subgroups/specific exposures, strong evidence was found for toluene diisocyanates, Aspergillus, Cladosporium, Penicillium, and work tasks involving exposure to laboratory animals, whereas moderate evidence was found for 52 subgroups/specific exposures. CONCLUSIONS This overview identified hundreds of potential occupational sensitizing exposures suspected to cause asthma and evaluated the level of evidence for each exposure. Strong evidence was found for wood dust in general and for toluene diisocyanates, Aspergillus, Cladosporium, Penicillium, and work tasks involving exposure to laboratory animals.
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Affiliation(s)
- Annett Dalbøge
- Department of Occupational Medicine, Danish Ramazzini Centre, Aarhus University Hospital, 8200 Aarhus, Denmark.,Department of Clinical Medicine, Aarhus University, 8200 Aarhus, Denmark
| | - Henrik Albert Kolstad
- Department of Occupational Medicine, Danish Ramazzini Centre, Aarhus University Hospital, 8200 Aarhus, Denmark
| | - Charlotte Suppli Ulrik
- Department of Respiratory Medicine, Hvidovre University Hospital, 2650 Hvidovre, Denmark
| | - David Lee Sherson
- Department of Occupational and Environmental Medicine, Odense University Hospital, 5000 Odense, Denmark.,Department of Pulmonary Medicine, Odense University Hospital, 5000 Odense, Denmark
| | - Harald William Meyer
- Department of Occupational and Environmental Medicine, Bispebjerg and Frederiksberg Hospital, 2400 Copenhagen, Denmark
| | - Niels Ebbehøj
- Department of Occupational and Environmental Medicine, Bispebjerg and Frederiksberg Hospital, 2400 Copenhagen, Denmark
| | - Torben Sigsgaard
- Department of Public Health, Environment, Occupation, and Health, Danish Ramazzini Centre, Aarhus University, 8000 Aarhus, Denmark
| | - Jan-Paul Zock
- National Institute for Public Health and the Environment (RIVM), Bilthoven, 3721 MA, The Netherlands
| | - Xaver Baur
- Institut für Arbeitsmedizin, Charité Universitätsmedizin Berlin, 10117 Berlin, Germany
| | - Vivi Schlünssen
- National Research Centre for the Working Environment, 2100 Copenhagen, Denmark.,Department of Public Health, Environment, Occupation, and Health, Danish Ramazzini Centre, Aarhus University, 8000 Aarhus, Denmark
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Kurt OK, Ergun D, Anlar HG, Hazar M, Aydin Dilsiz S, Karatas M, Basaran N. Evaluation of Oxidative Stress Parameters and Genotoxic Effects in Patients With Work-Related Asthma and Silicosis. J Occup Environ Med 2023; 65:146-151. [PMID: 36075368 DOI: 10.1097/jom.0000000000002701] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
OBJECTIVE To determine the mechanistic roles of oxidative stress, inflammation, and genotoxicity parameters in patients with work-related asthma (WRA) and silicosis. METHODS Thirty-eight healthy office workers, 27 employees with a history of exposure and no disease, 24 employees with WRA, and 23 employees with silicosis were included in this study. Superoxide dismutase, catalase, glutathione peroxidase, malondialdehyde, and interleukins (IL) 17, 23, and 27 levels were measured in the serum. Genotoxic damage was evaluated by calculating the frequency of micronuclei in swab samples and 8-hydroxy-2'-deoxyguanosine in serum. RESULTS Serum superoxide dismutase, catalase, glutathione peroxidase, malondialdehyde, 8-hydroxy-2'-deoxyguanosine, and IL-17, IL-23, and IL-27 levels were found to be statistically significantly higher in the exposure, WRA, and silicosis groups compared with the control group. The frequency of micronuclei in buccal epithelial cells of the patient group was found to be significantly higher than that of the control group. CONCLUSION These results may provide information for molecular mechanisms and early diagnosis of WRA and silicosis and will be a guide for taking precautions in the early period.
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Affiliation(s)
- Ozlem Kar Kurt
- From the Department of Pulmonary Medicine and Occupational Medicine, Yedikule Chest Diseases and Thoracic Surgery Training and Research Hospital, Istanbul, Turkey (Dr Ozlem Kar); Department of Pharmaceutical Toxicology, Faculty of Pharmacy, Hacettepe University, Ankara, Turkey (Drs Ozlem Kar, Dilsiz, and Basaran); Department of Pulmonary Medicine, Faculty of Medicine, Selcuk University, Konya, Turkey (Dr Ergun); Department of Pharmaceutical Toxicology, Faculty of Pharmacy, Bulent Ecevit University, Zonguldak, Turkey (Anlar); Department of Pharmaceutical Toxicology, Faculty of Pharmacy, Ibrahim Cecen University, Agri, Turkey (Ms Hazar); Department of Pulmonary Medicine, Occupational and Environmental Diseases Hospital, Ankara, Turkey (Dr Karatas); and Department of Pharmaceutical Toxicology, Faculty of Pharmacy, Baskent University, Ankara, Turkey (Dr Basaran)
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Peyneau M, de Chaisemartin L, Gigant N, Chollet-Martin S, Kerdine-Römer S. Quaternary ammonium compounds in hypersensitivity reactions. FRONTIERS IN TOXICOLOGY 2022; 4:973680. [PMID: 36211198 PMCID: PMC9534575 DOI: 10.3389/ftox.2022.973680] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Accepted: 08/18/2022] [Indexed: 11/13/2022] Open
Abstract
Quaternary ammonium compounds (QAC) are commonly used disinfectants, antiseptics, preservatives, and detergents due to their antibacterial property and represent the first used biocides before phenolic or nitrogen products. Their common structure consists of one or more quaternary ammonium bound with four lateral substituents. Their amphiphilic structure allows them to intercalate into microorganism surfaces which induces an unstable and porous membrane that explains their antimicrobial activity towards bacteria, fungi, and viruses. QAC are thus found in many areas, such as household products, medicines, hygiene products, cosmetics, agriculture, or industrial products but are also used in medical practice as disinfectants and antiseptics and in health care facilities where they are used for cleaning floors and walls. QAC exposure has already been involved in occupational asthma in healthcare workers or professional cleaners by many authors. They also have been suggested to play a role in contact dermatitis (CD) and urticaria in workers using cosmetics such as hairdressers or healthcare workers, inciting reglementary agencies to make recommendations regarding those products. However, distinguishing the irritant or sensitizing properties of chemicals is complex and as a result, the sensitizing property of QAC is still controverted. Moreover, the precise mechanisms underlying the possible sensitization effect are still under investigation, and to date, only a few studies have documented an immunological mechanism. Besides, QAC have been suggested to be responsible for neuromuscular blocking agents (NMBA) sensitization by cross-reactivity. This hypothesis is supported by a higher prevalence of quaternary ammonium (QA)-specific IgE in the professionally exposed populations, such as hairdressers, cleaners, or healthcare workers, suggesting that the sensitization happens with structurally similar compounds present in the environment. This review summarizes the newest knowledge about QAC and their role in hypersensitivities. After describing the different QAC, their structure and use, the most relevant studies about the effects of QAC on the immune system will be reviewed and discussed.
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Affiliation(s)
- Marine Peyneau
- Université Paris-Saclay, Inserm, Inflammation microbiome immunosurveillance, Châtenay-Malabry, France
- Department « Autoimmunité, Hypersensibilités et Biothérapies », DMU BioGeM, APHP, Hôpital Bichat, Paris, France
- *Correspondence: Marine Peyneau,
| | - Luc de Chaisemartin
- Université Paris-Saclay, Inserm, Inflammation microbiome immunosurveillance, Châtenay-Malabry, France
- Department « Autoimmunité, Hypersensibilités et Biothérapies », DMU BioGeM, APHP, Hôpital Bichat, Paris, France
| | - Nicolas Gigant
- CNRS, BioCIS, Université Paris-Saclay, Châtenay-Malabry, France
| | - Sylvie Chollet-Martin
- Université Paris-Saclay, Inserm, Inflammation microbiome immunosurveillance, Châtenay-Malabry, France
- Department « Autoimmunité, Hypersensibilités et Biothérapies », DMU BioGeM, APHP, Hôpital Bichat, Paris, France
| | - Saadia Kerdine-Römer
- Université Paris-Saclay, Inserm, Inflammation microbiome immunosurveillance, Châtenay-Malabry, France
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Effect of Different Molecular Weights of Polyacrylic Acid on Rat Lung Following Intratracheal Instillation. Int J Mol Sci 2022; 23:ijms231810345. [PMID: 36142256 PMCID: PMC9499135 DOI: 10.3390/ijms231810345] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2022] [Revised: 09/02/2022] [Accepted: 09/05/2022] [Indexed: 11/30/2022] Open
Abstract
Background: We conducted intratracheal instillations of different molecular weights of polyacrylic acid (PAA) into rats in order to examine what kinds of physicochemical characteristics of acrylic acid-based polymer affect responses in the lung. Methods: F344 rats were intratracheally exposed to a high molecular weight (HMW) of 598 thousand g/mol or a low molecular weight (LMW) of 30.9 thousand g/mol PAA at low and high doses. Rats were sacrificed at 3 days, 1 week, 1 month, 3 months and 6 months post exposure. Results: HMW PAA caused persistent increases in neutrophil influx, cytokine-induced neutrophil chemoattractants (CINC) in the bronchoalveolar lavage fluid (BALF), and heme oxygenase-1 (HO-1) in the lung tissue from 3 days to 3 months and 6 months following instillation. On the other hand, LMW PAA caused only transient increases in neutrophil influx, CINC in BALF, and HO-1 in the lung tissue from 3 days to up to 1 week or 1 month following instillation. Histopathological findings of the lungs demonstrated that the extensive inflammation and fibrotic changes caused by the HMW PAA was greater than that in exposure to the LMW PAA during the observation period. Conclusion: HMW PAA induced persistence of lung disorder, suggesting that molecular weight is a physicochemical characteristic of PAA-induced lung disorder.
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Tsui HC, Ronsmans S, Hoet PHM, Nemery B, Vanoirbeek JAJ. Occupational Asthma Caused by Low-Molecular-Weight Chemicals Associated With Contact Dermatitis: A Retrospective Study. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY. IN PRACTICE 2022; 10:2346-2354.e4. [PMID: 35643279 DOI: 10.1016/j.jaip.2022.05.014] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Revised: 04/12/2022] [Accepted: 05/06/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Occupational asthma (OA) may have different etiologies, but it is not clear whether the etiologic agents influence the clinical presentation, especially the co-occurrence of skin lesions. OBJECTIVE To determine the impact of different asthmagens on the characteristics of OA, with a focus on the occurrence of prior or concomitant skin disorders. METHODS In a retrospective analysis of patients who visited the Occupational and Environmental Disease Clinic of a tertiary referral hospital from 2009 to 2019, we classified patients into definite, probable, or possible OA according to prespecified diagnostic guidelines. In multivariate logistic regression with sensitivity analysis, we examined the relation of high- and low-molecular-weight (HMW and LMW) agents with the clinical presentation. RESULTS Of 209 cases of OA, 66 were caused by HMW agents and 143 by LMW agents. Patients with OA exposed to LMW agents had higher odds of having (had) allergic contact dermatitis (odds ratio, 5.45 [1.80-23.70]; P < .01), compared with patients exposed to HMW agents. Conversely, HMW agents were associated with higher odds of rhinitis symptoms (odds ratio of LMW/HMW, 0.33 [0.17-0.63]; P < .001) and high total IgE (odds ratio of LMW/HMW, 0.35 [0.17-0.70]; P < .01). Risk factors for having coexisting contact dermatitis included construction work, hairdressing, and exposure to metals or epoxy resins. CONCLUSIONS Among patients with OA, exposure to specific LMW agents was associated with a high frequency of contact dermatitis. Different types of asthmagens within HMW or LMW agents appear to determine the phenotype and comorbidity of OA.
