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da Paz ER, de Lima CMF, Felix SN, Schaeffer B, Galvão CES, Correia AT, Righetti RF, de Arruda Martins M, de Fátima Lopes Calvo Tibério I, Saraiva-Romanholo BM. Airway inflammatory profile among cleaning workers from different workplaces. BMC Pulm Med 2022; 22:170. [PMID: 35488256 PMCID: PMC9052628 DOI: 10.1186/s12890-022-01949-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2021] [Accepted: 04/11/2022] [Indexed: 01/01/2023] Open
Abstract
Background Cleaning workers represent a significant proportion of the active population worldwide, with poor remuneration, particularly in developing countries. Despite this, they remain a relatively poorly studied occupational group. They are constantly exposed to agents that can cause symptoms and respiratory problems. This study aimed to evaluate upper airway inflammation in professional cleaning workers in three different occupational settings by comparing nasal cytology inflammation and clinical profiles. Methods We performed a cross-sectional study on the prevalence of upper airway inflammation and symptoms of asthma/rhinitis related to cleaning work, according to workplace. A total of 167 participants were divided into four groups: hospital, university, housekeeper and control. A nasal swab was collected for upper airway inflammation evaluation. Clinical profiles and respiratory symptom employee evaluations were performed using specific questionnaires (European Community Respiratory Health Survey—ECRS and the International Study of Asthma and Allergies in Childhood—ISAAC). Results Cleaning workers showed increased neutrophils and lymphocytes; the hospital and university groups showed increased macrophages compared to the housekeeper and control groups. The hospital and housekeeper groups showed increased eosinophils when they performed cleaning services for up to one year and reported having more asthma symptoms than the control group. Cleaning workers showed increased rhinitis symptoms. The university group showed increased rhinitis symptoms aggravated by the workplace compared with the hospital and housekeeper groups. Cleaning workers showed an increased affirmative response when directly asked about rhinitis symptoms compared to the control group. Conclusions Cleaning workers showed airway inflammation, asthma symptoms and rhinitis, regardless of the occupational environment to which they were exposed, as well as showed increased rhinitis and asthma symptoms. Hospital cleaning workers showed increased macrophages, lymphocytes and eosinophils compared to the others. The length of time spent performing cleaning work was not related to nasal inflammation or respiratory symptoms in this population. However, there were differences in workplaces. Registered on ClinicalTrials.gov. Trial registration number: NCT03311048. Registration date: 10.16.2017. Retrospectively registered. Supplementary Information The online version contains supplementary material available at 10.1186/s12890-022-01949-5.
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Affiliation(s)
- Edinéia Rosa da Paz
- Instituto de Assistência Médica Ao Servidor Público Estadual (IAMSPE), Hospital Do Servidor Público Do Estado de São Paulo, Sao Paulo, SP, Brazil
| | | | - Soraia Nogueira Felix
- Instituto de Assistência Médica Ao Servidor Público Estadual (IAMSPE), Hospital Do Servidor Público Do Estado de São Paulo, Sao Paulo, SP, Brazil.
