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Lau A, Tarlo SM. Update on the Management of Occupational Asthma and Work-Exacerbated Asthma. ALLERGY, ASTHMA & IMMUNOLOGY RESEARCH 2019; 11:188-200. [PMID: 30661311 PMCID: PMC6340795 DOI: 10.4168/aair.2019.11.2.188] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/31/2018] [Revised: 10/25/2018] [Accepted: 10/28/2018] [Indexed: 12/16/2022]
Abstract
Work-related asthma is the most common occupational lung disease encountered in clinical practice. In adult asthmatics, work-relatedness can account for 15%-33% of cases, but delays in diagnosis remain common and lead to worse outcomes. Accurate diagnosis of asthma is the first step to managing occupational asthma, which can be sensitizer-induced or irritant-induced asthma. While latency has traditionally been recognized as a hallmark of sensitizer-induced asthma and rapid-onset a defining feature of irritant-induced asthma (as in Reactive Airway Dysfunction Syndrome), there is epidemiological evidence for irritant-induced asthma with latency from chronic moderate exposure. Diagnostic testing while the patient is still in the workplace significantly improves sensitivity. While specific inhalational challenges remain the gold-standard for the diagnosis of occupational asthma, they are not available outside of specialized centers. Commonly available tests including bronchoprovocation challenges and peak flow monitoring are important tools for practicing clinicians. Management of sensitizer-induced occupational asthma is notable for the central importance of removal from the causative agent: ideally, removal of the culprit agent; but if not feasible, this may require changes in the work process or ultimately, removal of the worker from the workplace. While workers' compensation programs may reduce income loss, these are not universal and there can be significant socio-economic impact from work-related asthma. Primary prevention remains the preferred method of reducing the burden of occupational asthma, which may include modification to work processes, better worker education and substitution of sensitizing agents from the workplace with safer compounds.
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Affiliation(s)
- Ambrose Lau
- Respiratory Division, Department of Medicine, Toronto Western Hospital and St. Michael's Hospital, Toronto, Ontario, Canada
| | - Susan M Tarlo
- Respiratory Division, Department of Medicine, Toronto Western Hospital and St. Michael's Hospital, Toronto, Ontario, Canada.
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Newton AN, Davis M, Koehler K, Shreffler W, Ahluwalia S, Metwali N, Thorne PS, Paigen BJ, Matsui EC. Atopy as a Modifier of the Relationships Between Endotoxin Exposure and Symptoms Among Laboratory Animal Workers. Ann Work Expo Health 2018; 61:1024-1028. [PMID: 29028247 DOI: 10.1093/annweh/wxx061] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2016] [Accepted: 06/30/2017] [Indexed: 01/13/2023] Open
Abstract
Background Exposure to endotoxin is known to trigger airway inflammation and symptoms, and atopy may modify the relationship between endotoxin exposure and symptom development. Objective To test the a priori hypothesis that atopic status modifies the relationship between endotoxin exposure and respiratory symptom development. Methods A prospective study of laboratory workers at The Jackson Laboratories was conducted. Allergy skin testing was performed and population demographic and clinical information was obtained at baseline. Personal exposure assessments for airborne endotoxin and surveys of self-reported symptoms were performed every 6 months. Cox proportional hazards models were used to examine the relationship between endotoxin exposure and development of mouse-associated symptoms and multivariate regression was used to test for interaction. Results Overall, 16 (9%) of 174 worker-participants developed mouse-associated rhinoconjunctivitis symptoms by 24 months and 8 (5%) developed mouse-associated lower respiratory symptoms by 24 months. Among workers with endotoxin exposure above the median (≥2.4 EU m-3), 5 (6% of 80) atopics reported mouse-associated rhinoconjunctivitis symptoms at 24 months as compared to 3 (3% of 94) non-atopics. Among workers below the median endotoxin exposure (<2.4 EU m-3), 1 (1% of 80) atopic reported mouse-associated rhinoconjunctivitis symptoms at 24 months as compared to 7 (7% of 94) non-atopics. For the combination of symptoms, the adjusted hazard ratio was 6.8 (95% confidence interval: 0.7-67.2) for atopics and 0.07 (95% confidence interval: 0.01-0.5) for non-atopics. Conclusion In this occupational cohort, atopic workers may be more susceptible to, and non-atopic workers protected from, endotoxin-associated upper and lower respiratory symptoms.