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Affiliation(s)
- Hung-Chang Tsui
- Centre for Environment and Health, Department of Public Health and Primary Care, University of Leuven, Leuven, Belgium
| | - Steven Ronsmans
- Centre for Environment and Health, Department of Public Health and Primary Care, University of Leuven, Leuven, Belgium
| | - Peter H M Hoet
- Centre for Environment and Health, Department of Public Health and Primary Care, University of Leuven, Leuven, Belgium
| | - Benoit Nemery
- Centre for Environment and Health, Department of Public Health and Primary Care, University of Leuven, Leuven, Belgium.
| | - Jeroen A J Vanoirbeek
- Centre for Environment and Health, Department of Public Health and Primary Care, University of Leuven, Leuven, Belgium.
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Roach K, Roberts J. A comprehensive summary of disease variants implicated in metal allergy. JOURNAL OF TOXICOLOGY AND ENVIRONMENTAL HEALTH. PART B, CRITICAL REVIEWS 2022; 25:279-341. [PMID: 35975293 PMCID: PMC9968405 DOI: 10.1080/10937404.2022.2104981] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Allergic disease represents one of the most prominent global public health crises of the 21st century. Although many different substances are known to produce hypersensitivity responses, metals constitute one of the major classes of allergens responsible for a disproportionately large segment of the total burden of disease associated with allergy. Some of the most prevalent forms of metal allergy - including allergic contact dermatitis - are well-recognized; however, to our knowledge, a comprehensive review of the many unique disease variants implicated in human cases of metal allergy is not available within the current scientific literature. Consequently, the main goal in composing this review was to (1) generate an up-to-date reference document containing this information to assist in the efforts of lab researchers, clinicians, regulatory toxicologists, industrial hygienists, and other scientists concerned with metal allergy and (2) identify knowledge gaps related to disease. Accordingly, an extensive review of the scientific literature was performed - from which, hundreds of publications describing cases of metal-specific allergic responses in human patients were identified, collected, and analyzed. The information obtained from these articles was then used to compile an exhaustive list of distinctive dermal/ocular, respiratory, gastrointestinal, and systemic hypersensitivity responses associated with metal allergy. Each of these disease variants is discussed briefly within this review, wherein specific metals implicated in each response type are identified, underlying immunological mechanisms are summarized, and major clinical presentations of each reaction are described.Abbreviations: ACD: allergic contact dermatitis, AHR: airway hyperreactivity, ASIA: autoimmune/ autoinflammatory syndrome induced by adjuvants, BAL: bronchoalveolar lavage, CBD: chronic beryllium disease, CTCL: cutaneous T-cell lymphoma, CTL: cytotoxic T-Lymphocyte, DRESS: drug reaction with eosinophilia and systemic symptoms, GERD: gastro-esophageal reflux disease, GI: gastrointestinal, GIP: giant cell interstitial pneumonia, GM-CSF: granulocyte macrophage-colony stimulating factor, HMLD: hard metal lung disease, HMW: high molecular weight, IBS: irritable bowel syndrome, Ig: immunoglobulin, IL: interleukin, LMW: low molecular weight, PAP: pulmonary alveolar proteinosis, PPE: personal protective equipment, PRR: pathogen recognition receptor, SLE: systemic lupus erythematosus, SNAS: systemic nickel allergy syndrome, Th: helper T-cell, UC: ulcerative colitis, UV: ultraviolet.
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Affiliation(s)
- Ka Roach
- Allergy and Clinical Immunology Branch (ACIB), National Institute of Occupational Safety and Health (NIOSH), Morgantown, WV, USA
| | - Jr Roberts
- Allergy and Clinical Immunology Branch (ACIB), National Institute of Occupational Safety and Health (NIOSH), Morgantown, WV, USA
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Pacheco Da Silva E, Sit G, Goldberg M, Leynaert B, Nadif R, Ribet C, Roche N, Zins M, Varraso R, Dumas O, Le Moual N. Household use of green and homemade cleaning products, wipe application mode, and asthma among French adults from the CONSTANCES cohort. INDOOR AIR 2022; 32:e13078. [PMID: 35904383 PMCID: PMC9545541 DOI: 10.1111/ina.13078] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Revised: 06/13/2022] [Accepted: 06/30/2022] [Indexed: 06/15/2023]
Abstract
While exposure to irritant and sprayed cleaning products at home is known to have a harmful role in asthma, the potential health effect of other categories or forms has not been investigated. We studied the associations of household use of cleaning products, including green, homemade products, and disinfecting wipes, with asthma based on data from the large French population-based CONSTANCES cohort. Participants completed standardized questionnaires on respiratory health and household use of cleaning products. Cross-sectional associations of cleaning products with current asthma, adjusted for gender, age, smoking status, BMI, and educational level, were evaluated by logistic regressions. Analyses were conducted in 41 570 participants (mean age: 47 years, 56% women, weekly use of the six specific products/forms studied varied from 11% to 37%). Weekly use of irritants (OR = 1.23 [1.13-1.35]), scented (OR = 1.15 [1.06-1.26]), green (OR = 1.09 [1.00-1.20]), and homemade products (OR = 1.19 [1.06-1.34]), as well as sprays (OR = 1.18 [1.08-1.29]), disinfecting wipes (OR = 1.21 [1.09-1.34]) were significantly associated with asthma, with significant trends according to the frequency of use. When they were not co-used with irritants/sprays, associations were reduced and persisted only for disinfecting wipes. Weekly use of disinfecting wipes at home was associated with current asthma, but fewer risks were observed for the use of green and homemade products.
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Affiliation(s)
- Emilie Pacheco Da Silva
- Université Paris‐Saclay, UVSQ, Univ. Paris‐Sud, InsermÉquipe d'Épidémiologie Respiratoire Intégrative, CESPVillejuifFrance
| | - Guillaume Sit
- Université Paris‐Saclay, UVSQ, Univ. Paris‐Sud, InsermÉquipe d'Épidémiologie Respiratoire Intégrative, CESPVillejuifFrance
| | - Marcel Goldberg
- Université de Paris, Unité "Cohortes en Population" INSERMUniversité Paris Saclay, UVSQ, UMSParisFrance
| | - Bénédicte Leynaert
- Université Paris‐Saclay, UVSQ, Univ. Paris‐Sud, InsermÉquipe d'Épidémiologie Respiratoire Intégrative, CESPVillejuifFrance
| | - Rachel Nadif
- Université Paris‐Saclay, UVSQ, Univ. Paris‐Sud, InsermÉquipe d'Épidémiologie Respiratoire Intégrative, CESPVillejuifFrance
| | - Céline Ribet
- Université de Paris, Unité "Cohortes en Population" INSERMUniversité Paris Saclay, UVSQ, UMSParisFrance
| | - Nicolas Roche
- Pneumologie, Hôpital CochinAPHP.Centre – Université de ParisParisFrance
| | - Marie Zins
- Université de Paris, Unité "Cohortes en Population" INSERMUniversité Paris Saclay, UVSQ, UMSParisFrance
| | - Raphaëlle Varraso
- Université Paris‐Saclay, UVSQ, Univ. Paris‐Sud, InsermÉquipe d'Épidémiologie Respiratoire Intégrative, CESPVillejuifFrance
| | - Orianne Dumas
- Université Paris‐Saclay, UVSQ, Univ. Paris‐Sud, InsermÉquipe d'Épidémiologie Respiratoire Intégrative, CESPVillejuifFrance
| | - Nicole Le Moual
- Université Paris‐Saclay, UVSQ, Univ. Paris‐Sud, InsermÉquipe d'Épidémiologie Respiratoire Intégrative, CESPVillejuifFrance
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Lenander-Ramirez A, Bryngelsson IL, Vihlborg P, Westberg H, Andersson L. Respirable Dust and Silica: Respiratory Diseases Among Swedish Iron Foundry Workers. J Occup Environ Med 2022; 64:593-598. [PMID: 35275887 PMCID: PMC9301988 DOI: 10.1097/jom.0000000000002533] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
OBJECTIVE The mortality and morbidity pattern for respiratory diseases was determined in a cohort of 1752 Swedish foundry workers, particularly for respirable silica dust exposure. METHODS The morbidity follow-up in the Swedish National Non-primary Outpatient Register covered 2001 to 2017 (NPR; specialist not in care patients), the mortality from the National Causes of Death Register covered 2001 to 2017. Cumulative exposures to silica and dust were determined. RESULTS The morbidity in COPD showed significantly increased risk for all exposure groups, as did silicosis in the high exposure group, these cases corresponded to silica exposure levels below 0.05 mg/m3. The mortality of all causes and respiratory diseases was significantly increased by cumulative silica exposure in the high exposure group. CONCLUSIONS Significantly increased morbidity for respiratory diseases and COPD was determined at silica exposure levels below the current Swedish OEL.
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Affiliation(s)
- Alexander Lenander-Ramirez
- From the Department of Occupational and Environmental Medicine, Faculty of Medicine and Health, Örebro University, Örebro, Sweden (Lenander-Ramirez, Bryngelsson, Westberg, and Dr Andersson); Geriatic Clinic, Faculty of Medicine and Health, Örebro University, Örebro Sweden (Dr Vihlborg); School of Medical Sciences, Faculty of Medicine and Health, Örebro University, Örebro, Sweden (Westberg and Dr Andersson)
| | - Ing-Liss Bryngelsson
- From the Department of Occupational and Environmental Medicine, Faculty of Medicine and Health, Örebro University, Örebro, Sweden (Lenander-Ramirez, Bryngelsson, Westberg, and Dr Andersson); Geriatic Clinic, Faculty of Medicine and Health, Örebro University, Örebro Sweden (Dr Vihlborg); School of Medical Sciences, Faculty of Medicine and Health, Örebro University, Örebro, Sweden (Westberg and Dr Andersson)
| | - Per Vihlborg
- From the Department of Occupational and Environmental Medicine, Faculty of Medicine and Health, Örebro University, Örebro, Sweden (Lenander-Ramirez, Bryngelsson, Westberg, and Dr Andersson); Geriatic Clinic, Faculty of Medicine and Health, Örebro University, Örebro Sweden (Dr Vihlborg); School of Medical Sciences, Faculty of Medicine and Health, Örebro University, Örebro, Sweden (Westberg and Dr Andersson)
| | - Håkan Westberg
- From the Department of Occupational and Environmental Medicine, Faculty of Medicine and Health, Örebro University, Örebro, Sweden (Lenander-Ramirez, Bryngelsson, Westberg, and Dr Andersson); Geriatic Clinic, Faculty of Medicine and Health, Örebro University, Örebro Sweden (Dr Vihlborg); School of Medical Sciences, Faculty of Medicine and Health, Örebro University, Örebro, Sweden (Westberg and Dr Andersson)
| | - Lena Andersson
- From the Department of Occupational and Environmental Medicine, Faculty of Medicine and Health, Örebro University, Örebro, Sweden (Lenander-Ramirez, Bryngelsson, Westberg, and Dr Andersson); Geriatic Clinic, Faculty of Medicine and Health, Örebro University, Örebro Sweden (Dr Vihlborg); School of Medical Sciences, Faculty of Medicine and Health, Örebro University, Örebro, Sweden (Westberg and Dr Andersson)
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Mokarami H, Choobineh S, Rahimian F, Soleimani E. Respiratory symptoms among crop farmers and comparison with a general population sample: a cross-sectional study. TOXICOLOGY AND ENVIRONMENTAL HEALTH SCIENCES 2022; 14:187-192. [DOI: 10.1007/s13530-022-00128-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 04/18/2022] [Indexed: 09/13/2023]
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Takeda T, Yamano S, Goto Y, Hirai S, Furukawa Y, Kikuchi Y, Misumi K, Suzuki M, Takanobu K, Senoh H, Saito M, Kondo H, Daghlian G, Hong YK, Yoshimatsu Y, Hirashima M, Kobashi Y, Okamoto K, Kishimoto T, Umeda Y. Dose-response relationship of pulmonary disorders by inhalation exposure to cross-linked water-soluble acrylic acid polymers in F344 rats. Part Fibre Toxicol 2022; 19:27. [PMID: 35395797 PMCID: PMC8994297 DOI: 10.1186/s12989-022-00468-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Accepted: 03/30/2022] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND In Japan, six workers handling cross-linked water-soluble acrylic acid polymer (CWAAP) at a chemical plant suffered from lung diseases, including fibrosis, interstitial pneumonia, emphysema, and pneumothorax. We recently demonstrated that inhalation of CWAAP-A, one type of CWAAP, causes pulmonary disorders in rats. It is important to investigate dose-response relationships and recoverability from exposure to CWAAPs for establishing occupational health guidelines, such as setting threshold limit value for CWAAPs in the workplace. METHODS Male and female F344 rats were exposed to 0.3, 1, 3, or 10 mg/m3 CWAAP-A for 6 h/day, 5 days/week for 13 weeks using a whole-body inhalation exposure system. At 1 h, 4 weeks, and 13 weeks after the last exposure the rats were euthanized and blood, bronchoalveolar lavage fluid, and all tissues including lungs and mediastinal lymph nodes were collected and subjected to biological and histopathological analyses. In a second experiment, male rats were pre-treated with clodronate liposome or polymorphonuclear leukocyte-neutralizing antibody to deplete macrophages or neutrophils, respectively, and exposed to CWAAP-A for 6 h/day for 2 days. RESULTS CWAAP-A exposure damaged only the alveoli. The lowest observed adverse effect concentration (LOAEC) was 1 mg/m3 and the no observed adverse effect concentration (NOAEC) was 0.3 mg/m3. Rats of both sexes were able to recover from the tissue damage caused by 13 weeks exposure to 1 mg/m3 CWAAP-A. In contrast, tissue damage caused by exposure to 3 and 10 mg/m3 was irreversible due to the development of interstitial lung lesions. There was a gender difference in the recovery from CWAAP-A induced pulmonary disorders, with females recovering less than males. Finally, acute lung effects caused by CWAAP-A were significantly reduced by depletion of alveolar macrophages. CONCLUSIONS Pulmonary damage caused by inhalation exposure to CWAAP-A was dose-dependent, specific to the lung and lymph nodes, and acute lung damage was ameliorated by depleting macrophages in the lungs. CWAAP-A had both a LOAEC and a NOAEC, and tissue damage caused by exposure to 1 mg/m3 CWAAP-A was reversible: recovery in female rats was less than for males. These findings indicate that concentration limits for CWAAPs in the workplace can be determined.