| | - Bruna Schaeffer
- Universidade Cidade de São Paulo (UNICID), São Paulo, SP, Brazil
| | | | - Aristides Tadeu Correia
- Departamento de Cardiopneumologia, Instituto do Coração, InCor-HCFMUSP, Universidade de São Paulo, Sao Paulo, SP, Brazil.,Laboratório de Investigação Médica- LIM 61, Serviço de Cirurgia Torácica, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, SP, Brazil
| | - Renato Fraga Righetti
- Hospital Sírio-Libanês, Serviço de Reabilitação, Sao Paulo, SP, Brazil.,Laboratório de Terapêutica Experimental (LIM-20), Faculdade de Medicina da USP (FMUSP), Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Milton de Arruda Martins
- Laboratório de Terapêutica Experimental (LIM-20), Faculdade de Medicina da USP (FMUSP), Universidade de Sao Paulo, Sao Paulo, Brazil
| | | | - Beatriz Mangueira Saraiva-Romanholo
- Instituto de Assistência Médica Ao Servidor Público Estadual (IAMSPE), Hospital Do Servidor Público Do Estado de São Paulo, Sao Paulo, SP, Brazil.,Universidade Cidade de São Paulo (UNICID), São Paulo, SP, Brazil.,Laboratório de Terapêutica Experimental (LIM-20), Faculdade de Medicina da USP (FMUSP), Universidade de Sao Paulo, Sao Paulo, Brazil
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Muntean IA, Bocsan IC, Vesa S, Miron N, Nedelea I, Buzoianu AD, Deleanu D. Could FeNO Predict Asthma in Patients with House Dust Mites Allergic Rhinitis? ACTA ACUST UNITED AC 2020; 56:medicina56050235. [PMID: 32422966 PMCID: PMC7279291 DOI: 10.3390/medicina56050235] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2020] [Revised: 04/30/2020] [Accepted: 05/11/2020] [Indexed: 01/28/2023]
Abstract
Background and Objectives: The evolution of allergic rhinitis to asthma is a part of "atopic march". The aim of this study was to analyze possible predictive markers for asthma occurrence in patients with allergic rhinitis to house dust mites (HDM). Materials and Methods: Fifty-eight patients with persistent allergic rhinitis (PAR) were included. The clinical, biological evaluation and fractionated exhaled nitric oxide (FeNO) measurement were performed at enrolment. The patients were clinically evaluated after one year to determine asthma occurrence. Results: The severity of rhinitis symptoms, levels of total immunoglobulin E (IgE), ICAM-1, VCAM-1, E-selectin and IL-6, but not IL-8 and TNF-α were higher in patients with allergic rhinitis who developed asthma compared to non-asthmatics, but the differences were not significant to considered them as predictive factors for asthma occurrence. The risk of asthma was independently influenced by patients aged over 30 years ((OR-3.74; CI95% 0.86-16.31; p = 0.07), a duration of allergic rhinitis over 12 months ((OR-4.20; CI95% 0.88-20; p = 0.07) and a basal FeNO over 28 parts per billion (pbb) ((OR-18.68; CI95% 3.79-92.05; p < 0.001). Conclusion: Clinical and biological parameters may predict asthma occurrence in patients with persistent allergic rhinitis to HDM. Adult patients with a longer duration of rhinitis symptoms and a high level of FeNO have a greater risk to develop asthma.
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Affiliation(s)
- Ioana Adriana Muntean
- Department of Allergology and Immunology, “Iuliu Hatieganu” University of Medicine and Pharmacy, 400162 Cluj Napoca, Romania; (I.A.M.); (I.N.); (D.D.)
| | - Ioana Corina Bocsan
- Toxicology and Clinical Pharmacology, Department of Pharmacology, “Iuliu Hatieganu” University of Medicine and Pharmacy, 400337 Cluj Napoca, Romania; (S.V.); (A.D.B.)
- Correspondence:
| | - Stefan Vesa
- Toxicology and Clinical Pharmacology, Department of Pharmacology, “Iuliu Hatieganu” University of Medicine and Pharmacy, 400337 Cluj Napoca, Romania; (S.V.); (A.D.B.)
| | - Nicolae Miron
- Department of Clinical Immunology, Sahlgrenska University Hospital, 41346 Göteborg, Sweden;
| | - Irena Nedelea
- Department of Allergology and Immunology, “Iuliu Hatieganu” University of Medicine and Pharmacy, 400162 Cluj Napoca, Romania; (I.A.M.); (I.N.); (D.D.)
| | - Anca Dana Buzoianu
- Toxicology and Clinical Pharmacology, Department of Pharmacology, “Iuliu Hatieganu” University of Medicine and Pharmacy, 400337 Cluj Napoca, Romania; (S.V.); (A.D.B.)
| | - Diana Deleanu
- Department of Allergology and Immunology, “Iuliu Hatieganu” University of Medicine and Pharmacy, 400162 Cluj Napoca, Romania; (I.A.M.); (I.N.); (D.D.)