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Affiliation(s)
- Ashley N Newton
- Department of Environmental Health Sciences, Johns Hopkins Bloomberg School of Public Health
| | - Meghan Davis
- Department of Environmental Health Sciences, Johns Hopkins Bloomberg School of Public Health
| | - Kirsten Koehler
- Department of Environmental Health Sciences, Johns Hopkins Bloomberg School of Public Health
| | | | - Sharon Ahluwalia
- Walter Reed National Military Medical Center, Allergy, Immunology and Immunizations
| | - Nervana Metwali
- Department of Occupational and Environmental Health, University of Iowa
| | - Peter S Thorne
- Department of Occupational and Environmental Health, University of Iowa
| | | | - Elizabeth C Matsui
- Division of Pediatric Allergy and Immunology, Johns Hopkins School of Medicine
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Oppliger A, Barresi F, Maggi M, Schmid-Grendelmeier P, Huaux F, Hotz P, Dressel H. Association of Endotoxin and Allergens with Respiratory and Skin Symptoms: A Descriptive Study in Laboratory Animal Workers. Ann Work Expo Health 2018; 61:822-835. [PMID: 28810679 DOI: 10.1093/annweh/wxx048] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2016] [Accepted: 06/09/2017] [Indexed: 11/15/2022] Open
Abstract
Background In laboratory animal work, allergens are classically considered to play a prominent role in generation of respiratory and skin symptoms. However, recent development may have changed working conditions and require an updating of preventive measures. Objective In workers exposed to a range of animals besides laboratory mice and rats the relative role of endotoxin, irritants, and allergens in symptom generation was assessed for updating preventative measures and health surveillance. Methods Eligible workers were recruited from university units in which exposure to rats and/or mice, occurrence of respiratory and/or skin symptoms, and/or a history of animal bites had been reported. Exposure to endotoxin and rat and mouse allergen was assessed (71 half-day personal samples). 'Symptomatic' was defined by work-related ocular, nasal, respiratory, or skin symptoms. A concentration of specific IgE against rat or mouse (e87 and e88) ≥0.35 kU/l defined sensitization. Sensitivity analyses examined the effect of alternative exposure indicators and definitions of 'sensitized' and 'symptomatic'. Results From 302 eligible workers, 177 participated. There were 121 and 41 workers in the asymptomatic and non-sensitized and symptomatic but non-sensitized group, respectively. Eight subjects were symptomatic and sensitized. Six sensitized subjects were asymptomatic. One participant could not be assigned to a subgroup. Airborne endotoxin and allergen concentrations were mostly below 20 EU m-3 or the detection limit, respectively. Clinical history showed that irritants and sensitizers other than mouse/rat allergen or endotoxin were a major cause of symptoms. Results were sensitive to the selected exposure indicator and the definition of 'symptomatic'. Conclusions Health surveillance programs need to be adapted to include a larger range of allergens and pay more attention to irritants.
