Allergy Asthma Immunol Res.  2020 Jan;12(1):164-170. 10.4168/aair.2020.12.1.164.

Bronchial Response to High and Low Molecular Weight Occupational Inhalant Allergens

• LipiÅ„ska-Ojrzanowska A
• Nowakowska-Åšwirta E
• Wiszniewska M
• Walusiak-Skorupa J

• KMID: 2462580
• DOI: http://doi.org/10.4168/aair.2020.12.1.164

Abstract

PURPOSE
Occupational asthma may be induced by high- or low-molecular weight allergens (HMWA or LMWA, respectively). The study was conducted to compare the pattern of bronchial response in 200 HMWA-induced asthmatics (n = 130) and LMWA-induced asthmatics (n = 70).
METHODS
The study participants underwent a single-blind, placebo-controlled specific inhalation challenge (SIC) with workplace allergens, accompanied by evaluation of non-specific bronchial hyperresponsiveness (NSBHR) with methacholine before and after the SIC.
RESULTS
A single early bronchial response more frequently occurred in HMWA-induced asthmatics than in LMWA-induced asthmatics (86.2% vs. 20%). An isolated late bronchial response or atypical patterns were more frequently observed in LMWA-induced asthmatics than in LMWA-induced asthmatics (45.7% vs. 3.8% or 34.3% vs. 10%, respectively). Baseline NSBHR before SIC was more often detected in LMWA-induced asthmatics than in HMWA-induced asthmatics (81.4% vs. 54.6%), and the median value of the provocation concentration of methacholine was relevantly lower in these patients before and after SIC. A significant 3-fold increase in NSBHR after SIC was observed more often in LMWA-induced asthmatics than in HMWA-induced asthmatics (82.8% vs. 66.1%). In addition, compared to LMWA-induced asthmatics, HMWA-induced asthmatics were older, were more frequently active smokers, showed lower level of NSBHR, and more frequently continued their work in harmful occupational exposure.
CONCLUSIONS
The results of this study suggest that HMWA-induced asthmatics may have milder clinical courses and that there is a possibility of job continuation despite asthma exacerbation requiring medical surveillance.

Keyword

Occupational asthma; prognosis; bronchial hyperreactivity; allergens; asthma; immunoglobulin E

MeSH Terms

Allergens*
Asthma
Asthma, Occupational
Bronchial Hyperreactivity
Humans
Immunoglobulin E
Inhalation
Methacholine Chloride
Molecular Weight*
Occupational Exposure
Prognosis
Allergens
Immunoglobulin E
Methacholine Chloride

Figure

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  Figure SIC procedure chart. SCI, specific inhalant challenge.

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