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Burnt sugarcane harvesting is associated with rhinitis symptoms and inflammatory markers. Braz J Otorhinolaryngol 2019; 85:337-343. [PMID: 29661675 PMCID: PMC9442896 DOI: 10.1016/j.bjorl.2018.02.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2017] [Revised: 02/02/2018] [Accepted: 02/20/2018] [Indexed: 12/17/2022] Open
Abstract
Introduction Burnt sugarcane harvesting requires intense physical exertion in an environment of high temperature and exposure to particulate matter. Objective To evaluate the effects of burnt sugarcane harvesting on rhinitis symptoms and inflammatory markers in sugarcane workers. Methods A total of 32 male sugarcane workers were evaluated with questionnaire for rhinitis symptoms, and for inflammatory markers on peripheral blood and nasal lavage, in the non-harvesting, and 3 and 6 months into the sugarcane harvesting period. Weather data and particulate matter fine concentrations were measured in the same day. Results The particulate matter concentrations in sugarcane harvesting were 27 (23–33 μg/m3), 112 (96–122 μg/m3), and 63 (17–263 μg/m3); 24 h temperatures were 32.6 (25.4–37.4 °C), 32.3 (26.7–36.7 °C) and 29.7 (24.1–34.0 °C) and relative humidities were 45.4 (35.0–59.7%), 47.9 (39.1–63.0%), and 59.9 (34.7–63.2%) in the non-harvesting period, three and 6 months of the harvesting period. The age was 37.4 ± 10.9 years. The prevalence of rhinitis symptoms was significantly higher at 3 months of the harvesting period (53.4%), compared to non-harvesting period (26.7%; p = 0.039) and at 6 months into the harvesting period (20%; p = 0.006). Concentrations of interleukin 6 (IL-6) in nasal lavage increased after 3 months of the harvesting period compared to the non-harvesting period (p = 0.012). The presence of rhinitis symptoms, after 3 months of the harvesting period, was directly associated with blood eosinophils and inversely associated with neutrophils. Conclusions After 3 months of work in burnt sugarcane harvesting the prevalence of rhinitis symptoms and IL-6 in nasal lavage increased. Furthermore, eosinophil counts were directly associated with the rhinitis symptoms in the period of higher concentration of particulate matter.
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Castano R, Yucesoy B, Johnson VJ, Castellanos L, Cartier A. Inflammatory proteins in nasal lavage of workers exposed to occupational agents. Clin Exp Allergy 2017; 47:1566-1573. [DOI: 10.1111/cea.13039] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2017] [Revised: 08/04/2017] [Accepted: 09/02/2017] [Indexed: 12/26/2022]
Affiliation(s)
- R. Castano
- Department of Otolaryngology; Hôpital du Sacré-Coeur de Montréal; Montreal QC Canada
- Research Center; Axe Maladies Chroniques; Hôpital du Sacré-Coeur de Montréal; Montreal QC Canada
| | - B. Yucesoy
- Formerly of the Health Effects Laboratory Division; CDC/NIOSH; Morgantown WV USA
| | - V. J. Johnson
- Burleson Research Technologies, Inc.; Morrisville NC USA
| | - L. Castellanos
- Research Center; Axe Maladies Chroniques; Hôpital du Sacré-Coeur de Montréal; Montreal QC Canada
| | - A. Cartier
- Department of Chest Medicine; Hôpital du Sacré-Coeur de Montréal; Montreal QC Canada
- Research Center; Axe Maladies Chroniques; Hôpital du Sacré-Coeur de Montréal; Montreal QC Canada
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Precision medicine in patients with allergic diseases: Airway diseases and atopic dermatitis-PRACTALL document of the European Academy of Allergy and Clinical Immunology and the American Academy of Allergy, Asthma & Immunology. J Allergy Clin Immunol 2017; 137:1347-58. [PMID: 27155030 DOI: 10.1016/j.jaci.2016.03.010] [Citation(s) in RCA: 217] [Impact Index Per Article: 31.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2016] [Revised: 03/14/2016] [Accepted: 03/15/2016] [Indexed: 01/01/2023]
Abstract
In this consensus document we summarize the current knowledge on major asthma, rhinitis, and atopic dermatitis endotypes under the auspices of the PRACTALL collaboration platform. PRACTALL is an initiative of the European Academy of Allergy and Clinical Immunology and the American Academy of Allergy, Asthma & Immunology aiming to harmonize the European and American approaches to best allergy practice and science. Precision medicine is of broad relevance for the management of asthma, rhinitis, and atopic dermatitis in the context of a better selection of treatment responders, risk prediction, and design of disease-modifying strategies. Progress has been made in profiling the type 2 immune response-driven asthma. The endotype driven approach for non-type 2 immune response asthma, rhinitis, and atopic dermatitis is lagging behind. Validation and qualification of biomarkers are needed to facilitate their translation into pathway-specific diagnostic tests. Wide consensus between academia, governmental regulators, and industry for further development and application of precision medicine in management of allergic diseases is of utmost importance. Improved knowledge of disease pathogenesis together with defining validated and qualified biomarkers are key approaches to precision medicine.