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Affiliation(s)
- Anne Oppliger
- Institute for Work and Health, University of Lausanne, CH-1011 Lausanne, Switzerland
| | - Fabio Barresi
- Division of Occupational and Environmental Medicine, EBPI, University of Zurich and University Hospital Zurich, Zurich, Switzerland
| | - Marion Maggi
- Division of Occupational and Environmental Medicine, EBPI, University of Zurich and University Hospital Zurich, Zurich, Switzerland
| | | | - Francois Huaux
- Louvain Centre for Toxicology and Applied Pharmacology, Institut de Recherche Expérimentale et Clinique (IREC), Université Catholique de Louvain, Brussels, Belgium
| | - Philipp Hotz
- Division of Occupational and Environmental Medicine, EBPI, University of Zurich and University Hospital Zurich, Zurich, Switzerland
| | - Holger Dressel
- Division of Occupational and Environmental Medicine, EBPI, University of Zurich and University Hospital Zurich, Zurich, Switzerland
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Abstract
PURPOSE OF REVIEW Work-related asthma is a common disorder among adult asthma patients, and in the case of occupational asthma, it is induced by workplace exposures. RECENT FINDINGS Occupational asthma provides an excellent model and benchmark for identifying and testing different allergy or inflammatory biomarkers associated with its inception or progression. Moreover, specific inhalation challenge with the incriminated agent represents an experimental setting to identify and validate potential systemic or local biomarkers. Some biomarkers are mainly blood-borne, while local airway biomarkers are derived from inflammatory or resident cells. Genetic and gene-environment interaction studies also provide an excellent framework to identify relevant profiles associated with the risk of developing these work-related conditions. Despite significant efforts to identify clinically relevant inflammatory and genomic markers for occupational asthma, apart from the documented utility of airway inflammatory biomarkers, it remains elusive to define specific markers or signatures clearly associated with different endpoints or outcomes in occupational asthma.
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Lipińska-Ojrzanowska A, Marcinkiewicz A, Walusiak-Skorupa J. Usefulness of Biomarkers in Work-Related Airway Disease. CURRENT TREATMENT OPTIONS IN ALLERGY 2017; 4:181-190. [PMID: 28680796 PMCID: PMC5488075 DOI: 10.1007/s40521-017-0121-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Determination of biomarkers may be useful in the surveillance of occupational exposure and workers' health. The possibility of predicting development/clinical course of specific disorders or current disease, diagnosing in early steps, and health condition monitoring is a real necessity. Various agents present in the workplace environment (or their metabolites) can be measured in samples possessed from human body (blood and urine, saliva, etc.). On the other hand, inhalant exposure may induce specific or non-specific, local or systemic, acute or chronic biological response expressed by synthesis or releasing specific or non-specific substances/mediators that also can be determined in blood, nasal and bronchial lavage or sputum, tear fluid, exhaled breath, etc. The least is known about genetic markers which may predict individual susceptibility to develop some work-related disorders under the influence of occupational exposure. Due to common exposure to inhalant agents at workplace, researches on biomarkers that allow to inspect the impact of exposure to humans' health are still needed. The authors of this article summarize the utility of biomarkers' determination in work-related airway diseases in a recent clinical approach.
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Affiliation(s)
- Agnieszka Lipińska-Ojrzanowska
- Department of Occupational Diseases and Environmental Health, Nofer Institute of Occupational Medicine, 8 St. Teresy, 91-348 Lodz, Poland
| | - Andrzej Marcinkiewicz
- Department of Occupational Diseases and Environmental Health, Nofer Institute of Occupational Medicine, 8 St. Teresy, 91-348 Lodz, Poland
| | - Jolanta Walusiak-Skorupa
- Department of Occupational Diseases and Environmental Health, Nofer Institute of Occupational Medicine, 8 St. Teresy, 91-348 Lodz, Poland