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Affiliation(s)
- Tomoki Takeda
- Japan Bioassay Research Center, Japan Organization of Occupational Health and Safety, Hadano, Kanagawa, 257-0015, Japan.
| | - Shotaro Yamano
- Japan Bioassay Research Center, Japan Organization of Occupational Health and Safety, Hadano, Kanagawa, 257-0015, Japan.
| | - Yuko Goto
- Japan Bioassay Research Center, Japan Organization of Occupational Health and Safety, Hadano, Kanagawa, 257-0015, Japan
| | - Shigeyuki Hirai
- Japan Bioassay Research Center, Japan Organization of Occupational Health and Safety, Hadano, Kanagawa, 257-0015, Japan
| | - Yusuke Furukawa
- Japan Bioassay Research Center, Japan Organization of Occupational Health and Safety, Hadano, Kanagawa, 257-0015, Japan
| | - Yoshinori Kikuchi
- Japan Bioassay Research Center, Japan Organization of Occupational Health and Safety, Hadano, Kanagawa, 257-0015, Japan
| | - Kyohei Misumi
- Japan Bioassay Research Center, Japan Organization of Occupational Health and Safety, Hadano, Kanagawa, 257-0015, Japan
| | - Masaaki Suzuki
- Japan Bioassay Research Center, Japan Organization of Occupational Health and Safety, Hadano, Kanagawa, 257-0015, Japan
| | - Kenji Takanobu
- Japan Bioassay Research Center, Japan Organization of Occupational Health and Safety, Hadano, Kanagawa, 257-0015, Japan
| | - Hideki Senoh
- Japan Bioassay Research Center, Japan Organization of Occupational Health and Safety, Hadano, Kanagawa, 257-0015, Japan
| | - Misae Saito
- Japan Bioassay Research Center, Japan Organization of Occupational Health and Safety, Hadano, Kanagawa, 257-0015, Japan
| | - Hitomi Kondo
- Japan Bioassay Research Center, Japan Organization of Occupational Health and Safety, Hadano, Kanagawa, 257-0015, Japan
| | - George Daghlian
- Department of Surgery, Norris Comprehensive Cancer Center, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Young-Kwon Hong
- Department of Surgery, Norris Comprehensive Cancer Center, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Yasuhiro Yoshimatsu
- Division of Pharmacology, Niigata University Graduate School of Medical and Dental Sciences, Niigata, 951-8510, Japan
| | - Masanori Hirashima
- Division of Pharmacology, Niigata University Graduate School of Medical and Dental Sciences, Niigata, 951-8510, Japan
| | - Yoichiro Kobashi
- Department of Pathology, Tenri Hospital, Tenri, Nara, 632-8552, Japan
| | - Kenzo Okamoto
- Department of Pathology, Hokkaido Chuo Rosai Hospital, Japan Organization of Occupational Health and Safety, Iwamizawa, Hokkaido, 068-0004, Japan
| | - Takumi Kishimoto
- Director of Research and Training Center for Asbestos-Related Diseases, Okayama, Okayama, 702-8055, Japan
| | - Yumi Umeda
- Japan Bioassay Research Center, Japan Organization of Occupational Health and Safety, Hadano, Kanagawa, 257-0015, Japan
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Barber CM, Cullinan P, Feary J, Fishwick D, Hoyle J, Mainman H, Walters GI. British Thoracic Society Clinical Statement on occupational asthma. Thorax 2022; 77:433-442. [DOI: 10.1136/thoraxjnl-2021-218597] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Duc Nguyen H, Oh H, Kim MS. Association between exposure to chemical mixtures in relation to serum total IgE among adults 19-86 years old. Int Immunopharmacol 2021; 102:108428. [PMID: 34911030 DOI: 10.1016/j.intimp.2021.108428] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Revised: 11/20/2021] [Accepted: 11/30/2021] [Indexed: 02/02/2023]
Abstract
There is a scarcity of studies on the effects of mixed chemicals on total IgE. We aim to assess whether there is a link between chemical mixtures (blood and urine of 26 chemicals including lead, mercury, cadmium, t,t-muconic acid, benzylmercapturic acid , 1-hydroxypyrene, 2-naphthol, 2-hydroxyfluorene, 1-hydroxyphenanthrene, mono-(2-ethyl-5-hydroxyhexyl) phthalate, mono-(2-ethyl-5-oxohexyl) phthalate, mono-n-butyl phthalate, mono-benzyl phthalate, mono-(2-ethyl-5-carboxypentyl) phthalate, mono-carboxyoctyl phthalate, mono-carboxy-isononly phthalate, mono (3-carboxypropyl) phthalate, bisphenol A, bisphenol F, bisphenol S, triclosan, methylparaben, ethylparaben, propylparaben, 3-phenoxybenzoic acid, and cotinine), and total IgE in 3,642 Korean adults aged ≥ 19. The effects of mixed chemical exposure on total IgE were identified using linear regression models, weighted quantile sum (WQS) regression, quantile g-computation (qgcomp), and Bayesian kernel machine regression (BKMR). The most relevant factors linked with IgE, according to the linear regression models, were blood or urine mercury and urine bisphenol A levels, with significant trends detected for these chemical tertiles (p < 0.01). The WQS index was significantly linked with ln2-transformed levels of serum total IgE (β = 0.30, 95 %CI 0.25-0.32). The qgcomp index also found a significant link between chemicals and ln2-transformed levels of serum total IgE (β = 0.52, 95 %CI 0.21-0.82), and elevated serum total IgE levels (OR = 2.55, 95 %CI 1.14-5.71). In BKMR analysis, the overall effect of the mixture was significantly associated with ln2-transformed levels of serum total IgE. The cutoff levels for exposure levels related to serum total IgE levels/elevated serum total IgE levels were reported. We discovered that whole-body exposure to 26 chemicals was associated with serum total IgE levels after assessing the findings of these four models. More research is needed in the future to gain a better understanding of the impact of mixed chemical exposure on allergic disorders and how to minimize chemical exposure, especially for people under the age of 18.
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Affiliation(s)
- Hai Duc Nguyen
- Department of Pharmacy, College of Pharmacy and Research Institute of Life and Pharmaceutical Sciences, Sunchon National University, Sunchon, Jeonnam, Republic of Korea
| | - Hojin Oh
- Department of Pharmacy, College of Pharmacy and Research Institute of Life and Pharmaceutical Sciences, Sunchon National University, Sunchon, Jeonnam, Republic of Korea
| | - Min-Sun Kim
- Department of Pharmacy, College of Pharmacy and Research Institute of Life and Pharmaceutical Sciences, Sunchon National University, Sunchon, Jeonnam, Republic of Korea.
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Sit G, Letellier N, Iwatsubo Y, Goldberg M, Leynaert B, Nadif R, Ribet C, Roche N, Roquelaure Y, Varraso R, Zins M, Descatha A, Le Moual N, Dumas O. Occupational Exposures to Organic Solvents and Asthma Symptoms in the CONSTANCES Cohort. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18179258. [PMID: 34501848 PMCID: PMC8431091 DOI: 10.3390/ijerph18179258] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Revised: 08/25/2021] [Accepted: 08/27/2021] [Indexed: 01/17/2023]
Abstract
Solvents are used in many workplaces and may be airway irritants but few studies have examined their association with asthma. We studied this question in CONSTANCES (cohort of ‘CONSulTANts des Centres d’Examens de Santé’), a large French cohort. Current asthma and asthma symptom scores were defined by participant-reported respiratory symptoms, asthma medication or attacks, and the sum of 5 symptoms, in the past 12 months, respectively. Lifetime exposures to 5 organic solvents, paints and inks were assessed by questionnaire and a population-based Job-Exposure Matrix (JEM). Cross-sectional associations between exposures and outcomes were evaluated by gender using logistic and negative binomial regressions adjusted for age, smoking habits and body mass index. Analyses included 115,757 adults (54% women, mean age 47 years, 9% current asthma). Self-reported exposure to ≥1 solvent was significantly associated with current asthma in men and women, whereas using the JEM, a significant association was observed only in women. Significant associations between exposures to ≥1 solvent and asthma symptom score were observed for both self-report (mean score ratio, 95%CI, women: 1.36, 1.31–1.42; men: 1.34, 1.30–1.40) and JEM (women: 1.10, 1.07–1.15; men: 1.14, 1.09–1.18). Exposure to specific solvents was significantly associated with higher asthma symptom score. Occupational exposure to solvents should be systematically sought when caring for asthma.
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Affiliation(s)
- Guillaume Sit
- Université Paris-Saclay, UVSQ, Univ. Paris-Sud, Inserm, Équipe d’Épidémiologie respiratoire intégrative, CESP, 94807 Villejuif, France; (G.S.); (B.L.); (R.N.); (N.R.); (R.V.); (A.D.); (O.D.)
| | - Noémie Letellier
- Herbert Wertheim School of Public Health and Human Longevity Science & Scripps, Institution of Oceanography, UC San Diego, La Jolla, CA 92093, USA;
| | - Yuriko Iwatsubo
- Santé publique France Direction Santé Environnement Travail, 94415 Saint-Maurice, France;
| | - Marcel Goldberg
- Population-Based Epidemiological Cohorts Unit, INSERM UMS 11, 94807 Villejuif, France; (M.G.); (C.R.); (M.Z.)
- Faculty of Medicine, University of Paris, 75006 Paris, France
| | - Bénédicte Leynaert
- Université Paris-Saclay, UVSQ, Univ. Paris-Sud, Inserm, Équipe d’Épidémiologie respiratoire intégrative, CESP, 94807 Villejuif, France; (G.S.); (B.L.); (R.N.); (N.R.); (R.V.); (A.D.); (O.D.)
| | - Rachel Nadif
- Université Paris-Saclay, UVSQ, Univ. Paris-Sud, Inserm, Équipe d’Épidémiologie respiratoire intégrative, CESP, 94807 Villejuif, France; (G.S.); (B.L.); (R.N.); (N.R.); (R.V.); (A.D.); (O.D.)
| | - Céline Ribet
- Population-Based Epidemiological Cohorts Unit, INSERM UMS 11, 94807 Villejuif, France; (M.G.); (C.R.); (M.Z.)
| | - Nicolas Roche
- Université Paris-Saclay, UVSQ, Univ. Paris-Sud, Inserm, Équipe d’Épidémiologie respiratoire intégrative, CESP, 94807 Villejuif, France; (G.S.); (B.L.); (R.N.); (N.R.); (R.V.); (A.D.); (O.D.)
