Division of Allergy and Immunology, Department of Internal Medicine, College of Medicine, University of Nebraska Medical Center, Omaha, NE, USA.
Curr Allergy Asthma Rep. 2023 Jun;23(6):313-324. doi: 10.1007/s11882-023-01079-w. Epub 2023 May 8.
Occupational lung disease, including asthma, is a significant cause of disability worldwide. The dose, exposure frequency, and nature of the causal agent influence the inflammatory pathomechanisms that inform asthma disease phenotype and progression. While surveillance, systems engineering, and exposure mitigation strategies are essential preventative considerations, no targeted medical therapies are currently available to ameliorate lung injury post-exposure and prevent chronic airway disease development.
This article reviews contemporary understanding of allergic and non-allergic occupational asthma mechanisms. In addition, we discuss the available therapeutic options, patient-specific susceptibility and prevention measures, and recent scientific advances in post-exposure treatment conception. The course of occupational lung disease that follows exposure is informed by individual predisposition, immunobiologic response, agent identity, overall environmental risk, and preventative workplace practices. When protective strategies fail, knowledge of underlying disease mechanisms is necessary to inform targeted therapy development to lessen occupational asthma disease severity and occurrence.
职业性肺病，包括哮喘，是全球范围内导致残疾的重要原因。剂量、暴露频率和致病因子的性质影响炎症发病机制，从而影响哮喘疾病表型和进展。虽然监测、系统工程和暴露缓解策略是必不可少的预防措施，但目前尚无针对暴露后肺损伤和预防慢性气道疾病发展的靶向治疗方法。
本文综述了当前对过敏性和非过敏性职业性哮喘发病机制的认识。此外，我们还讨论了现有的治疗选择、患者特异性易感性和预防措施，以及暴露后治疗概念的最新科学进展。暴露后职业性肺病的病程取决于个体易感性、免疫生物学反应、因子身份、整体环境风险和预防工作场所实践。当保护策略失败时，需要了解潜在的发病机制，以指导靶向治疗的开发，从而减轻职业性哮喘的严重程度和发生。