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LeVan TD, Smith LM, Heires AJ, Mikuls TR, Meza JL, Weissenburger-Moser LA, Romberger DJ. Interaction of CD14 haplotypes and soluble CD14 on pulmonary function in agricultural workers. Respir Res 2017; 18:49. [PMID: 28302109 PMCID: PMC5353891 DOI: 10.1186/s12931-017-0532-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2017] [Accepted: 03/07/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Agricultural environments are contaminated with organic dusts containing bacterial components. Chronic inhalation of organic dusts is implicated in respiratory diseases. CD14 is a critical receptor for gram-negative lipopolysaccharide; however, its association with respiratory disease among agricultural workers is unknown. The objective of this study was to determine if serum soluble CD14 (sCD14) levels are associated with lung function among agricultural workers and if this association is modified by genetic variants in CD14. METHODS This cross-sectional study included 584 veterans with >2 years of farming experience and that were between the ages of 40 and 80 years. Participants underwent spirometry and were genotyped for four tagging CD14 polymorphisms (CD14/-2838, rs2569193; CD14/-1720, rs2915863; CD14/-651, rs5744455; and CD14/-260, rs2569190). Serum sCD14 was assayed by ELISA. RESULTS Subjects were 98% white males with a mean age 64.5 years. High soluble CD14 levels (> median sCD14) were associated decreased lung function (FEV1/FVC, p = 0.011; % predicted FEV1, p = 0.03). When stratified by COPD (yes/no) and smoking status (ever/never), high sCD14 levels (> median sCD14) were associated with low lung function among ever smokers with COPD (% predicted FEV1, padj = 0.0008; FEV1/FVC, padj = 0.0002). A similar trend was observed for never smokers with COPD; however, results did not reach statistical significance due to small sample size. There was a significant sCD14 x COPD/smoking interaction with lung function (% predicted FEV1, pinter = 0.0498; FEV1/FVC, pinter = 0.011). Regression models were adjusted for age, body mass index, education, sex, race and years worked on a farm. No association was found between CD14 polymorphisms/haplotypes (CD14/-2838; CD14/-1720; CD14/-651; CD14/-260) and sCD14 levels. The final model included the variables sCD14 and haplotypes and a haplotype x sCD14 interaction term. Individuals with the GTTG haplotype (CD14/-2838 → CD14/-260) and high sCD14 levels (> median sCD14) had on average 6.94 lower % predicted FEV1 than individuals with the GCCA haplotype and low sCD14 levels (≤ median sCD14, padj = 0.03). CONCLUSION CD14 haplotypes and sCD14 are important mediators of lung function among those with COPD in this occupationally-exposed population.
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Affiliation(s)
- Tricia D LeVan
- Department of Epidemiology, University of Nebraska Medical Center, 985910, Omaha, NE, 68198-5910, USA. .,Department of Internal Medicine and Veterans Nebraska Western Iowa Healthcare System, Omaha, NE, USA.
| | - Lynette M Smith
- Department of Biostatistics, University of Nebraska Medical Center, Omaha, NE, USA
| | - Art J Heires
- Department of Internal Medicine, University of Nebraska Medical Center, Omaha, NE, USA
| | - Ted R Mikuls
- Department of Internal Medicine and Veterans Nebraska Western Iowa Healthcare System, Omaha, NE, USA
| | - Jane L Meza
- Department of Biostatistics, University of Nebraska Medical Center, Omaha, NE, USA
| | | | - Debra J Romberger
- Department of Internal Medicine and Veterans Nebraska Western Iowa Healthcare System, Omaha, NE, USA
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Wegienka G, Havstad S, Kim H, Zoratti E, Ownby D, Woodcroft KJ, Johnson CC. Subgroup differences in the associations between dog exposure during the first year of life and early life allergic outcomes. Clin Exp Allergy 2016; 47:97-105. [PMID: 27562398 DOI: 10.1111/cea.12804] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2016] [Revised: 08/12/2016] [Accepted: 08/15/2016] [Indexed: 02/06/2023]
Abstract