- APHP Centre—Université de Paris, Hôpital et Institut Cochin, Service de Pneumologie, 75014 Paris, France
| | - Yves Roquelaure
- UNIV Angers, CHU Angers, Univ Rennes, Inserm, EHESP, Irset (Institut de recherche en santé, environnement et travail)—UMR_S1085, F-49000 Angers, France;
| | - Raphaëlle Varraso
- Université Paris-Saclay, UVSQ, Univ. Paris-Sud, Inserm, Équipe d’Épidémiologie respiratoire intégrative, CESP, 94807 Villejuif, France; (G.S.); (B.L.); (R.N.); (N.R.); (R.V.); (A.D.); (O.D.)
| | - Marie Zins
- Population-Based Epidemiological Cohorts Unit, INSERM UMS 11, 94807 Villejuif, France; (M.G.); (C.R.); (M.Z.)
- Faculty of Medicine, University of Paris, 75006 Paris, France
| | - Alexis Descatha
- Université Paris-Saclay, UVSQ, Univ. Paris-Sud, Inserm, Équipe d’Épidémiologie respiratoire intégrative, CESP, 94807 Villejuif, France; (G.S.); (B.L.); (R.N.); (N.R.); (R.V.); (A.D.); (O.D.)
- UNIV Angers, CHU Angers, Univ Rennes, Inserm, EHESP, Irset (Institut de recherche en santé, environnement et travail)—UMR_S1085, F-49000 Angers, France;
| | - Nicole Le Moual
- Université Paris-Saclay, UVSQ, Univ. Paris-Sud, Inserm, Équipe d’Épidémiologie respiratoire intégrative, CESP, 94807 Villejuif, France; (G.S.); (B.L.); (R.N.); (N.R.); (R.V.); (A.D.); (O.D.)
- Correspondence:
| | - Orianne Dumas
- Université Paris-Saclay, UVSQ, Univ. Paris-Sud, Inserm, Équipe d’Épidémiologie respiratoire intégrative, CESP, 94807 Villejuif, France; (G.S.); (B.L.); (R.N.); (N.R.); (R.V.); (A.D.); (O.D.)
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25
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Andrianjafimasy MV, Febrissy M, Zerimech F, Dananché B, Kromhout H, Matran R, Nadif M, Oberson-Geneste D, Quinot C, Schlünssen V, Siroux V, Zock JP, Le Moual N, Nadif R, Dumas O. Association between occupational exposure to irritant agents and a distinct asthma endotype in adults. Occup Environ Med 2021; 79:155-161. [PMID: 34413158 DOI: 10.1136/oemed-2020-107065] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Accepted: 07/22/2021] [Indexed: 11/04/2022]
Abstract
AIM The biological mechanisms of work-related asthma induced by irritants remain unclear. We investigated the associations between occupational exposure to irritants and respiratory endotypes previously identified among never asthmatics (NA) and current asthmatics (CA) integrating clinical characteristics and biomarkers related to oxidative stress and inflammation. METHODS We used cross-sectional data from 999 adults (mean 45 years old, 46% men) from the case-control and familial Epidemiological study on the Genetics and Environments of Asthma (EGEA) study. Five respiratory endotypes have been identified using a cluster-based approach: NA1 (n=463) asymptomatic, NA2 (n=169) with respiratory symptoms, CA1 (n=50) with active treated adult-onset asthma, poor lung function, high blood neutrophil counts and high fluorescent oxidation products level, CA2 (n=203) with mild middle-age asthma, rhinitis and low immunoglobulin E level, and CA3 (n=114) with inactive/mild untreated allergic childhood-onset asthma. Occupational exposure to irritants during the current or last held job was assessed by the updated occupational asthma-specific job-exposure matrix (levels of exposure: no/medium/high). Associations between irritants and each respiratory endotype (NA1 asymptomatic as reference) were studied using logistic regressions adjusted for age, sex and smoking status. RESULTS Prevalence of high occupational exposure to irritants was 7% in NA1, 6% in NA2, 16% in CA1, 7% in CA2 and 10% in CA3. High exposure to irritants was associated with CA1 (adjusted OR aOR, (95% CI) 2.7 (1.0 to 7.3)). Exposure to irritants was not significantly associated with other endotypes (aOR range: 0.8 to 1.5). CONCLUSION Occupational exposure to irritants was associated with a distinct respiratory endotype suggesting oxidative stress and neutrophilic inflammation as potential associated biological mechanisms.
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Affiliation(s)
- Miora Valérie Andrianjafimasy
- Université Paris-Saclay, UVSQ, Univ. Paris-Sud, Inserm, Équipe d'Épidémiologie respiratoire intégrative, CESP, 94807, Villejuif, Île-de-France, France
| | - Mickaël Febrissy
- LIPADE, Université Paris 5 Descartes, Paris, Île-de-France, France
| | - Farid Zerimech
- Univ. Lille, ULR 4483 - IMPECS, CHU Lille, F-59000 Lille, Lille, France.,Institut Pasteur de Lille, F-59000, Lille, France
| | | | - Hans Kromhout
- Utrecht University, Division of Environmental Epidemiology, Institute for Risk Assessment Sciences, Utrecht, Netherlands
| | - Régis Matran
- Univ. Lille, ULR 4483 - IMPECS, CHU Lille, F-59000 Lille, Lille, France.,Institut Pasteur de Lille, F-59000, Lille, France
| | - Mohamed Nadif
- LIPADE, Université Paris 5 Descartes, Paris, Île-de-France, France
| | | | - Catherine Quinot
- Université Paris-Saclay, UVSQ, Univ. Paris-Sud, Inserm, Équipe d'Épidémiologie respiratoire intégrative, CESP, 94807, Villejuif, Île-de-France, France
| | - Vivi Schlünssen
- Aarhus University, Department of Public Health, Environment, Occupation and Health, Danish Ramazzini Centre, Aarhus, Denmark.,National Research Centre for the Working Environment, Kobenhavn, Denmark
| | - Valérie Siroux
- Universite Grenoble Alpes, Inserm, CNRS, Team of environmental epidemiology applied to Reproduction and Respiratory health, IAB, Grenoble, France
| | - Jan-Paul Zock
- Institute for Global Health (ISGlobal) and Universitat Pompeu Fabra (UPF), Barcelona, Spain
| | - Nicole Le Moual
- Université Paris-Saclay, UVSQ, Univ. Paris-Sud, Inserm, Équipe d'Épidémiologie respiratoire intégrative, CESP, 94807, Villejuif, Île-de-France, France
| | - Rachel Nadif
- Université Paris-Saclay, UVSQ, Univ. Paris-Sud, Inserm, Équipe d'Épidémiologie respiratoire intégrative, CESP, 94807, Villejuif, Île-de-France, France
| | - Orianne Dumas
- Université Paris-Saclay, UVSQ, Univ. Paris-Sud, Inserm, Équipe d'Épidémiologie respiratoire intégrative, CESP, 94807, Villejuif, Île-de-France, France
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26
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Occupational Respiratory Allergy: Risk Factors, Diagnosis, and Management. Handb Exp Pharmacol 2021; 268:213-225. [PMID: 34031758 DOI: 10.1007/164_2021_472] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Occupational allergies are among the most common recorded occupational diseases. The skin and the upper and lower respiratory tract are the classical manifestation organs. More than 400 occupational agents are currently documented as being potential "respiratory sensitizers" and new reported causative agents are reported each year. These agents may induce occupational rhinitis (OR) or occupational asthma (OA) and can be divided into high-molecular weight (HMW) and low-molecular weight (LMW) agents. The most common occupational HMW agents are (glycol)proteins found in flour and grains, enzymes, laboratory animals, fish and seafood, molds, and Hevea brasiliensis latex. Typical LMW substances are isocyanates, metals, quaternary ammonium persulfate, acid anhydrides, and cleaning products/disinfectants. Diagnosis of occupational respiratory allergy is made by a combination of medical history, physical examination, positive methacholine challenge result or bronchodilator responsiveness, determination of IgE-mediated sensitization, and specific inhalation challenge tests as the gold standard. Accurate diagnosis of asthma is the first step to managing OA as shown above. Removal from the causative agent is of central importance for the management of OA. The best strategy to avoid OA is primary prevention, ideally by avoiding the use of and exposure to the sensitizer or substituting safer substances for these agents.
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27
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Cullinan P, Vandenplas O, Bernstein D. Assessment and Management of Occupational Asthma. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY-IN PRACTICE 2021; 8:3264-3275. [PMID: 33161958 DOI: 10.1016/j.jaip.2020.06.031] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Revised: 05/27/2020] [Accepted: 06/02/2020] [Indexed: 12/01/2022]
Abstract
Exposures at work can give rise to different phenotypes of "work-related asthma." The focus of this review is on the diagnosis and management of sensitizer-induced occupational asthma (OA) caused by either a high- or low-molecular-weight agent encountered in the workplace. The diagnosis of OA remains a challenge for the clinician because there is no simple test with a sufficiently high level of accuracy. Instead, the diagnostic process combines different procedures in a stepwise manner. These procedures include a detailed clinical history, immunologic testing, measurement of lung function parameters and airway inflammatory markers, as well as various methods that relate changes in these functional and inflammatory indices to workplace exposure. Their diagnostic performances, alone and in combination, are critically reviewed and summarized into evidence-based key messages. A working diagnostic algorithm is proposed that can be adapted to the suspected agent, purpose of diagnosis, and available resources. Current information on the management options of OA is summarized to provide pragmatic guidance to clinicians who have to advise their patients with OA.
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Affiliation(s)
- Paul Cullinan
- Department of Occupational and Environmental Medicine, Royal Brompton Hospital and Imperial College (NHLI), London, United Kingdom
| | - Olivier Vandenplas
- Department of Chest Medicine, Centre Hospitalier Universitaire UCL Namur, Université Catholique de Louvain, Yvoir, Belgium.
| | - David Bernstein
- Division of Immunology, Allergy and Rheumatology, University of Cincinnati College of Medicine, Cincinnati, Ohio
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28
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Migueres N, Debaille C, Walusiak-Skorupa J, Lipińska-Ojrzanowska A, Munoz X, van Kampen V, Suojalehto H, Suuronen K, Seed M, Lee S, Rifflart C, Godet J, de Blay F, Vandenplas O. Occupational Asthma Caused by Quaternary Ammonium Compounds: A Multicenter Cohort Study. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY-IN PRACTICE 2021; 9:3387-3395. [PMID: 33940212 DOI: 10.1016/j.jaip.2021.04.041] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Revised: 04/11/2021] [Accepted: 04/16/2021] [Indexed: 01/11/2023]
Abstract
BACKGROUND Quaternary ammonium compounds (QACs) are used extensively for cleaning and disinfection and have been documented in scattered reports as a cause of occupational asthma (OA) through bronchoprovocation tests (BPTs). OBJECTIVE To examine the clinical, functional, and inflammatory profile of QAC-induced OA compared with OA caused by other low-molecular weight (LMW) agents. METHODS The study was conducted in a retrospective multicenter cohort of 871 subjects with OA ascertained by a positive BPT. Subjects with QAC-induced OA (n = 22) were identified based on a positive BPT to QACs after exclusion of those challenged with cleaning products or disinfectants that contained other potential respiratory sensitizers. They were compared with 289 subjects with OA caused by other LMW agents. RESULTS Most subjects with QAC-induced OA were working in the health care sector (n = 14). A twofold or greater increase in the postchallenge level of nonspecific bronchial hyperresponsiveness was recorded in eight of 11 subjects with QAC-induced OA (72.7%) and in 49.7% of those with OA caused by other LMW agents. Although sputum assessment was available in only eight subjects with QAC-induced OA, they showed a significantly greater median (interquartile) increase in sputum eosinophils (18.1% [range, 12.1% to 21.1%]) compared with those with OA caused by other LMW agents (2.0% [range, 0% to 5.2%]; P < .001). CONCLUSIONS This study indicates that QAC-induced OA is associated with a highly eosinophilic pattern of airway response and provides further evidence supporting the sensitizing potential of QACs. The findings highlight the heterogeneous nature of the pathobiologic pathways involved in OA caused by LMW agents.
