Kimber Ian, Dearman Rebecca J
Syngenta Central Toxicology Laboratory, Alderley Park, Macclesfield, Cheshire SK10 4TJ, UK.
Toxicology. 2002 Dec 27;181-182:311-5. doi: 10.1016/s0300-483x(02)00299-8.
Chemicals are able to cause various forms of allergic disease in susceptible individuals. Among those of greatest importance in the context of occupational disease is chemical respiratory allergy, where allergic sensitization of the respiratory tract is associated with elicitation of rhinitis, asthma and/or other pulmonary symptoms following inhalation exposure to the inducing chemical allergen. Although for some chemical respiratory allergens (including the acid anhydrides) there exists a strong correlation between symptoms and the presence of specific IgE antibody, for other respiratory sensitizers (and notably the diisocyanates) such an association is variable or absent. These data have resulted in speculation about a universal mandatory role for specific IgE antibody in the induction and elicitation of respiratory allergy to chemicals and of the nature of alternative or complementary mechanisms of sensitization. There is debate also regarding the routes through which exposure to relevant chemical allergens may result in the acquisition of respiratory sensitization. Although inhalation exposure is probably the most common and most important route through which allergic sensitization of the respiratory tract is achieved, there is evidence also that respiratory sensitization to chemicals may be acquired also by dermal contact; observations that have important implications for occupational health management. The significance of IgE antibody and dermal exposure in the context of occupational respiratory allergy to chemicals is discussed.
化学物质能够在易感个体中引发各种形式的过敏性疾病。在职业病范畴内，最重要的当属化学性呼吸道过敏，即呼吸道的过敏性致敏与吸入诱发化学变应原后引发鼻炎、哮喘和/或其他肺部症状相关。尽管对于某些化学性呼吸道变应原（包括酸酐）而言，症状与特异性IgE抗体的存在之间存在很强的相关性，但对于其他呼吸道致敏剂（尤其是二异氰酸酯），这种关联则不固定或不存在。这些数据引发了关于特异性IgE抗体在化学物质诱发和引发呼吸道过敏过程中普遍强制性作用以及致敏替代或互补机制性质的推测。关于接触相关化学变应原可能导致获得呼吸道致敏的途径也存在争议。尽管吸入接触可能是实现呼吸道过敏性致敏最常见且最重要的途径，但也有证据表明，通过皮肤接触也可能获得对化学物质的呼吸道致敏；这些观察结果对职业健康管理具有重要意义。本文讨论了IgE抗体和皮肤接触在职业性化学物质呼吸道过敏中的意义。