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Abstract
Occupational rhinitis (OR) involves nasal congestion, rhinorrhea, nasal itching, and/or sneezing resulting from workplace exposures. OR can have a significant negative effect on quality of life and productivity. OR can be divided into allergic or nonallergic subgroups based on the underlying pathogenesis. Certain occupational exposures place employees at greater risk for developing disease. Primary treatment is avoidance of implicated exposures. Antihistamines, saline rinses, and nasal steroids may be useful. OR can coexist with occupational asthma, and rhinitis symptoms have been reported to precede those of the lower respiratory tract. OR is has both medical and socioeconomic implications.
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Affiliation(s)
- Leslie C Grammer
- Division of Allergy-Immunology, Department of Medicine, Northwestern University Feinberg School of Medicine, 211 East Ontario Street Suite 1000, Chicago, IL 60611, USA.
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Biomarker as a research tool in linking exposure to air particles and respiratory health. BIOMED RESEARCH INTERNATIONAL 2015; 2015:962853. [PMID: 25984536 PMCID: PMC4422993 DOI: 10.1155/2015/962853] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/27/2014] [Revised: 08/11/2014] [Accepted: 09/08/2014] [Indexed: 01/08/2023]
Abstract
Some of the environmental toxicants from air pollution include particulate matter (PM10), fine particulate matter (PM2.5), and ultrafine particles (UFP). Both short- and long-term exposure could result in various degrees of respiratory health outcomes among exposed persons, which rely on the individuals' health status. Methods. In this paper, we highlight a review of the studies that have used biomarkers to understand the association between air particles exposure and the development of respiratory problems resulting from the damage in the respiratory system. Data from previous epidemiological studies relevant to the application of biomarkers in respiratory system damage reported from exposure to air particles are also summarized. Results. Based on these analyses, the findings agree with the hypothesis that biomarkers are relevant in linking harmful air particles concentrations to increased respiratory health effects. Biomarkers are used in epidemiological studies to provide an understanding of the mechanisms that follow airborne particles exposure in the airway. However, application of biomarkers in epidemiological studies of health effects caused by air particles in both environmental and occupational health is inchoate. Conclusion. Biomarkers unravel the complexity of the connection between exposure to air particles and respiratory health.
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Abstract
Occupational rhinitis is characterized by nasal congestion, rhinorrhea, nasal itching, and/or sneezing that occur secondary to exposures in the workplace. This disease can be classified into allergic or nonallergic subgroups based upon the underlying disease pathogenesis as well as the type of causative agent. While the true prevalence of occupational rhinitis is unknown, there are certain professions and occupational exposures that place workers at a higher risk for developing the disease. Additionally, occupational rhinitis can be associated with occupational asthma and upper airway symptoms may precede those of the lower respiratory tract. Taken together, occupational rhinitis is an important disease for study given its medical as well as socioeconomic implications. This review will focus on the classification of occupational rhinitis as well the prevalence, diagnosis, and treatment strategies.
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Affiliation(s)
- Whitney W Stevens
- Division of Allergy-Immunology, Department of Medicine, Northwestern University Feinberg School of Medicine, 211 E Ontario St, Suite 1010, Chicago, IL, 60611, USA,
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Hox V, Steelant B, Fokkens W, Nemery B, Hellings PW. Occupational upper airway disease: how work affects the nose. Allergy 2014; 69:282-91. [PMID: 24397491 DOI: 10.1111/all.12347] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/12/2013] [Indexed: 01/24/2023]
Abstract
Chronic inflammation of the upper airways is common and can arbitrarily be divided into rhinitis and rhinosinusitis. Infection and allergy represent two well-characterized and most frequently diagnosed etiologies of upper airway inflammation. Persistent upper airway inflammation caused by agents inhaled in the work environment represents a diagnostic challenge in clinical practice, and its pathophysiology has been little studied. Occupational rhinitis is a recognized medical condition with diagnostic and therapeutic guidelines. In contrast, only limited evidence is available about the relationship between work exposures and rhinosinusitis. This review aims at providing a comprehensive overview of the available literature on occupational upper airway disease with a focus on pathophysiological mechanisms and with an emphasis on the current unmet needs in work-related upper airway disease.
