Alvarez M J, Estrada J L, Gozalo F, Fernandez-Rojo F, Barber D
Sección de Alergología, Hospital de León, Spain.
Allergy. 2001 Feb;56(2):185-8. doi: 10.1034/j.1398-9995.2001.056002185.x.
Farmers are exposed to a wide variety of sensitizers. Since occupational asthma (OA) can lead to permanent disability, exposure discontinuation is the preferred treatment. When this is not possible, the identification of the causative allergen may allow an alternative therapy.
We present three farmers diagnosed with OA as a consequence of handling fodder. We carried out skin tests with common and occupational allergens and with oilseed rape (OSR) extract. Total and specific serum IgE levels were measured. The patients underwent the OSR-bronchial provocation test (OSR-BPT). The day before and 24 h after the OSR-BPT, the methacholine (M)-BPT and induced sputum were performed. Eosinophil percentages and ECP levels were measured in the sputum samples.
OSR sensitization (skin tests and specific serum IgE) was detected in all the patients. The OSR-BPT elicited early responses in two subjects. Methacholine sensitivity, sputum eosinophils, and sputum ECP levels increased 24 h after the OSR-BPT in all the patients.
We have demonstrated that inhalation of OSR flour causes bronchoconstriction, induces an eosinophilic inflammatory bronchial response, and increases bronchial hyperresponsiveness in sensitized asthmatics. OSR flour contained in animal fodder should be considered another potential cause of OA among farmers.
农民接触多种致敏原。由于职业性哮喘(OA)可导致永久性残疾,停止接触是首选治疗方法。若无法做到这一点,确定致病过敏原可能会带来替代疗法。
我们报告了三名因处理饲料而被诊断为职业性哮喘的农民。我们用常见和职业过敏原以及油菜籽(OSR)提取物进行了皮肤试验。检测了总血清IgE和特异性血清IgE水平。患者接受了OSR支气管激发试验(OSR - BPT)。在OSR - BPT前一天和后24小时,进行了乙酰甲胆碱(M) - BPT和诱导痰检查。测量了痰样本中的嗜酸性粒细胞百分比和嗜酸性粒细胞阳离子蛋白(ECP)水平。
所有患者均检测到OSR致敏(皮肤试验和特异性血清IgE)。两名受试者的OSR - BPT引发了早期反应。所有患者在OSR - BPT后24小时,乙酰甲胆碱敏感性、痰嗜酸性粒细胞和痰ECP水平均升高。
我们已证明,吸入OSR粉尘会导致支气管收缩,引发嗜酸性粒细胞性炎症性支气管反应,并增加致敏哮喘患者的支气管高反应性。动物饲料中含有的OSR粉尘应被视为农民职业性哮喘的另一个潜在病因。