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Affiliation(s)
- Nicolas Migueres
- Groupe Méthode Recherche Clinique, Pôle de Santé Publique, Strasbourg University, Strasbourg, France; Division of Asthma and Allergy, Department of Chest Diseases, University Hospital of Strasbourg and Fédération de Médecine Translationnelle, Strasbourg University, Strasbourg, France
| | - Charlotte Debaille
- Department of Chest Medicine, Centre Hospitalier Universitaire UCL Namur, Université Catholique de Louvain, Yvoir, Belgium
| | - Jolanta Walusiak-Skorupa
- Department of Occupational Diseases and Environmental Health, Nofer Institute of Occupational Medicine, Lodz, Poland
| | | | - Xavier Munoz
- Servei Pneumologia, Hospital Vall d'Hebron, Universitat Autonoma de Barcelona and CIBER de Enfermedades Respiratorias, Barcelona, Spain
| | - Vera van Kampen
- Institute for Prevention and Occupational Medicine of the German Social Accident Insurance, Ruhr University, Bochum, Germany
| | - Hille Suojalehto
- Occupational Health, Finnish Institute of Occupational Health, Helsinki, Finland
| | - Katri Suuronen
- Occupational Health, Finnish Institute of Occupational Health, Helsinki, Finland
| | - Martin Seed
- Centre for Occupational and Environmental Health, The University of Manchester, Manchester, United Kingdom
| | - Sewon Lee
- Centre for Occupational and Environmental Health, The University of Manchester, Manchester, United Kingdom
| | - Catherine Rifflart
- Department of Chest Medicine, Centre Hospitalier Universitaire UCL Namur, Université Catholique de Louvain, Yvoir, Belgium
| | - Julien Godet
- Groupe Méthode Recherche Clinique, Pôle de Santé Publique, Strasbourg University, Strasbourg, France
| | - Frédéric de Blay
- Division of Asthma and Allergy, Department of Chest Diseases, University Hospital of Strasbourg and Fédération de Médecine Translationnelle, Strasbourg University, Strasbourg, France
| | - Olivier Vandenplas
- Department of Chest Medicine, Centre Hospitalier Universitaire UCL Namur, Université Catholique de Louvain, Yvoir, Belgium.
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Sidthilaw S, Sapbamrer R, Pothirat C, Wunnapuk K, Khacha-Ananda S. Factors associated with respiratory symptoms among herbicide applicators and assistant applicators in maize field. ARCHIVES OF ENVIRONMENTAL & OCCUPATIONAL HEALTH 2021; 77:320-327. [PMID: 33663354 DOI: 10.1080/19338244.2021.1893628] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
A cross-sectional study was conducted with 3,291 maize farmers enrolled whose main roles were herbicide applicators and assistant applicators. This study aimed to compare the prevalence of respiratory symptoms and the use of personal protective equipment (PPE) between herbicide applicators and assistant applicators, and determine factors associated with respiratory symptoms. Our results suggest that wheeze and dyspnea were associated with the task on the farm (adj. OR = 10.33 for wheeze and 24.13 for dyspnea), amount of herbicide use (adj. OR = 1.95 for wheeze and 1.41 for dyspnea), frequency of herbicide use (adj. OR = 2.87 for wheeze and 4.08 for dyspnea), not always wearing a mask (adj. OR = 1.49 for wheeze and 3.17 for dyspnea), not always wearing gloves (adj. OR = 2.63 for wheeze and 2.44 for dyspnea), and not always wearing goggles (adj.OR = 2.01 for dyspnea) after adjusting for confounding factors.
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Affiliation(s)
- Sutthinee Sidthilaw
- Department of Community Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Ratana Sapbamrer
- Department of Community Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Chaicharn Pothirat
- Division of Pulmonary, Critical Care and Allergy, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Klintean Wunnapuk
- Department of Forensic Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Supakit Khacha-Ananda
- Department of Forensic Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
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30
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De Matteis S, Ronsmans S, Nemery B. Respiratory Health Effects of Exposure to Cleaning Products. Clin Chest Med 2021; 41:641-650. [PMID: 33153684 DOI: 10.1016/j.ccm.2020.08.010] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
There is consistent and growing evidence of an epidemic of "asthma-like" symptoms among professional cleaners. Questions include how big is this problem worldwide, which cleaning agents are dangerous, how do they affect the lungs, and is it really asthma? This issue is important to public health because of the increasing number of professional cleaners, many from vulnerable categories. There are implications for anybody exposed to cleaning products during housekeeping, including children. This article uses available evidence to give a broad but concise overview on what we know so far and how we can prevent the cleaning-associated respiratory public health burden.
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Affiliation(s)
- Sara De Matteis
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy; NHLI, Imperial College London, London, United Kingdom.
| | - Steven Ronsmans
- Clinic for Occupational and Environmental Medicine, Department of Pulmonary Medicine, University Hospitals Leuven, Leuven, Belgium; Centre for Environment and Health, Department of Public Health and Primary Care, KU Leuven, Leuven, Belgium
| | - Benoit Nemery
- Centre for Environment and Health, Department of Public Health and Primary Care, KU Leuven, Leuven, Belgium
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31
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Raulf M. Immediate-Type Hypersensitivity by Occupational Materials. Contact Dermatitis 2021. [DOI: 10.1007/978-3-030-36335-2_73] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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32
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Gharibi V, Ebrahimi MH, Soleimani E, Khanjani N, Fakherpour A, Hosseinabadi MB. The role of oxidative stress in pulmonary function in bakers exposed to flour dust. INTERNATIONAL JOURNAL OF OCCUPATIONAL SAFETY AND ERGONOMICS 2020; 28:555-561. [PMID: 32815471 DOI: 10.1080/10803548.2020.1812919] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Objective. This study aimed to determine the effect of exposure to flour dust on pulmonary function and the role of oxidative stress. Methods. This case-control study was conducted on 163 bakery workers (exposed group) and 177 administrative workers (unexposed group). Pulmonary function and flour dust exposure were measured by spirometry and NIOSH 0500 and 0600 methods. Oxidative stress indices including malondialdehyde (MDA), nitric oxide (NO) and total antioxidant capacity (TAC) were measured in serum samples. Results. The mean respirable and total dust exposure of bakery workers were 2.5 ± 1.72 and 6.53 ± 3.26 mg/m3. The forced vital capacity (FVC) and forced expiratory volume in the first 1 s (FEV1) were significantly lower in the exposed group than in the unexposed group. The levels of MDA and NO were higher in smokers than in non-smokers in the exposed group. The most important variables that predicted FVC and FEV1 were MDA, NO and TAC. With increased exposure to respirable dust, the levels of MDA (β = 3.39, p < 0.001) and NO (β = 16.48, p < 0.001) increased and total antioxidant levels decreased (β = -0.37, p < 0.001). Conclusions. Exposure to flour dust may impair pulmonary function by increasing oxidative stress and weakening antioxidant defense.
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Affiliation(s)
- Vahid Gharibi
- School of Public Health, Shahroud University of Medical Sciences, Iran.,School of Health, Shiraz University of Medical Sciences, Iran
| | - Mohammad Hossein Ebrahimi
- Environmental and Occupational Health Research Center, Shahroud University of Medical Sciences, Iran
| | | | - Narges Khanjani
- Environmental Health Engineering Research Center, Kerman University of Medical Sciences, Iran
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Cui H, Cheng Y, He Y, Cheng W, Zhao W, Zhao H, Zhou FH, Wang L, Dong J, Cai S. The AKT inhibitor MK2206 suppresses airway inflammation and the pro‑remodeling pathway in a TDI‑induced asthma mouse model. Mol Med Rep 2020; 22:3723-3734. [PMID: 33000187 PMCID: PMC7533517 DOI: 10.3892/mmr.2020.11450] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2020] [Accepted: 07/14/2020] [Indexed: 12/14/2022] Open
Abstract
The cellular and molecular mechanisms via which MK2206, an AKT inhibitor, prevents the activation of AKT in toluene diisocyanate (TDI)‑induced asthma remain unclear. Thus, the present study aimed to evaluate the potential effects of MK2206 on airway AKT activation, inflammation and remodeling in a TDI‑induced mouse model of asthma. A total of 24 BALB/c mice were selected and randomly divided into untreated (AOO), asthma (TDI), MK2206 (TDI + MK2206), and dexamethasone (TDI + DEX) groups. Phosphorylated AKT (p‑AKT), total AKT, airway remodeling indices, α‑smooth muscle actin (α‑SMA) and collagen I levels in pulmonary tissue were measured using western blotting. Airway inflammation factors, including interleukin (IL)‑4, ‑5, ‑6, and ‑13 in bronchoalveolar lavage fluid (BALF) and IgE in serum, were determined using ELISA. Additionally, the airway hyperresponsiveness (AHR) and pulmonary pathology of all groups were evaluated. The results of the present study demonstrated that p‑AKT levels in lung protein lysate were upregulated, and neutrophil, eosinophil and lymphocyte counts were increased in the lungs obtained from the asthma group compared with the AOO group. Both MK2206 and DEX treatment in TDI‑induced mice resulted not only in the attenuation of AKT phosphorylation, but also reductions in neutrophil, eosinophil and lymphocyte counts in the lungs of mice in the asthma group. Consistently, increases in the levels of the inflammatory cytokines IL‑4, ‑5, ‑6 and ‑13 analyzed in BALF, and serum IgE in the TDI group were demonstrated to be attenuated in the TDI + MK2206 and TDI + DEX groups. Furthermore, α‑SMA and AHR were significantly attenuated in the TDI + MK2206 group compared with the TDI group. These results revealed that MK2206 not only inhibited AKT activation, but also served a role in downregulating airway inflammation and airway remodeling in chemical‑induced asthma. Therefore, the findings of the present study may provide important insight into further combination therapy.
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Affiliation(s)
- Haiyan Cui
- Department of Respiratory and Critical Care Medicine, Chronic Airway Disease Laboratory, Nanfang Hospital of Southern Medical University, Guangzhou, Guangdong 510000, P.R. China
| | - Yuanxiong Cheng
- Department of Respiratory and Critical Care Medicine, The Third Affiliated Hospital of Southern Medical University, Guangzhou, Guangdong 510630, P.R. China
| | - Yi He
- Department of Immunology Medicine, The Third Affiliated Hospital of Southern Medical University, Guangzhou, Guangdong 510630, P.R. China
| | - Weiying Cheng
- Department of Respiratory and Critical Care Medicine, The Third Affiliated Hospital of Southern Medical University, Guangzhou, Guangdong 510630, P.R. China
| | - Wenqu Zhao
- Department of Respiratory and Critical Care Medicine, Chronic Airway Disease Laboratory, Nanfang Hospital of Southern Medical University, Guangzhou, Guangdong 510000, P.R. China
| | - Haijin Zhao
- Department of Respiratory and Critical Care Medicine, Chronic Airway Disease Laboratory, Nanfang Hospital of Southern Medical University, Guangzhou, Guangdong 510000, P.R. China
| | - Fiona H Zhou
- UniSA Clinical and Health Sciences, UniSA Cancer Research Institute, University of South Australia, Adelaide, South Australia 5001, Australia
| | - Liping Wang
- UniSA Clinical and Health Sciences, UniSA Cancer Research Institute, University of South Australia, Adelaide, South Australia 5001, Australia
| | - Jianghui Dong
- UniSA Clinical and Health Sciences, UniSA Cancer Research Institute, University of South Australia, Adelaide, South Australia 5001, Australia
| | - Shaoxi Cai
- Department of Respiratory and Critical Care Medicine, Chronic Airway Disease Laboratory, Nanfang Hospital of Southern Medical University, Guangzhou, Guangdong 510000, P.R. China
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Amaral-Machado L, Oliveira WN, Moreira-Oliveira SS, Pereira DT, Alencar ÉN, Tsapis N, Egito EST. Use of Natural Products in Asthma Treatment. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE : ECAM 2020; 2020:1021258. [PMID: 32104188 PMCID: PMC7040422 DOI: 10.1155/2020/1021258] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/10/2019] [Revised: 12/31/2019] [Accepted: 01/06/2020] [Indexed: 12/14/2022]
Abstract
Asthma, a disease classified as a chronic inflammatory disorder induced by airway inflammation, is triggered by a genetic predisposition or antigen sensitization. Drugs currently used as therapies present disadvantages such as high cost and side effects, which compromise the treatment compliance. Alternatively, traditional medicine has reported the use of natural products as alternative or complementary treatment. The aim of this review was to summarize the knowledge reported in the literature about the use of natural products for asthma treatment. The search strategy included scientific studies published between January 2006 and December 2017, using the keywords "asthma," "treatment," and "natural products." The inclusion criteria were as follows: (i) studies that aimed at elucidating the antiasthmatic activity of natural-based compounds or extracts using laboratory experiments (in vitro and/or in vivo); and (ii) studies that suggested the use of natural products in asthma treatment by elucidation of its chemical composition. Studies that (i) did not report experimental data and (ii) manuscripts in languages other than English were excluded. Based on the findings from the literature search, aspects related to asthma physiopathology, epidemiology, and conventional treatment were discussed. Then, several studies reporting the effectiveness of natural products in the asthma treatment were presented, highlighting plants as the main source. Moreover, natural products from animals and microorganisms were also discussed and their high potential in the antiasthmatic therapy was emphasized. This review highlighted the importance of natural products as an alternative and/or complementary treatment source for asthma treatment, since they present reduced side effects and comparable effectiveness as the drugs currently used on treatment protocols.
