Quirce Santiago
Fundación Jiménez Díaz, Allergy Department, Madrid, Spain.
Curr Opin Allergy Clin Immunol. 2004 Apr;4(2):87-91. doi: 10.1097/00130832-200404000-00003.
The purpose of this review is to report that eosinophilic bronchitis without asthma may occur as an occupational airway disease. This condition is characterized by cough that is responsive to corticosteroids and eosinophilia detectable in the sputum, without variable airflow obstruction or airway hyperresponsiveness.
Eosinophilic bronchitis can be regarded as an occupational respiratory disorder when it develops as a consequence of work exposures. Recently, exposure to certain occupational allergens or sensitizers, such as natural rubber latex, mushroom spores, acrylates and an epoxy resin hardener, have been reported to cause eosinophilic bronchitis without asthma. Several hypotheses have been put forward trying to explain why patients with eosinophilic bronchitis do not have airway hyperresponsiveness. It is unknown whether eosinophilic bronchitis may progress to typical occupational asthma, or if eosinophilic airway inflammation may persist when asthma symptoms and airway hyperresponsiveness have waned after the cessation of exposure to the occupational agent.
Eosinophilic bronchitis, like asthma, may arise from occupational exposures. The examination of induced sputum should be added to the objective monitoring of lung function during periods at work and away from work, as well as before and after specific inhalation challenges with occupational agents.
本综述旨在报告无哮喘的嗜酸性粒细胞性支气管炎可能作为一种职业性气道疾病出现。这种疾病的特征是咳嗽对皮质类固醇有反应，痰液中可检测到嗜酸性粒细胞增多，且无可变气流受限或气道高反应性。
当嗜酸性粒细胞性支气管炎因工作接触而发生时，可被视为一种职业性呼吸系统疾病。最近，据报道，接触某些职业过敏原或致敏剂，如天然橡胶乳胶、蘑菇孢子、丙烯酸酯和环氧树脂硬化剂，可导致无哮喘的嗜酸性粒细胞性支气管炎。已经提出了几种假说试图解释为什么嗜酸性粒细胞性支气管炎患者没有气道高反应性。尚不清楚嗜酸性粒细胞性支气管炎是否会进展为典型的职业性哮喘，或者当停止接触职业性致病因素后哮喘症状和气道高反应性减弱时，嗜酸性气道炎症是否会持续存在。
与哮喘一样，嗜酸性粒细胞性支气管炎可能由职业接触引起。在工作期间、非工作期间以及用职业性致病因素进行特异性吸入激发试验前后，除了客观监测肺功能外，还应检查诱导痰。