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Affiliation(s)
- V. Hox
- Department of Otorhinolaryngology, Head and Neck Surgery; University Hospitals Leuven; Leuven Belgium
- Laboratory of Clinical Immunology; Department of Microbiology and Immunology; KU Leuven; Leuven Belgium
| | - B. Steelant
- Laboratory of Clinical Immunology; Department of Microbiology and Immunology; KU Leuven; Leuven Belgium
| | - W. Fokkens
- Department of Otorhinolaryngology; Academic Medical Centre; Amsterdam the Netherlands
| | - B. Nemery
- Research Unit of Lung Toxicology; Department of Public Health and Primary Care; KU Leuven; Leuven Belgium
| | - P. W. Hellings
- Department of Otorhinolaryngology, Head and Neck Surgery; University Hospitals Leuven; Leuven Belgium
- Laboratory of Clinical Immunology; Department of Microbiology and Immunology; KU Leuven; Leuven Belgium
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Lima TMD, Kazama CM, Koczulla AR, Hiemstra PS, Macchione M, Fernandes ALG, Santos UDP, Bueno-Garcia ML, Zanetta DM, André CDSD, Saldiva PHN, Nakagawa NK. pH in exhaled breath condensate and nasal lavage as a biomarker of air pollution-related inflammation in street traffic-controllers and office-workers. Clinics (Sao Paulo) 2013; 68:1488-94. [PMID: 24473505 PMCID: PMC3840367 DOI: 10.6061/clinics/2013(12)03] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2013] [Revised: 05/14/2013] [Accepted: 06/08/2013] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVE To utilize low-cost and simple methods to assess airway and lung inflammation biomarkers related to air pollution. METHODS A total of 87 male, non-smoking, healthy subjects working as street traffic-controllers or office-workers were examined to determine carbon monoxide in exhaled breath and to measure the pH in nasal lavage fluid and exhaled breath condensate. Air pollution exposure was measured by particulate matter concentration, and data were obtained from fixed monitoring stations (8-h work intervals per day, during the 5 consecutive days prior to the study). RESULTS Exhaled carbon monoxide was two-fold greater in traffic-controllers than in office-workers. The mean pH values were 8.12 in exhaled breath condensate and 7.99 in nasal lavage fluid in office-workers; these values were lower in traffic-controllers (7.80 and 7.30, respectively). Both groups presented similar cytokines concentrations in both substrates, however, IL-1β and IL-8 were elevated in nasal lavage fluid compared with exhaled breath condensate. The particulate matter concentration was greater at the workplace of traffic-controllers compared with that of office-workers. CONCLUSION The pH values of nasal lavage fluid and exhaled breath condensate are important, robust, easy to measure and reproducible biomarkers that can be used to monitor occupational exposure to air pollution. Additionally, traffic-controllers are at an increased risk of airway and lung inflammation during their occupational activities compared with office-workers.
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Affiliation(s)
| | - Cristiane Mayumi Kazama
- Department of Pathology, Faculdade de Medicina, Universidade de São Paulo, São PauloSP, Brazil
| | | | - Pieter S Hiemstra
- Department of Pulmonology, Leiden University Medical Center, Leiden, The Netherlands
| | - Mariangela Macchione
- Department of Pathology, Faculdade de Medicina, Universidade de São Paulo, São PauloSP, Brazil
| | - Ana Luisa Godoy Fernandes
- Department of Pneumology, School of Medicine, Universidade Federal de São Paulo, São PauloSP, Brazil
| | - Ubiratan de Paula Santos
- Pneumology Division, Instituto do Coração, Faculdade de Medicina, Universidade de São Paulo, São PauloSP, Brazil
| | - Maria Lucia Bueno-Garcia
- Department of Internal Medicine, Faculdade de Medicina, Universidade de São Paulo, São PauloSP, Brazil
| | - Dirce Maria Zanetta
- Department of Epidemiology, Public Health Faculty, Universidade de São Paulo, São PauloSP, Brazil
| | | | | | - Naomi Kondo Nakagawa
- Department of Pathology, Faculdade de Medicina, Universidade de São Paulo, São PauloSP, Brazil
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Castano R, Welman M, Trudeau C, Castellanos L, Maghni K, Malo JL. Specific inhalation challenge with flour induced release of brain-derived neurotrophic factor in nasal fluid. Int Forum Allergy Rhinol 2013; 4:49-55. [DOI: 10.1002/alr.21223] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2013] [Revised: 06/19/2013] [Accepted: 07/26/2013] [Indexed: 12/29/2022]