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Affiliation(s)
- Lucas Amaral-Machado
- Graduate Program in Health Sciences, Dispersed System Laboratory (LaSid), Pharmacy Department, Federal University of Rio Grande do Norte (UFRN), Av. General Gustavo de Cordeiro-SN-Petrópolis, Natal 59012-570, Brazil
- Institut Galien Paris-Sud, CNRS, Univ. Paris-Sud, Université Paris-Saclay, 92296 Châtenay-Malabry, France
| | - Wógenes N. Oliveira
- Graduate Program in Health Sciences, Dispersed System Laboratory (LaSid), Pharmacy Department, Federal University of Rio Grande do Norte (UFRN), Av. General Gustavo de Cordeiro-SN-Petrópolis, Natal 59012-570, Brazil
| | - Susiane S. Moreira-Oliveira
- Graduate Program in Health Sciences, Dispersed System Laboratory (LaSid), Pharmacy Department, Federal University of Rio Grande do Norte (UFRN), Av. General Gustavo de Cordeiro-SN-Petrópolis, Natal 59012-570, Brazil
| | - Daniel T. Pereira
- Graduate Program in Health Sciences, Dispersed System Laboratory (LaSid), Pharmacy Department, Federal University of Rio Grande do Norte (UFRN), Av. General Gustavo de Cordeiro-SN-Petrópolis, Natal 59012-570, Brazil
| | - Éverton N. Alencar
- Graduate Program in Pharmaceutical Nanotechnology, LaSid, UFRN, Av. General Gustavo de Cordeiro-SN-Petropolis, Natal 59012-570, Brazil
| | - Nicolas Tsapis
- Institut Galien Paris-Sud, CNRS, Univ. Paris-Sud, Université Paris-Saclay, 92296 Châtenay-Malabry, France
| | - Eryvaldo Sócrates T. Egito
- Graduate Program in Health Sciences, Dispersed System Laboratory (LaSid), Pharmacy Department, Federal University of Rio Grande do Norte (UFRN), Av. General Gustavo de Cordeiro-SN-Petrópolis, Natal 59012-570, Brazil
- Graduate Program in Pharmaceutical Nanotechnology, LaSid, UFRN, Av. General Gustavo de Cordeiro-SN-Petropolis, Natal 59012-570, Brazil
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Tsui HC, Ronsmans S, De Sadeleer LJ, Hoet PHM, Nemery B, Vanoirbeek JAJ. Skin Exposure Contributes to Chemical-Induced Asthma: What is the Evidence? A Systematic Review of Animal Models. ALLERGY, ASTHMA & IMMUNOLOGY RESEARCH 2020; 12:579-598. [PMID: 32400126 PMCID: PMC7224990 DOI: 10.4168/aair.2020.12.4.579] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/17/2019] [Revised: 01/17/2020] [Accepted: 01/21/2020] [Indexed: 12/11/2022]
Abstract
It is generally assumed that allergic asthma originates primarily through sensitization via the respiratory mucosa, but emerging clinical observations and experimental studies indicate that skin exposure to low molecular weight (LMW) agents, i.e. “chemicals,” may lead to systemic sensitization and subsequently develop asthma when the chemical is inhaled. This review aims to evaluate the accumulating experimental evidence that adverse respiratory responses can be elicited upon inhalation of an LMW chemical sensitizer after previous sensitization by dermal exposure. We systematically searched the PubMed and Embase databases up to April 15, 2017, and conducted forward and backward reference tracking. Animal studies involving both skin and airway exposure to LMW agents were included. We extracted 6 indicators of “selective airway hyper-responsiveness” (SAHR)—i.e. respiratory responses that only occurred in previously sensitized animals—and synthesized the evidence level for each indicator into strong, moderate or limited strength. The summarized evidence weight for each chemical agent was graded into high, middle, low or “not possible to assess.” We identified 144 relevant animal studies. These studies involved 29 LMW agents, with 107 (74%) studies investigating the occurrence of SAHR. Indicators of SAHR included physiological, cytological/histological and immunological responses in bronchoalveolar lavage, lung tissue and airway-draining lymph nodes. Evidence for skin exposure-induced SAHR was present for 22 agents; for 7 agents the evidence for SAHR was inconclusive, but could not be excluded. The ability of a chemical to cause sensitization via skin exposure should be regarded as constituting a risk of adverse respiratory reactions.
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Affiliation(s)
- Hung Chang Tsui
- Centre for Environment and Health, Department of Public Health and Primary Care, University of Leuven, Leuven, Belgium
| | - Steven Ronsmans
- Centre for Environment and Health, Department of Public Health and Primary Care, University of Leuven, Leuven, Belgium
| | - Laurens J De Sadeleer
- Department of Respiratory Diseases, Unit for Interstitial Lung Diseases, University Hospitals Leuven, Leuven, Belgium
| | - Peter H M Hoet
- Centre for Environment and Health, Department of Public Health and Primary Care, University of Leuven, Leuven, Belgium
| | - Benoit Nemery
- Centre for Environment and Health, Department of Public Health and Primary Care, University of Leuven, Leuven, Belgium.
| | - Jeroen A J Vanoirbeek
- Centre for Environment and Health, Department of Public Health and Primary Care, University of Leuven, Leuven, Belgium.
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Asthma Case Cluster during Renovation of a Water-Damaged and Toxic Building. Microorganisms 2019; 7:microorganisms7120642. [PMID: 31816917 PMCID: PMC6956061 DOI: 10.3390/microorganisms7120642] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2019] [Revised: 11/28/2019] [Accepted: 11/30/2019] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND An association between fungal exposure at work and asthma onset has been shown, but a causal relationship between them has not beTanle en established. METHODS The study describes an asthma cluster in workers in a building under renovation. Before renovation the work site had significant water damage, technical deficiencies, and ventilation problems. Worker protection was insufficient during renovation. In the building, toxicity was determined from dust as well as from cultured dust. Toxicity analysis was conducted in vitro using the boar spermatozoa motility assay. RESULTS During the 8-month renovation period, among 290 workers, 21 (7.2%) experienced new-onset asthma (9 women, 42.9%; 12 men, 57.1%; median age, 43 years (range, 30-60 years)). At the renovation site, they had been exposed to areas where remarkable toxicity was demonstrated in vitro. One year later, 13 (61.9%) of them still had moderate disease, and three (14.8%) had severe disease. Most patients had a poor response to inhaled corticosteroids. CONCLUSIONS This study documents a clear temporal association between occupational exposure during renovation of a water-damaged building and a cluster of 21 new occupational asthma cases. In addition, dust and cultured dust from their work spaces showed remarkable toxicity based on inhibition of boar sperm motility in vitro.
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Transforming growth factor-β1 and eosinophil-derived neurotoxins contribute to the development of work-related respiratory symptoms in bakery workers. World Allergy Organ J 2019; 12:100058. [PMID: 31641406 PMCID: PMC6796779 DOI: 10.1016/j.waojou.2019.100058] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2019] [Revised: 08/01/2019] [Accepted: 08/01/2019] [Indexed: 02/08/2023] Open
Abstract
Background In baker's asthma previous studies suggest that adaptive and innate immunity are involved in the development of work-related respiratory symptoms (WRS), where we hypothesized that epithelial cells derive airway inflammation through modulating the release of inflammatory cytokines. Thus, we conducted this study to investigate the role of epithelial cell-derived cytokines in the development of WRS among bakery workers. Methods We recruited 385 wheat-exposed subjects with WRS (WRS+)/without WRS (WRS-) working in a single industry and 243 unexposed controls from Ajou Medical Center (Suwon, South Korea). Levels of epithelial cell-derived cytokines (interleukin [IL-8], transforming growth factor-β1 [TGF-β1], eotaxin-2) and inflammatory mediators (eosinophil-derived neurotoxins [EDN]) in sera or cell-free supernatants were measured by ELISA. Human airway epithelial cells (HAECs), A549, were stimulated by wheat flour extracts and co-cultured with peripheral blood neutrophils isolated from 4 asthmatic patients. Results Serum TGF-β1 levels were significantly lower in exposed subjects than in unexposed controls, in the WRS+ group than in the WRS- group (P < 0.001 for each). The WRS+ group had a significantly higher level of serum EDN than the WRS- group (P < 0.001). Serum TGF-β1 and EDN levels predicted the development of WRS in exposed subjects (area under the curve [AUC] = 0.719, 72.4% sensitivity/70% specificity; AUC = 0.759, 78.6% sensitivity/60% specificity). From wheat-stimulated HAECs, TGF-β1 release peaked at 6 hours after wheat exposure, while eotaxin-2 peaked at 12 hours. Co-culture of HAECs with neutrophils did not affect TGF-β1 release. Conclusions Our results suggest that TGF-β1 may contribute to develop type-2 airway inflammation and WRS. Serum TGF-β1/EDN levels may be potential serum biomarkers for predicting WRS among bakery workers.
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Abstract
Occupational exposures are a major cause of lung disease and disability worldwide. This article reviews the broad range of types of occupational lung diseases, including airways disease, pneumoconioses, and cancer. Common causes of occupational lung disease are reviewed with specific examples and clinical features. Emphasis on the importance of a detailed history to make an accurate diagnosis of an occupational lung disease is discussed.
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Affiliation(s)
- David M Perlman
- Division of Pulmonary and Critical Care Medicine, University of Minnesota, MMC # 276, 420 Delaware Street Southeast, Minneapolis, MN 55045, USA
| | - Lisa A Maier
- Division of Environmental and Occupational Health Sciences, National Jewish Health, 1400 Jackson Street, G212, Denver, CO 80206, USA; Division of Pulmonary and Critical Care Sciences, Environmental Occupational Health Department, School of Medicine, Colorado School of Public Health, University of Colorado, Denver, CO, USA.