BACKGROUND The effect of dog exposure on the risk of children developing allergic disease remains controversial. Many analyses have not considered that associations may vary within population subgroups. OBJECTIVE To examine whether associations between living with a dog in the first year of life and allergic outcomes vary within subgroups selected a priori (race, gender and delivery mode). METHODS Black (n = 496) and White (n = 196) children enrolled in the WHEALS birth cohort study had a clinical examination at age 2 years to assess eczema and allergen-specific IgE (sIgE) and perform skin prick testing (SPT). Whether the child lived with an indoor dog in the first year of life was assessed through interview, as was doctor diagnosis of asthma at ages 3-6 years. RESULTS Living with a dog was associated with decreased odds of having ≥ 1 positive SPT (OR = 0.56, 95% CI: 0.34, 0.91) and having eczema (OR = 0.34, 95% CI: 0.20, 0.60). The association with SPT was stronger in those children born via caesarean section (c-section) vs. vaginally (OR = 0.29, 95% CI: 0.12, 0.74 vs. OR = 0.76, 95% CI: 0.43, 1.37, respectively, interaction P = 0.087) and in those who were firstborn vs. not (OR = 0.27, 95% CI: 0.11, 0.67 vs. OR = 0.82, 95% CI: 0.45, 1.47, respectively, interaction P = 0.044). The association with eczema was stronger in children born vaginally compared with those born via caesarean section (OR = 0.17, 95% CI: 0.06, 0.43 vs. OR = 0.65, 95% CI: 0.31, 1.35, respectively, interaction P = 0.025) and was stronger in Black vs. White children (OR = 0.30, 95% CI: 0.15, 0.61 vs. OR = 0.78, 95% CI: 0.29, 2.11, respectively, interaction P = 0.12). Dog keeping was not significantly inversely associated with having ≥ 1 elevated sIgE and only approached statistical significance with asthma. CONCLUSIONS AND CLINICAL RELEVANCE Results likely vary between studies due to variability of specific exposure-outcome associations in subgroups defined by other factors as well as the relative distributions of those subgroups. Important allergic disorder associations will be missed without subgroup analyses.
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Affiliation(s)
- G Wegienka
- Department of Public Health Sciences, Henry Ford Hospital, Detroit, MI, USA
| | - S Havstad
- Department of Public Health Sciences, Henry Ford Hospital, Detroit, MI, USA
| | - H Kim
- Division of Allergy and Clinical Immunology, Henry Ford Hospital, Detroit, MI, USA
| | - E Zoratti
- Division of Allergy and Clinical Immunology, Henry Ford Hospital, Detroit, MI, USA
| | - D Ownby
- Department of Pediatrics, Georgia Regents University, Augusta, GA, USA
| | - K J Woodcroft
- Department of Public Health Sciences, Henry Ford Hospital, Detroit, MI, USA
| | - C C Johnson
- Department of Public Health Sciences, Henry Ford Hospital, Detroit, MI, USA
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Freitas AS, Simoneti CS, Ferraz E, Bagatin E, Brandão IT, Silva CL, Borges MC, Vianna EO. Exposure to high endotoxin concentration increases wheezing prevalence among laboratory animal workers: a cross-sectional study. BMC Pulm Med 2016; 16:69. [PMID: 27153990 PMCID: PMC4859959 DOI: 10.1186/s12890-016-0233-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2015] [Accepted: 04/27/2016] [Indexed: 12/04/2022] Open
Abstract
Background Endotoxin from Gram-negative bacteria are found in different concentrations in dust and on the ground of laboratories dealing with small animals and animal houses. Methods Cross-sectional study performed in workplaces of two universities. Dust samples were collected from laboratories and animal facilities housing rats, mice, guinea pigs, rabbits or hamsters and analyzed by the “Limulus amebocyte lysate” (LAL) method. We also sampled workplaces without animals. The concentrations of endotoxin detected in the workplaces were tested for association with wheezing in the last 12 months, asthma defined by self-reported diagnosis and asthma confirmed by bronchial hyperresponsiveness (BHR) to mannitol. Results Dust samples were obtained at 145 workplaces, 92 with exposure to animals and 53 with no exposure. Exposed group comprised 412 subjects and non-exposed group comprised 339 subjects. Animal-exposed workplaces had higher concentrations of endotoxin, median of 34.2 endotoxin units (EU) per mg of dust (interquartile range, 12.6–65.4), as compared to the non-exposed group, median of 10.2 EU/mg of dust (interquartile range, 2.6–22.2) (p < 0.001). The high concentration of endotoxin (above whole sample median, 20.4 EU/mg) was associated with increased wheezing prevalence (p < 0.001), i.e., 61 % of workers exposed to high endotoxin concentration reported wheezing in the last 12 months compared to 29 % of workers exposed to low endotoxin concentration. The concentration of endotoxin was not associated with asthma report or with BHR confirmed asthma. Conclusion Exposure to endotoxin is associated with a higher prevalence of wheezing, but not with asthma as defined by the mannitol bronchial challenge test or by self-reported asthma. Preventive measures are necessary for these workers.
