Centre for Environment and Health, Department of Public Health and Primary Care, University of Leuven, Leuven, Belgium.
Centre for Environment and Health, Department of Public Health and Primary Care, University of Leuven, Leuven, Belgium.
J Allergy Clin Immunol Pract. 2022 Sep;10(9):2346-2354.e4. doi: 10.1016/j.jaip.2022.05.014. Epub 2022 May 25.
Occupational asthma (OA) may have different etiologies, but it is not clear whether the etiologic agents influence the clinical presentation, especially the co-occurrence of skin lesions.
To determine the impact of different asthmagens on the characteristics of OA, with a focus on the occurrence of prior or concomitant skin disorders.
In a retrospective analysis of patients who visited the Occupational and Environmental Disease Clinic of a tertiary referral hospital from 2009 to 2019, we classified patients into definite, probable, or possible OA according to prespecified diagnostic guidelines. In multivariate logistic regression with sensitivity analysis, we examined the relation of high- and low-molecular-weight (HMW and LMW) agents with the clinical presentation.
Of 209 cases of OA, 66 were caused by HMW agents and 143 by LMW agents. Patients with OA exposed to LMW agents had higher odds of having (had) allergic contact dermatitis (odds ratio, 5.45 [1.80-23.70]; P < .01), compared with patients exposed to HMW agents. Conversely, HMW agents were associated with higher odds of rhinitis symptoms (odds ratio of LMW/HMW, 0.33 [0.17-0.63]; P < .001) and high total IgE (odds ratio of LMW/HMW, 0.35 [0.17-0.70]; P < .01). Risk factors for having coexisting contact dermatitis included construction work, hairdressing, and exposure to metals or epoxy resins.
Among patients with OA, exposure to specific LMW agents was associated with a high frequency of contact dermatitis. Different types of asthmagens within HMW or LMW agents appear to determine the phenotype and comorbidity of OA.
职业性哮喘（OA）可能有不同的病因，但尚不清楚病因是否会影响临床特征，尤其是皮肤病变的共存情况。
确定不同变应原对 OA 特征的影响，重点关注先前或同时发生的皮肤疾病。
我们对 2009 年至 2019 年期间在一家三级转诊医院的职业与环境疾病诊所就诊的患者进行了回顾性分析，根据预先规定的诊断指南将患者分为明确、可能或疑似 OA。我们在多变量逻辑回归分析中进行了敏感性分析，以检查高低分子量（HMW 和 LMW）变应原与临床特征的关系。
在 209 例 OA 患者中，66 例由 HMW 变应原引起，143 例由 LMW 变应原引起。与接触 HMW 变应原的患者相比，接触 LMW 变应原的 OA 患者发生（曾发生）过敏性接触性皮炎的可能性更高（比值比，5.45 [1.80-23.70]；P <.01）。相反，HMW 变应原与鼻炎症状的可能性更高相关（LMW/HMW 的比值比，0.33 [0.17-0.63]；P <.001）和总 IgE 较高（LMW/HMW 的比值比，0.35 [0.17-0.70]；P <.01）。共存接触性皮炎的危险因素包括建筑工作、美发工作以及接触金属或环氧树脂。
在 OA 患者中，接触特定的 LMW 变应原与接触性皮炎的高发生率相关。HMW 或 LMW 变应原内的不同类型似乎决定了 OA 的表型和合并症。