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Noh SR, Kim JA, Cheong HK, Ha M, Jee YK, Park MS, Choi KH, Kim H, Cho SI, Choi K, Paek D. Hebei Spirit oil spill and its long-term effect on children's asthma symptoms. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2019; 248:286-294. [PMID: 30798030 DOI: 10.1016/j.envpol.2019.02.034] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/13/2018] [Revised: 02/11/2019] [Accepted: 02/12/2019] [Indexed: 06/09/2023]
Abstract
On December 7th, 2007, an estimated 12,547 kL of crude oil was spilled from the collision of Hebei Spirit near residential area. Our previous study demonstrated worsening of children's asthma symptoms one year after the accident. This study investigated long-term effect of the oil spill on children's asthma symptoms up to five years after the accident. All elementary and middle school students in the exposure area were surveyed on one year (n = 655), three years (664), and five years (611) after the accident. Oil spill exposure was estimated using two estimates including distance from the oil spill (A) and modeled estimates of benzene, toluene, ethylbenzene, and xylene (BTEX) compounds (B), and each was dichotomously categorized (A: high-exposure vs low-exposure; B: ≥20 mg/m3 vs < 20 mg/m3). Asthma symptoms were evaluated using a standard questionnaire. Oil spill exposure estimates were associated with asthma symptoms on one year (odds ratio (95% confidence interval) A: 1.9 (1.1-3.1); B: 1.6 (0.9-2.7)), three years (A: 1.9 (1.1-3.2); B: 1.3 (0.8-2.2)), and five years (A: 1.2 (0.7-1.9); B: 1.8 (1.1-2.8)) after the oil spill. Significant longitudinal relationship between oil spill exposure estimates and asthma symptoms was also observed (A: 1.6 (1.2-2.2); B: 1.6 (1.1-2.1)). Overall, the effect of oil spill exposure estimates was more severe on younger children. Oil spill exposure estimates were associated with asthma symptoms in children up to five years after the oil spill.
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Affiliation(s)
- Su Ryeon Noh
- Department of Public Health and Environment, Kosin University, Pusan, Republic of Korea
| | - Jung-Ah Kim
- Department of Environment and Ecology Research, ChungNam Institute, Gongju, Republic of Korea
| | - Hae-Kwan Cheong
- Department of Social and Preventive Medicine, Sungkyunkwan University School of Medicine, Suwon, Republic of Korea.
| | - Mina Ha
- Department of Preventive Medicine, Dankook University College of Medicine, Cheonan, Republic of Korea
| | - Young-Koo Jee
- Department of Internal Medicine, Dankook University College of Medicine, Cheonan, Republic of Korea
| | | | - Kyung-Hwa Choi
- Taean Environmental Health Center, Taean, Republic of Korea
| | - Ho Kim
- Department of Public Health, Seoul National University Graduate School of Public Health, Seoul, Republic of Korea
| | - Sung-Il Cho
- Department of Public Health, Seoul National University Graduate School of Public Health, Seoul, Republic of Korea
| | - Kyungho Choi
- Department of Environmental Health, Seoul National University Graduate School of Public Health, Seoul, Republic of Korea
| | - Domyung Paek
- Department of Environmental Health, Seoul National University Graduate School of Public Health, Seoul, Republic of Korea
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Zamani A, Khanjani N, Bagheri Hosseinabadi M, Ranjbar Homghavandi M, Miri R. The effect of chronic exposure to flour dust on pulmonary functions. INTERNATIONAL JOURNAL OF OCCUPATIONAL SAFETY AND ERGONOMICS 2019; 27:497-503. [DOI: 10.1080/10803548.2019.1582853] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- Ahmadreza Zamani
- Vice-chancellery of Health, Kerman University of Medical Sciences, Iran
| | - Narges Khanjani
- Neurology Research Center, Kerman University of Medical Sciences, Iran
| | | | | | - Roholah Miri
- Vice-chancellery of Health, Lorestan University of Medical Sciences, Iran
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Vandenplas O, Godet J, Hurdubaea L, Rifflart C, Suojalehto H, Wiszniewska M, Munoz X, Sastre J, Klusackova P, Moore V, Merget R, Talini D, Svanes C, Mason P, dell'Omo M, Cullinan P, Moscato G, Quirce S, Hoyle J, Sherson DL, Kauppi P, Preisser A, Meyer N, de Blay F. Are high- and low-molecular-weight sensitizing agents associated with different clinical phenotypes of occupational asthma? Allergy 2019; 74:261-272. [PMID: 29956349 DOI: 10.1111/all.13542] [Citation(s) in RCA: 63] [Impact Index Per Article: 12.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2018] [Revised: 05/31/2018] [Accepted: 06/19/2018] [Indexed: 11/28/2022]
Abstract
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.
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Affiliation(s)
- Olivier Vandenplas
- Department of Chest Medicine; Centre Hospitalier Universitaire UCL Namur; Université Catholique de Louvain; Yvoir Belgium
| | - Julien Godet
- Pôle de Santé Publique; Strasbourg University; Strasbourg France
| | - Laura Hurdubaea
- Division of Asthma and Allergy; Department of Chest Diseases; University Hospital of Strasbourg and Fédération de Médecine translationnelle; Strasbourg University; Strasbourg France
| | - Catherine Rifflart
- Department of Chest Medicine; Centre Hospitalier Universitaire UCL Namur; Université Catholique de Louvain; Yvoir Belgium
| | - Hille Suojalehto
- Occcupational Medicine; Finnish Institute of Occupational Health; Helsinki Finland
| | - Marta Wiszniewska
- Department of Occupational Diseases and Environmental Health; Nofer Institute of Occupational Medicine; Lodz Poland
| | - Xavier Munoz
- Servei Pneumologia; Hospital Vall d'Hebron; Universitat Autonoma de Barcelona and CIBER de Enfermedades Respiratorias (CIBERES); Barcelona Spain
| | - Joaquin Sastre
- Department of Allergy; Fundacion Jimenez Dıaz and CIBER de Enfermedades Respiratorias (CIBERES); Madrid Spain
| | - Pavlina Klusackova
- Department of Occupational Medicine; 1st Faculty of Medicine; Charles University; Prague Czech Republic
| | - Vicky Moore
- Occupational Lung Disease Unit; Birmingham Heartlands Hospital; Birmingham UK
| | - Rolf Merget
- Institute for Prevention and Occupational Medicine of the German Social Accident Insurance (PA); Ruhr University; Bochum Germany
| | - Donatella Talini
- Cardio-Thoracic and Vascular Department; University of Pisa; Pisa Italy
| | - Cecilie Svanes
- Department of Occupational Medicine; Haukeland University Hospital; Bergen Norway
| | - Paola Mason
- Unit of Occupational Medicine and Public Health; University of Padova; Padova Italy
| | - Marco dell'Omo
- Department of Medicine; Section of Occupational Medicine, Respiratory Diseases and Occupational and Environmental Toxicology; University of Perugia; Perugia Italy
| | - Paul Cullinan
- Department of Occupational and Environmental Medicine; Royal Brompton Hospital and Imperial College (NHLI); Royal Brompton and Harefield NHS Foundation Trust; London UK
| | - Gianna Moscato
- Department of Public Health, Experimental and Forensic Medicine; University of Pavia; Pavia Italy
- Allergy and Immunology Unit; Istituti Clinici Scientifici Maugeri; IRCCS; Pavia Italy
| | - Santiago Quirce
- Department of Allergy; Hospital La Paz; Institute for Health Research (IdiPAZ) and CIBER de Enfermedades Respiratorias (CIBERES); Madrid Spain
| | - Jennifer Hoyle
- Department of Respiratory Medicine; North Manchester General Hospital; Manchester UK
| | - David L. Sherson
- Department of Pulmonary Medicine and Occupational Medicine; Odense University Hospital; Odense Denmark
| | - Paula Kauppi
- Department of Allergy, Skin and Allergy Hospital; Helsinki University Central Hospital; Helsinki Finland
| | - Alexandra Preisser
- Institute for Occupational and Maritime Medicine; University Medical Center Hamburg-Eppendorf; Hamburg Germany
| | - Nicolas Meyer
- Pôle de Santé Publique; Strasbourg University; Strasbourg France
| | - Frédéric de Blay
- Division of Asthma and Allergy; Department of Chest Diseases; University Hospital of Strasbourg and Fédération de Médecine translationnelle; Strasbourg University; Strasbourg France
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Vandenplas O, Rifflart C, Evrard G, Thimpont J, Seed M, Agius R. Occupational asthma caused by an epoxy amine hardener. Occup Med (Lond) 2019; 67:722-724. [PMID: 29040709 DOI: 10.1093/occmed/kqx151] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
We describe a 43-year-old epoxy floor layer who developed work-related asthma while exposed to an epoxy hardener based on isophorone diamine (IPDA). Challenge exposures to the curing of the epoxy resin system and subsequently to the polyfunctional amine hardener containing IPDA both elicited delayed asthmatic reactions. This report further indicates that exposure to epoxy hardeners containing polyfunctional amines should be considered as a potential cause of occupational asthma. Appropriate work hygiene measures should be implemented to minimize airborne exposure to these volatile compounds.
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Affiliation(s)
- O Vandenplas
- Department of Chest Medicine, Centre Hospitalier Universitaire UCL Namur, Université Catholique de Louvain, Belgium.,Medical Department, Agence fédérale des risques professionnels (Fedris), Belgium
| | - C Rifflart
- Department of Chest Medicine, Centre Hospitalier Universitaire UCL Namur, Université Catholique de Louvain, Belgium
| | - G Evrard
- Department of Chest Medicine, Centre Hospitalier Universitaire UCL Namur, Université Catholique de Louvain, Belgium
| | - J Thimpont
- Medical Department, Agence fédérale des risques professionnels (Fedris), Belgium
| | - M Seed
- Centre for Occupational and Environmental Health, School of Health Sciences, The University of Manchester, Manchester, UK
| | - R Agius
- Centre for Occupational and Environmental Health, School of Health Sciences, The University of Manchester, Manchester, UK
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Raulf M. Immediate-Type Hypersensitivity by Occupational Materials. Contact Dermatitis 2019. [DOI: 10.1007/978-3-319-72451-5_73-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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44
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Metwali A, Thorne PS, Ince MN, Metwali N, Winckler S, Guan X, Beyatli S, Truscott J, Urban JF, Elliott DE. Recirculating Immunocompetent Cells in Colitic Mice Intensify Their Lung Response to Bacterial Endotoxin. Dig Dis Sci 2018; 63:2930-2939. [PMID: 30022451 PMCID: PMC6182434 DOI: 10.1007/s10620-018-5196-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2017] [Accepted: 07/03/2018] [Indexed: 12/17/2022]
Abstract
BACKGROUND Patients with inflammatory bowel disease have higher incidence of airway hyperresponsiveness compared to the general population. Lung inflammation leading to airway hyperresponsiveness causes illnesses for more than ten percent of the population in USA. AIMS We investigated the lung response to bacterial endotoxin in colitic mice. METHODS Rag-1 mice were transplanted with negatively selected splenic T cells. Some mice groups were treated with NSAID to develop colitis. All mice were treated with bacterial endotoxin and necropsied 3 weeks later. RESULTS Colitic mice developed intensified lung inflammation on day 21 of treatment with bacterial endotoxin. Pulmonary lymphocytes from colitic mice displayed a proinflammatory cytokine profile, expressed high ICAM1 and low FoxP3. CD11c+, CD8+ cells bound and responded to non-systemic antigens from gut-localized microbiota and had higher expression of TLR4. CONCLUSIONS Colitic mice developed exacerbated lung inflammation in response to bacterial endotoxin compared to non-colitic mice. Proinflammatory cytokines from pulmonary lymphocytes induced high expression of ICAM1 and suppressed FoxP3 on CD4+ cells. CD11c+, CD8+ cells binding and responding to gut-localized antigens as well as high expression of TLR4 indicate innate and adaptive lung response to bacterial endotoxin. Inflammatory cells from colons of colitic mice homed in the lungs as well as the intestine suggesting recirculation of sensitized immunocompetent cells. These data support our hypothesis that colitis intensifies lung inflammation.