Affiliation(s)
- Roberto Castano
- Division of Otolaryngology-Head and Neck Surgery; University of Montreal; Montreal Canada
- Chronic Disease Research Division; Hôpital du Sacré-Coeur de Montréal; Montreal Canada
| | - Melanie Welman
- Chronic Disease Research Division; Hôpital du Sacré-Coeur de Montréal; Montreal Canada
| | - Carole Trudeau
- Chronic Disease Research Division; Hôpital du Sacré-Coeur de Montréal; Montreal Canada
| | - Lucero Castellanos
- Chronic Disease Research Division; Hôpital du Sacré-Coeur de Montréal; Montreal Canada
| | - Karim Maghni
- Chronic Disease Research Division; Hôpital du Sacré-Coeur de Montréal; Montreal Canada
| | - Jean-Luc Malo
- Chronic Disease Research Division; Hôpital du Sacré-Coeur de Montréal; Montreal Canada
- Chest Department; Hôpital du Sacré-Coeur de Montréal; Montreal Canada
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Prospective Outcome Assessment of Occupational Rhinitis After Removal From Exposure. J Occup Environ Med 2013; 55:579-85. [DOI: 10.1097/jom.0b013e318289ee17] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
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Dissecting the role of eosinophil cationic protein in upper airway disease. Curr Opin Allergy Clin Immunol 2012; 12:18-23. [PMID: 22157160 DOI: 10.1097/aci.0b013e32834eccaf] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
PURPOSE OF REVIEW Eosinophil granulocyte myeloid cells are increased in atopic and nonatopic rhinitis, chronic rhinosinusitis (CRS) and atopic keratoconjunctivitis, diseases of the upper respiratory tract. Eosinophils contain several basic granule proteins, the best known being the eosinophil cationic protein (ECP). ECP is a cytotoxic, pro-fibrotic ribonuclease, which is found deposited in these eosinophil-related diseases and is often used in parallel with blood eosinophilia to monitor those diseases. The contribution of eosinophils and their granule proteins to disease pathogenesis have been debated; recent findings might bring these cells to the center of attention. RECENT FINDINGS Novel mediators of atopic disease, interleukin-17 (IL-17) and IL-33 have been found in the upper respiratory tract. These cytokines stimulate eosinophils to survival and degranulation, IL-17 via granulocyte-macrophage colony-stimulating factor (GM-CSF), and IL-33 directly. Transforming growth factor (TGF)-β has been found in CRS and atopic keratoconjunctivitis mucosa, its production possibly stimulated by ECP. ECP is detected in nasal mucosa of local allergic reactions, entopy, in rhinitis and CRS. ECP might be released from freely circulating eosinophil granules or in association with eosinophil mitochondrial DNA, both means of release for pathogen defence. SUMMARY Novel evidence suggests that eosinophils and ECP might have new prominent roles in development of diseases of the upper respiratory tract.
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Occupational rhinitis: consensus on diagnosis and medicolegal implications. Curr Opin Otolaryngol Head Neck Surg 2011; 19:36-42. [PMID: 21124223 DOI: 10.1097/moo.0b013e328341e228] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
PURPOSE OF REVIEW Work-related rhinitis is a common disease in many working groups, frequently associated with asthma. The purpose of this review is to summarize the specific literature published within the past 12 months, to discuss the diagnostic workup and to illustrate the medicolegal aspects pertaining to this disease. RECENT FINDINGS Recently, there has been a growing scientific interest in work-related rhinitis, which includes both occupational rhinitis and work-exacerbated rhinitis. The epidemiological relevance and the relationships to asthma have been evaluated. New etiologic agents and populations at risk have been identified. A new definition and classification, and a diagnostic algorithm, have been proposed. SUMMARY In consideration of the epidemiological relevance and of the medicolegal implications, occupational rhinitis should be considered in daily clinical practice by all physicians. In adults with late-onset rhinitis, occupational causes should be queried and patients in whom an occupational association is suspected should be referred for specific assessments.
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