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Affiliation(s)
- Amanda Souza Freitas
- Department of Social Medicine, Medical School of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil
| | - Christian Silva Simoneti
- Department of Medicine, Medical School of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil
| | - Erica Ferraz
- Department of Medicine, Medical School of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil
| | - Ericson Bagatin
- Department of Preventive and Social Medicine, State University of Campinas, Campinas, Brazil
| | - Izaira Tincani Brandão
- Department of Biochemistry and Immunology, Medical School of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil
| | - Celio Lopes Silva
- Department of Biochemistry and Immunology, Medical School of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil
| | - Marcos Carvalho Borges
- Department of Medicine, Medical School of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil
| | - Elcio Oliveira Vianna
- Department of Medicine, Medical School of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil.
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Long term effect and allergic sensitization in newly employed workers in laboratory animal facilities. Respir Med 2015; 109:1164-73. [DOI: 10.1016/j.rmed.2015.06.007] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2015] [Revised: 06/04/2015] [Accepted: 06/12/2015] [Indexed: 11/13/2022]
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Hur GY, Park HS. Biological and genetic markers in occupational asthma. Curr Allergy Asthma Rep 2015; 15:488. [PMID: 25430950 DOI: 10.1007/s11882-014-0488-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
Occupational asthma (OA) is a complex disease that is often hard to diagnose due to difficulties in detecting relevant exposure, along with inherent differences in disease susceptibility. Numerous studies have attempted to identify relevant biological and genetic markers for OA and to devise tools capable of detecting exposure to the causative agent. Immunological markers, including skin prick test reactivity and specific IgE and IgG antibodies can be used to detect high-molecular-weight allergens in cases of baker's asthma. For OA induced by low-molecular-weight agents, such as isocyanate, potential biomarkers include serum-specific IgE and IgG antibodies to isocyanate-HSA conjugate and IgG to cytokeratin 19 and transglutaminase-2. For protein-based markers, ferritin/transferrin and vitamin D-binding protein levels have been suggested for isocyanate-OA. Genetic markers of susceptibility to isocyanate-OA include human leukocyte antigen and CTNNA3. Further investigations will be needed to identify better biomarkers for OA, which may be used to inform clinical decision.
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Affiliation(s)
- Gyu-Young Hur
- Department of Internal Medicine, Korea University College of Medicine, 148 Gurodong-Ro, Guro, Seoul, 152-703, South Korea,
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Sahiner UM, Semic-Jusufagic A, Curtin JA, Birben E, Belgrave D, Sackesen C, Simpson A, Yavuz TS, Akdis CA, Custovic A, Kalayci O. Polymorphisms of endotoxin pathway and endotoxin exposure: in vitro IgE synthesis and replication in a birth cohort. Allergy 2014; 69:1648-58. [PMID: 25102764 DOI: 10.1111/all.12504] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/05/2014] [Indexed: 12/25/2022]
Abstract
BACKGROUND Genetic variants in endotoxin signaling pathway are important in modulating the effect of environmental endotoxin on asthma and atopic phenotypes. Our objective was to determine the single nucleotide polymorphisms (SNPs) in the endotoxin signaling pathway that may influence in vitro IgE synthesis and to investigate the relationship between these variants and endotoxin exposure in relation to the development of asthma and atopy in a birth cohort. METHODS Peripheral blood mononuclear cells from 45 children with asthma were stimulated with 2 and 200 ng/ml lipopolysaccharide in vitro and IgE was measured in the culture supernatants. Children were genotyped for 121 SNPs from 30 genes in the endotoxin signaling pathway. Variants with a dose-response IgE production in relation to lipopolysaccharide (LPS) were selected for replication in a population-based birth cohort, in which we investigated the interaction between these SNPs and endotoxin exposure in relation to airway hyper-responsiveness, wheeze, and atopic sensitization. RESULTS Twenty-one SNPs in nine genes (CD14, TLR4, IRF3, TRAF-6, TIRAP, TRIF, IKK-1, ST-2, SOCS1) were found to modulate the effect of endotoxin on in vitro IgE synthesis, with six displaying high linkage disequilibrium. Of the remaining 15 SNPs, for seven we found significant relationships between genotype and endotoxin exposure in the genetic association study in relation to symptomatic airway hyper-responsiveness (CD14-rs2915863 and rs2569191, TRIF-rs4807000), current wheeze (ST-2-rs17639215, IKK-1-rs2230804, and TRIF-rs4807000), and atopy (CD14-rs2915863 and rs2569192, TRAF-6-rs5030411, and IKK-1-rs2230804). CONCLUSIONS Variants in the endotoxin signaling pathway are important determinants of asthma and atopy. The genotype effect is a function of the environmental endotoxin exposure.