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Affiliation(s)
- Ahmed Metwali
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, University of Iowa, Carver College of Medicine, Iowa City, IA USA
- Veterans Administration Medical Center, Iowa City, IA USA
| | - Peter S. Thorne
- Department of Occupational and Environmental Health Pulmonary Toxicology Facility, University of Iowa, Iowa City, USA
| | - M. Nedim Ince
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, University of Iowa, Carver College of Medicine, Iowa City, IA USA
| | - Nervana Metwali
- Department of Occupational and Environmental Health Pulmonary Toxicology Facility, University of Iowa, Iowa City, USA
| | - Sarah Winckler
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, University of Iowa, Carver College of Medicine, Iowa City, IA USA
- Veterans Administration Medical Center, Iowa City, IA USA
| | - Xiaoqun Guan
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, University of Iowa, Carver College of Medicine, Iowa City, IA USA
| | - Sonay Beyatli
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, University of Iowa, Carver College of Medicine, Iowa City, IA USA
| | - Jamie Truscott
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, University of Iowa, Carver College of Medicine, Iowa City, IA USA
| | | | - David E. Elliott
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, University of Iowa, Carver College of Medicine, Iowa City, IA USA
- Veterans Administration Medical Center, Iowa City, IA USA
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Scherzer R, Grayson MH. Heterogeneity and the origins of asthma. Ann Allergy Asthma Immunol 2018; 121:400-405. [PMID: 29928982 PMCID: PMC6237278 DOI: 10.1016/j.anai.2018.06.009] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2018] [Revised: 06/01/2018] [Accepted: 06/10/2018] [Indexed: 12/13/2022]
Abstract
OBJECTIVE To examine the roots of asthma across different ages, including atopy, the role of the microbiome and viral infections, and comorbidities and confounders, such as obesity, aspirin-exacerbated respiratory disease, neutrophilic asthma, cigarette smoking, and the possibility of an asthma-chronic obstructive pulmonary disease overlap syndrome. DATA SOURCES Data were taken from various scientific search engines, including PubMed and Science Direct databases. STUDY SELECTIONS Articles that reviewed information on the origins of asthma in persons of all ages, including different phenotypes and genotypes of asthma, were used. RESULTS Asthma is a common and complex disease whose origins are likely a combination of both genetic predisposition and environmental exposures. Factors such as the microbiome, other atopic disease, viral infections in young children, and other diagnoses, such as obesity or aspirin-exacerbated respiratory disease, are important to consider when creating a treatment plan for patients. CONCLUSION Asthma is a disease that is often diagnosed in childhood but can present at any age. There is debate in the field as to whether asthma is one disease or several different diseases that include airway inflammation as a key finding. There are risk factors for disease in the environment and through comorbidities that likely play significant roles in the origins of asthma, the development of symptoms, and the response to treatment. These factors are even more important as we look toward the future with the goal of personalized medicine.
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Affiliation(s)
- Rebecca Scherzer
- Division of Allergy and Immunology, Department of Pediatrics, Nationwide Children's Hospital-The Ohio State University College of Medicine, Columbus, Ohio.
| | - Mitchell H Grayson
- Division of Allergy and Immunology, Department of Pediatrics, Nationwide Children's Hospital-The Ohio State University College of Medicine, Columbus, Ohio
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Demange V, Zmirou-Navier D, Bohadana A, Wild P. Do airway inflammation and airway responsiveness markers at the start of apprenticeship predict their evolution during initial training? A longitudinal study among apprentice bakers, pastry makers and hairdressers. BMC Pulm Med 2018; 18:113. [PMID: 29996808 PMCID: PMC6042364 DOI: 10.1186/s12890-018-0674-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2017] [Accepted: 06/13/2018] [Indexed: 11/15/2022] Open
Abstract
Background The natural history of airway inflammation and symptoms in occupations at risk of asthma is still not fully understood. We aimed to study the evolution during apprenticeship of inflammation markers, bronchial hyperresponsiveness (BHR) and symptoms in at-risk subgroups as defined from measurements of markers made shortly after the start of training. Methods Respiratory symptoms, FEV1 and airway resistance post-bronchial challenge (MBC) test results, fractional exhaled nitric oxide (FeNO) measurements, and eosinophils in nasal lavage fluid were investigated in apprentice bakers, pastry-makers and hairdressers. Four visits were conducted: at the start of the training and every six months thereafter. Four baseline risk groups were defined, based on, (i) a high level of FeNO (NO), (ii) eosinophils > 1% (Eosino), (iii) a ≥ 15% decrease in FEV1 during the MBC test (HR), and (iv) a ≥ 50% increase in the resistance (Resist). The statistical analysis relied on mixed models. Results At baseline, the inflammation markers were related to the MBC markers. There was no evidence to suggest that the baseline risk groups predict a differential evolution of the airway inflammation and bronchial responsiveness markers, or the asthma-like symptoms considered. The baseline risk groups defined from MBC test predicted the levels of MBC markers. Similarly, the baseline risk groups based on eosinophilic inflammation predicted the levels of markers for eosinophilia. These results were similar in the three training tracks, with the exception of the FeNO levels which were not different according to the Eosino risk group. Twelve possible new asthma cases were identified, only the HR risk group predicted their occurrence. Conclusions Among this young population, at-risk groups based on initial high levels of inflammation markers did not experience any worsening during the follow-up. However, initial BHR predicted consistently high levels of all markers considered and occurrence of possible asthma. Electronic supplementary material The online version of this article (10.1186/s12890-018-0674-9) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Valérie Demange
- Institut National de Recherche et de Sécurité (INRS), 1 rue du Morvan, 54519, Vandoeuvre-les-Nancy, France.
| | - Denis Zmirou-Navier
- School of Public Health (EHESP), 15 avenue du Professeur Léon-Bernard, 35043, Rennes Cedex, France
| | - Abraham Bohadana
- Pulmonary Institute, Shaare Zedek Medical Center, 12 Baiyt Street, 91031, Jerusalem, Israel
| | - Pascal Wild
- Institut National de Recherche et de Sécurité (INRS), 1 rue du Morvan, 54519, Vandoeuvre-les-Nancy, France
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Broström JM, Ghalali A, Zheng H, Högberg J, Stenius U, Littorin M, Tinnerberg H, Broberg K. Toluene diisocyanate exposure and autotaxin-lysophosphatidic acid signalling. Toxicol Appl Pharmacol 2018; 355:43-51. [PMID: 29940203 DOI: 10.1016/j.taap.2018.06.019] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2018] [Revised: 06/11/2018] [Accepted: 06/21/2018] [Indexed: 02/07/2023]
Abstract
Toluene diisocyanate (TDI) is a reactive chemical used in manufacturing plastics. TDI exposure adversely affects workers' health, causing occupational asthma, but individuals differ in susceptibility. We recently suggested a role for signalling mediated by the enzyme autotaxin (ATX) and its product, lysophosphatidic acid (LPA), in TDI toxicity. Here we genotyped 118 TDI-exposed workers for six single-nucleotide polymorphisms (SNPs) in genes encoding proteins implicated in ATX-LPA signalling: purinergic receptor P2X7 (P2RX7), CC motif chemokine ligand 2 (CCL2), interleukin 1β (IL1B), and caveolin 1 (CAV1). Two P2RX7 SNPs (rs208294 and rs2230911) significantly modified the associations between a biomarker of TDI exposure (urinary 2,4-toluene diamine) and plasma LPA; two IL1B SNPs (rs16944 and rs1143634) did not. CAV1 rs3807989 modified the associations, but the effect was not statistically significant (p = 0.05-0.09). In vitro, TDI-exposed bronchial epithelial cells (16HBE14o-) rapidly released ATX and IL-1β. P2X7 inhibitors attenuated both responses, but confocal microscopy showed non-overlapping localizations of ATX and IL-1β, and down-regulation of CAV1 inhibited the ATX response but not the IL-1β response. This study indicates that P2X7 is pivotal for TDI-induced ATX-LPA signalling, which was modified by genetic variation in P2RX7. Furthermore, our data suggest that the TDI-induced ATX and IL-1β responses occur independently.
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Affiliation(s)
- Julia M Broström
- Division of Occupational and Environmental Medicine, Lund University, SE 221 85 Lund, Sweden
| | - Aram Ghalali
- Institute of Environmental Medicine, Karolinska Institutet, Box 210, SE171 77 Stockholm, Sweden
| | - Huiyuan Zheng
- Institute of Environmental Medicine, Karolinska Institutet, Box 210, SE171 77 Stockholm, Sweden
| | - Johan Högberg
- Institute of Environmental Medicine, Karolinska Institutet, Box 210, SE171 77 Stockholm, Sweden
| | - Ulla Stenius
- Institute of Environmental Medicine, Karolinska Institutet, Box 210, SE171 77 Stockholm, Sweden
| | - Margareta Littorin
- Division of Occupational and Environmental Medicine, Lund University, SE 221 85 Lund, Sweden
| | - Håkan Tinnerberg
- Division of Occupational and Environmental Medicine, Lund University, SE 221 85 Lund, Sweden
| | - Karin Broberg
- Division of Occupational and Environmental Medicine, Lund University, SE 221 85 Lund, Sweden; Institute of Environmental Medicine, Karolinska Institutet, Box 210, SE171 77 Stockholm, Sweden.
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Abstract
PURPOSE OF REVIEW Numerous clinically relevant allergenic molecules enhance the performance of specific (s) IgE tests and improve the specificity of allergy diagnosis. This review aimed to summarize our current knowledge of the high-molecular-weight allergens involved in the development of occupational asthma and rhinitis and to critically analyze the contribution of component-resolved diagnosis in the management of these conditions. RECENT FINDINGS There is a lack of standardization and validation for most available extracts of occupational agents, and assessment of sIgE reactivity to occupational allergen components has been poorly investigated, with the notable exception of natural rubber latex (NRL) and wheat flour. In the case of NRL, the application of recombinant single allergens and amplification of natural extracts with stable recombinant allergens improved the test sensitivity. IgE-sensitization profile in patients with baker's asthma showed great interindividual variation, and extract-based diagnostic is still recommended. For other occupational allergens, it remains necessary to evaluate the relevance of single allergen molecules for the sensitization induced by occupational exposure. Progress has been made to characterize occupational allergens especially NRL and wheat, although there is still an unmet need to increase the knowledge of occupational allergens, to include standardized tools into routine diagnostic, and to evaluate their usefulness in clinical practice.
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Affiliation(s)
- Monika Raulf
- Institute of Prevention and Occupational Medicine of the German Social accident Insurance, Institute of the Ruhr-University Bochum (IPA), Bochum, Germany.
| | - Santiago Quirce
- Department of Allergy, Hospital La Paz Institute for Health Research (IdiPAZ) and CIBER of Respiratory diseases (CIBERES), Madrid, Spain
| | - Olivier Vandenplas
- Centre Hospitalier Universitaire UCL Namur, Department of Chest Medicine, Université Catholique de Louvain, Yvoir, Belgium
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Ederle C, Donnay C, Khayath N, Mielcarek M, de Blay F. Asthma and Cleaning: What’s New? CURRENT TREATMENT OPTIONS IN ALLERGY 2018. [DOI: 10.1007/s40521-018-0153-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Irritant-induced asthma to hypochlorite in mice due to impairment of the airway barrier. Arch Toxicol 2018; 92:1551-1561. [PMID: 29368146 DOI: 10.1007/s00204-018-2161-8] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2017] [Accepted: 01/17/2018] [Indexed: 12/14/2022]
Abstract
Inhalation of commonly present irritants, such as chlorine and chlorine derivatives, can cause adverse respiratory effects, including irritant-induced asthma (IIA). We hypothesize that due to airway barrier impairment, exposure to hypochlorite (ClO-) can result in airway hypersensitivity. C57Bl/6 mice received an intra-peritoneal (i.p.) injection of the airway damaging agent naphthalene (NA, 200 mg/kg body weight) or vehicle (mineral oil, MO). In vivo micro-computed tomography (CT) images of the lungs were acquired before and at regular time points after the i.p. TREATMENT After a recovery period of 14 days an intranasal (i.n.) challenge with 0.003% active chlorine (in ClO-) or vehicle (distilled water, H2O) was given, followed by assessment of the breathing frequency. One day later, pulmonary function, along with pulmonary inflammation was determined. Lung permeability was assessed by means of total broncho-alveolar lavage (BAL) protein content and plasma surfactant protein (SP)-D levels. In vivo micro-CT imaging revealed enlargement of the lungs and airways early after NA treatment, with a return to normal at day 14. When challenged i.n. with ClO-, NA-pretreated mice immediately responded with a sensory irritant response. Twenty-four hours later, NA/ClO- mice showed airway hyperreactivity (AHR), accompanied by a neutrophilic and eosinophilic inflammation. NA administration followed by ClO- induced airway barrier impairment, as shown by increased BAL protein and plasma SP-D concentrations; histology revealed epithelial denudation. These data prove that NA-induced lung impairment renders the lungs of mice more sensitive to an airway challenge with ClO-, confirming the hypothesis that incomplete barrier repair, followed by irritant exposure results in airway hypersensitivity.
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