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制革工人职业性哮喘:与工作环境中真菌过敏致敏无关。

Cork workers' occupational asthma: lack of association with allergic sensitisation to fungi of the work environment.

作者信息

Winck João C, Delgado Luís, Murta Rita, Vanzeller Manuela, Marques J Agostinho

机构信息

Pneumology Department, Faculdade de Medicina, Universidade do Porto and Hospital de S. João, 4200, Porto, Portugal.

出版信息

Int Arch Occup Environ Health. 2004 May;77(4):296-300. doi: 10.1007/s00420-003-0494-x. Epub 2004 Jan 22.

Abstract

OBJECTIVES

To evaluate allergic sensitisation to Chrysonilia sitophila, Penicillium glabrum, and Trichoderma longibrachiatum in cork workers with asthma.

METHODS

Skin prick tests with a battery of common allergens and with the three fungi were performed on ten cork workers with asthma and eight non-exposed asthmatics. Based on serial peak expiratory flow measurements, five were classified as having occupational asthma (AO) and five as having non-occupational asthma (NOA). In exposed patients, specific antibodies for the three fungi were also studied by immunoblotting

RESULTS

Two out of ten patients with occupational exposure and four out of eight of the control group showed positive results for skin prick tests for common allergens. Moreover, two out of five patients with OA and three out of eight controls exhibited sensitisation to storage mites. All exposed patients (with OA or NOA) had negative skin prick test results for the fungal extracts. In patients with asthma and occupational exposure, immunoblotting results confirmed the absence of specific IgE. However, specific IgG4 was present in some cases.

CONCLUSIONS

Atopy does not seem to characterise occupational asthma in cork workers. Despite their long exposure to moulds, we could not find evidence of IgE sensitisation to the three most prevalent cork fungi in patients with OA, which points to the search for other causative agents, such as cork chemical compounds or contaminants.

摘要

目的

评估患有哮喘的软木塞工人对嗜卷书虱、光滑青霉和长枝木霉的过敏致敏情况。

方法

对10名患有哮喘的软木塞工人和8名未接触软木塞的哮喘患者进行了一系列常见过敏原及这三种真菌的皮肤点刺试验。根据连续的呼气峰值流速测量结果,5人被归类为患有职业性哮喘(AO),5人被归类为患有非职业性哮喘(NOA)。对于接触软木塞的患者,还通过免疫印迹法研究了针对这三种真菌的特异性抗体。

结果

10名职业暴露患者中有2人,对照组8人中有4人对常见过敏原的皮肤点刺试验呈阳性结果。此外,5名OA患者中有2人,8名对照组中有3人对仓储螨致敏。所有接触软木塞的患者(OA或NOA)对真菌提取物的皮肤点刺试验结果均为阴性。在患有哮喘且有职业暴露的患者中,免疫印迹结果证实不存在特异性IgE。然而,在某些情况下存在特异性IgG4。

结论

特应性似乎并非软木塞工人职业性哮喘的特征。尽管他们长期接触霉菌,但我们在OA患者中未发现对三种最常见软木塞真菌存在IgE致敏的证据,这表明需要寻找其他致病因素,如软木塞化合物或污染物。

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