Pauli G, Kopferschmitt M C, Dietemann A, Blaumeiser M, Bessot J C
Service de Pneumologie, Hôpital Civil, Hôpitaux Universitaires de Strasbourg.
Rev Pneumol Clin. 1993;49(3):115-9.
Isocyanate-induced occupational asthma is a model of experimental asthma related to the environment. Many of its features are identical with those of allergic asthma by sensitization to air-borne allergens. Exposure to isocyanate before the first symptoms of asthma varies from a few weeks to several years. The prevalence of isocyanate-induced asthma has been estimated at 5 to 25%. Atopy is found in less than 30% of the cases. A significant increase of HRBNS can be demonstrated in most patients, but it may be absent. It may also fluctuate with the working periods or after a bronchial provocation test with isocyanate. Elimination of this compound reduces the HRBNS level in only one quarter of the cases. Delayed or biphasic reactions are frequent: 30 to 60% depending of the authors. An early diagnosis followed by total elimination may result in complete cure, but more than 50% of the patients remain symptomatic and with HRBNS. An IgE-dependent mechanism can be demonstrated in about 20% of the cases. The course of isocyanate-induced asthma is interesting in that the same phenomena are probably observed in chronic asthma resulting from repeated exposures to environmental allergens.
异氰酸酯诱发的职业性哮喘是一种与环境相关的实验性哮喘模型。它的许多特征与因对空气传播过敏原致敏而引发的过敏性哮喘相同。在出现哮喘的首发症状之前接触异氰酸酯的时间从几周至数年不等。据估计，异氰酸酯诱发哮喘的患病率为5%至25%。不到30%的病例存在特应性。大多数患者可显示出HRBNS显著升高，但也可能不存在。它还可能随工作周期或在进行异氰酸酯支气管激发试验后波动。仅在四分之一的病例中，去除这种化合物可降低HRBNS水平。迟发或双相反应很常见：根据不同作者的研究，发生率为30%至60%。早期诊断并彻底去除可能会完全治愈，但超过50%的患者仍有症状且存在HRBNS。约20%的病例可证明存在IgE依赖机制。异氰酸酯诱发哮喘的病程很有意思，因为在因反复接触环境过敏原导致的慢性哮喘中可能会观察到相同的现象。