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Affiliation(s)
- U. M. Sahiner
- Pediatric Allergy and Asthma Unit; Hacettepe University School of Medicine; Ankara Turkey
| | - A. Semic-Jusufagic
- Centre for Respiratory Medicine and Allergy; Institute of Inflammation and Repair; University of Manchester & University Hospital of South Manchester; Manchester UK
| | - J. A. Curtin
- Centre for Respiratory Medicine and Allergy; Institute of Inflammation and Repair; University of Manchester & University Hospital of South Manchester; Manchester UK
| | - E. Birben
- Pediatric Allergy and Asthma Unit; Hacettepe University School of Medicine; Ankara Turkey
| | - D. Belgrave
- Centre for Respiratory Medicine and Allergy; Institute of Inflammation and Repair; University of Manchester & University Hospital of South Manchester; Manchester UK
- Centre for Health Informatics; Institute of Population Health; University of Manchester; Manchester UK
| | - C. Sackesen
- Pediatric Allergy and Asthma Unit; Hacettepe University School of Medicine; Ankara Turkey
| | - A. Simpson
- Centre for Respiratory Medicine and Allergy; Institute of Inflammation and Repair; University of Manchester & University Hospital of South Manchester; Manchester UK
| | - T. S. Yavuz
- Pediatric Allergy and Asthma Unit; Hacettepe University School of Medicine; Ankara Turkey
| | - C. A. Akdis
- Swiss Institute of Allergy and Asthma Research (SIAF); University of Zurich; Davos Switzerland
| | - A. Custovic
- Centre for Respiratory Medicine and Allergy; Institute of Inflammation and Repair; University of Manchester & University Hospital of South Manchester; Manchester UK
| | - O. Kalayci
- Pediatric Allergy and Asthma Unit; Hacettepe University School of Medicine; Ankara Turkey
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12
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The characteristics, treatment and prevention of laboratory animal allergy. Lab Anim (NY) 2013; 42:26-33. [PMID: 23246890 DOI: 10.1038/laban.163] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2012] [Accepted: 07/27/2012] [Indexed: 11/09/2022]
Abstract
Laboratory animal allergy (LAA) is a pervasive problem that affects up to one-third of laboratory animal personnel. An immediate hypersensitivity reaction can be triggered by contact with antigens present in urine, hair, dander and saliva of laboratory animals. The authors provide an overview of the epidemiology, triggering mechanisms, diagnosis, treatment and risk factors of LAA. They also discuss primary and secondary prevention measures that can be taken to reduce LAA morbidity and to allow personnel suffering from LAA to safely continue to do their jobs.
