Lemaire Muriel, Oppliger Anne, Hotz Philipp, Renauld Jean-Christophe, Braun Julia, Maggi Marion, Barresi Fabio, Schmid-Grendelmeier Peter, Huaux François, Dressel Holger
de Duve Institute, Université catholique de Louvain, Brussels, Belgium.
Ludwig Institute for Cancer Research, Brussels Branch, Brussels, Belgium.
Occup Environ Med. 2017 Aug;74(8):592-600. doi: 10.1136/oemed-2016-104137. Epub 2017 Apr 17.
In workers exposed mostly to laboratory animals (LA), symptoms may be due to irritants or allergens. Correct aetiological diagnosis is important for health surveillance.
This study aims to test whether work-related (WR) allergen-induced symptoms are associated with a cytokine profile distinct from that due to irritants.
In a cross-sectional study (n=114), WR respiratory and/or skin symptoms were assessed through a standardised clinical examination and sensitisation to rat and/or mouse allergen determined by serum immunoglobulin E. Serum cytokine concentrations were measured by multiplex assays. The predefined cytokine profiles 'sensitiser' (interleukin (IL)-4, IL-5, IL-13, eotaxin-1) and 'irritation' (IL-8, IL-17A, IL-17F, IL-22) were considered positive, when ≥3 concentrations exceeded the 95th percentile of the asymptomatic non-sensitised group. Results were examined by hierarchical clustering analyses (HCA) and multiple linear regression. Explorative analyses were carried out for nine additional cytokines. Exposure to allergens and endotoxin was assessed in a subpopulation.
The prevalence of the profile 'irritation' was comparable in 28 symptomatic non-sensitised workers and 71 asymptomatic non-sensitised workers. HCA showed that nearly all symptomatic non-sensitised workers were gathered in two subclusters, characterised by high IL-17A levels, but different IL-8 levels. Multiple linear regression identified drug consumption and current complaints as confounders. Sensitised subjects were too few (n=14) for testing the profile 'sensitiser'.
In this unselected population of LA workers, the profile 'irritation' did not prove to be a valuable health surveillance tool. Low power precluded assessment of the profile 'sensitiser'. The increased IL-17A concentration may originate from irritative constituents of organic dust.
在主要接触实验动物（LA）的工人中，症状可能由刺激物或变应原引起。正确的病因诊断对健康监测很重要。
本研究旨在测试与工作相关（WR）的变应原诱发症状是否与不同于刺激物所致的细胞因子谱相关。
在一项横断面研究（n = 114）中，通过标准化临床检查评估WR呼吸道和/或皮肤症状，并通过血清免疫球蛋白E测定对大鼠和/或小鼠变应原的致敏情况。通过多重检测测定血清细胞因子浓度。当≥3种浓度超过无症状未致敏组的第95百分位数时，预定义的细胞因子谱“致敏剂”（白细胞介素（IL）-4、IL-5、IL-13、嗜酸性粒细胞趋化因子-1）和“刺激”（IL-8、IL-17A、IL-17F、IL-22）被视为阳性。通过层次聚类分析（HCA）和多元线性回归检查结果。对另外9种细胞因子进行探索性分析。在一个亚组中评估变应原和内毒素暴露情况。
28名有症状未致敏工人和71名无症状未致敏工人中“刺激”谱的患病率相当。HCA显示，几乎所有有症状未致敏工人聚集在两个亚组中，其特征是IL-17A水平高，但IL-8水平不同。多元线性回归确定药物消耗和当前主诉为混杂因素。致敏受试者太少（n = 14），无法测试“致敏剂”谱。
在这个未经过筛选的LA工人人群中，“刺激”谱并未被证明是一种有价值的健康监测工具。低效能妨碍了对“致敏剂”谱的评估。IL-17A浓度升高可能源于有机粉尘的刺激性成分。
