Foss-Skiftesvik M H, Winther L, Mosbech H F, Skov P S, Opstrup M S, Søsted H, Zachariae C, Johansen J D, Johnsen C R
Department of Dermato-Allergology, National Allergy Research Centre, Copenhagen University Hospital Gentofte, Kildegårdsvej 28, 2900 Hellerup, Denmark ; Department of Dermato-Allergology, Research Centre for Hairdressers and Beauticians, Copenhagen University Hospital Gentofte, Hellerup, Denmark.
Allergy Clinic, Department of Dermato-Allergology, Copenhagen University Hospital Gentofte, Hellerup, Denmark.
Clin Transl Allergy. 2016 Jul 21;6:26. doi: 10.1186/s13601-016-0118-7. eCollection 2016.
Persulphates from hair bleaching products are considered the major cause of occupational-rhinitis and asthma in hairdressers. The specific inhalation challenge (SIC) is considered 'reference standard' for diagnosing persulphate-induced asthma and rhinitis; however, the currently validated method of performing SIC with persulphate powder is time consuming with a duration of up to 4 days. The value of skin prick tests (SPTs) and histamine release tests (HRTs) with persulphates is unknown. The aim of this study was to establish a novel rapid SIC with persulphate powder to test for both rhinitis and asthma simultaneously in 1 day. In addition, we assessed the suitability of SPTs and HRTs for detecting persulphate-induced respiratory diseases.
The study population included 19 hairdressers with a history of work-related rhinitis and/or asthma symptoms, 12 symptomatic controls (10 with concurrent allergic asthma and rhinitis and two with non-allergic asthma), and 40 healthy controls. A previous severe asthmatic reaction and/or anaphylactic reaction to persulphates was considered an exclusion criterion for hairdressers. The 19 hairdressers and 12 symptomatic controls had SIC performed with 3 × 5 min exposures to potassium persulphate powder in a provocation chamber. All participants, including the 40 healthy controls, were subjected also to SPTs and HRTs with three persulphate salts at concentrations of 2-20 % and 0.03-1 %, respectively.
None of the symptomatic controls had a nasal or bronchial response to SIC with potassium persulphate. Six hairdressers presented a nasal and two a bronchial response. No severe reactions occurred. No positive SPTs were recorded, neither among hairdressers, symptomatic controls, nor healthy controls. All three groups showed nonspecific non-IgE mediated histamine release to persulphates in HRT.
The proposed method for performing SIC showed a high specificity for detecting persulphate-induced asthma and rhinitis. The rapid SIC was able to produce positive nasal and bronchial responses in symptomatic hairdressers without any severe reactions occurring. SPTs and HRTs cannot predict asthma or rhinitis caused by persulphates.
美发产品中的过硫酸盐被认为是美发师职业性鼻炎和哮喘的主要病因。特异性吸入激发试验（SIC）被视为诊断过硫酸盐诱发的哮喘和鼻炎的“参考标准”；然而，目前经验证的用过硫酸钾粉末进行SIC的方法耗时长达4天。过硫酸盐皮肤点刺试验（SPT）和组胺释放试验（HRT）的价值尚不清楚。本研究的目的是建立一种新的用过硫酸钾粉末的快速SIC，以便在1天内同时检测鼻炎和哮喘。此外，我们评估了SPT和HRT在检测过硫酸盐诱发的呼吸道疾病方面的适用性。
研究人群包括19名有职业相关鼻炎和/或哮喘症状病史的美发师、12名有症状对照者（10名同时患有过敏性哮喘和鼻炎，2名患有非过敏性哮喘）以及40名健康对照者。既往对过硫酸盐有严重哮喘反应和/或过敏反应被视为美发师的排除标准。19名美发师和12名有症状对照者在激发试验室内用过硫酸钾粉末进行3次每次5分钟的SIC。所有参与者，包括40名健康对照者，也分别用浓度为2% - 20%和0.03% - 1%的三种过硫酸盐进行SPT和HRT。
有症状对照者中无人对用过硫酸钾的SIC产生鼻或支气管反应。6名美发师出现鼻部反应，2名出现支气管反应。未发生严重反应。在美发师、有症状对照者和健康对照者中均未记录到阳性SPT。所有三组在HRT中均显示对过硫酸盐有非特异性非IgE介导的组胺释放。
所提出的进行SIC的方法在检测过硫酸盐诱发的哮喘和鼻炎方面显示出高特异性。快速SIC能够在有症状的美发师中产生阳性鼻和支气管反应，且未发生任何严重反应。SPT和HRT无法预测过硫酸盐引起的哮喘或鼻炎。