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Hussein YM, Shalaby SM, Zidan HE, Sabbah NA, Karam NA, Alzahrani SS. CD14 tobacco gene-environment interaction in atopic children. Cell Immunol 2013; 285:31-7. [PMID: 24044964 DOI: 10.1016/j.cellimm.2013.08.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2013] [Revised: 07/24/2013] [Accepted: 08/01/2013] [Indexed: 02/03/2023]
Abstract
Studying gene-environment interactions may elucidate the complex origins of atopic diseases. The aim of this study was to evaluate the association of CD14 polymorphisms and atopy in Egyptian children and to study whether atopy is influenced by CD14 interaction with tobacco smoke exposure. CD14 -159 C/T and CD14 -550 C/T were genotyped in 500 asthmaic children, 150 allergic rhinitis children and 150 controls. We found that CD14 -159T allele, CD14 -550T allele and CD14 -159T/-550T haplotype were significantly associated with atopic asthma and allergic rhinitis groups. CD14 -159 TT and CD14 -550 TT genotypes associated with elevated IgE levels in children exposed to tobacco smoke. The TT genotype of CD14 -159 C/T and CD14 -550 C/T was associated with higher serum levels of sCD14. The present study indicated that CD14 gene polymorphisms may contribute to susceptibility to atopy in Egyptian children and influenced with tobacco smoke exposure.
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Affiliation(s)
- Yousri M Hussein
- Medical Biochemistry Department, Faculty of Medicine, Zagazig University, Zagazig, Egypt; Medical Laboratories Department, Faculty of Applied Medical Science, El-Taif University, Saudi Arabia
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March ME, Sleiman PM, Hakonarson H. Genetic polymorphisms and associated susceptibility to asthma. Int J Gen Med 2013; 6:253-65. [PMID: 23637549 PMCID: PMC3636804 DOI: 10.2147/ijgm.s28156] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
Abstract
As complex common diseases, asthma and allergic diseases are caused by the interaction of multiple genetic variants with a variety of environmental factors. Candidate-gene studies have examined the involvement of a very large list of genes in asthma and allergy, demonstrating a role for more than 100 loci. These studies have elucidated several themes in the biology and pathogenesis of these diseases. A small number of genes have been associated with asthma or allergy through traditional linkage analyses. The publication of the first asthma-focused genome-wide association (GWA) study in 2007 has been followed by nearly 30 reports of GWA studies targeting asthma, allergy, or associated phenotypes and quantitative traits. GWA studies have confirmed several candidate genes and have identified new, unsuspected, and occasionally uncharacterized genes as asthma susceptibility loci. Issues of results replication persist, complicating interpretation and making conclusions difficult to draw, and much of the heritability of these diseases remains undiscovered. In the coming years studies of complex diseases like asthma and allergy will probably involve the use of high-throughput next-generation sequencing, which will bring a tremendous influx of new information as well as new problems in dealing with vast datasets.
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Affiliation(s)
- Michael E March
- Center for Applied Genomics, Abramson Research Center of the Joseph Stokes Jr Research Institute, The Children's Hospital of Philadelphia
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Ober C, Vercelli D. Gene-environment interactions in human disease: nuisance or opportunity? Trends Genet 2011; 27:107-15. [PMID: 21216485 DOI: 10.1016/j.tig.2010.12.004] [Citation(s) in RCA: 104] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2010] [Revised: 12/07/2010] [Accepted: 12/10/2010] [Indexed: 02/08/2023]
Abstract
Many environmental risk factors for common, complex human diseases have been revealed by epidemiologic studies, but how genotypes at specific loci modulate individual responses to environmental risk factors is largely unknown. Gene-environment interactions will be missed in genome-wide association studies and could account for some of the 'missing heritability' for these diseases. In this review, we focus on asthma as a model disease for studying gene-environment interactions because of relatively large numbers of candidate gene-environment interactions with asthma risk in the literature. Identifying these interactions using genome-wide approaches poses formidable methodological problems, and elucidating molecular mechanisms for these interactions has been challenging. We suggest that studying gene-environment interactions in animal models, although more tractable, might not be sufficient to shed light on the genetic architecture of human diseases. Lastly, we propose avenues for future studies to find gene-environment interactions.
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Affiliation(s)
- Carole Ober
- Department of Human Genetics, 920 E. 58th Street, The University of Chicago, Chicago, IL 60637, USA.
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