Characterization of Occupational Eosinophilic Bronchitis in a Multicenter Cohort of Subjects with Work-Related Asthma Symptoms
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Characterization of Occupational Eosinophilic Bronchitis in a Multicenter Cohort of Subjects with Work-Related Asthma Symptoms. / Wiszniewska, Marta; Dellis, Perrine; van Kampen, Vera; Suojalehto, Hille; Munoz, Xavier; Walusiak-Skorupa, Jolanta; Lindström, Irmeli; Merget, Rolph; Romero-Mesones, Christian; Sastre, Joaquin; Quirce, Santiago; Mason, Paola; Rifflart, Catherine; Godet, Julien; de Blay, Frédéric; Vandenplas, Olivier; European network for the PHenotyping of OCcupational ASthma (E-PHOCAS) investigators.
in: J ALLER CL IMM-PRACT, Jahrgang 9, Nr. 2, 02.2021, S. 937-944.e4.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung
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T1 - Characterization of Occupational Eosinophilic Bronchitis in a Multicenter Cohort of Subjects with Work-Related Asthma Symptoms
AU - Wiszniewska, Marta
AU - Dellis, Perrine
AU - van Kampen, Vera
AU - Suojalehto, Hille
AU - Munoz, Xavier
AU - Walusiak-Skorupa, Jolanta
AU - Lindström, Irmeli
AU - Merget, Rolph
AU - Romero-Mesones, Christian
AU - Sastre, Joaquin
AU - Quirce, Santiago
AU - Mason, Paola
AU - Rifflart, Catherine
AU - Godet, Julien
AU - de Blay, Frédéric
AU - Vandenplas, Olivier
AU - European network for the PHenotyping of OCcupational ASthma (E-PHOCAS)
N1 - Copyright © 2020 American Academy of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.
PY - 2021/2
Y1 - 2021/2
N2 - BACKGROUND: Occupational eosinophilic bronchitis (OEB) has been described only as anecdotal case reports.OBJECTIVE: We investigated the clinical and inflammatory characteristics of subjects with OEB identified in a cohort of subjects who completed a specific inhalation challenge (SIC) with occupational agents.METHODS: In this retrospective multicenter study, OEB was defined by (1) a fall in FEV1 less than 15% during the SIC and the absence of nonspecific bronchial hyperresponsiveness both before and after the SIC and (2) a postchallenge increase of 3% or more in sputum eosinophils. The subjects who fulfilled these criteria were compared with 226 subjects with a negative SIC and 30 subjects with a positive SIC who failed to show baseline nonspecific bronchial hyperresponsiveness.RESULTS: An isolated increase in postchallenge sputum eosinophils was documented in 33 of 259 subjects (13%) with a negative SIC. These subjects reported significantly more often an isolated cough at work compared with the negative and positive SIC controls. When compared with positive SIC controls, the subjects with OEB experienced less frequently work-related wheezing and reported a shorter duration of symptoms at work. The sensitivity of the post-SIC increase in fractional exhaled nitric oxide in identifying OEB among subjects with a negative SIC was low, ranging from 43% to 24% using cutoff values of 8 ppb to 17.5 ppb, whereas the specificity was high (90%-97%).CONCLUSIONS: This study highlights the relevance of induced sputum analysis in the investigation of work-related asthma symptoms to identify isolated increases in sputum eosinophils that are consistent with a diagnosis of OEB.
AB - BACKGROUND: Occupational eosinophilic bronchitis (OEB) has been described only as anecdotal case reports.OBJECTIVE: We investigated the clinical and inflammatory characteristics of subjects with OEB identified in a cohort of subjects who completed a specific inhalation challenge (SIC) with occupational agents.METHODS: In this retrospective multicenter study, OEB was defined by (1) a fall in FEV1 less than 15% during the SIC and the absence of nonspecific bronchial hyperresponsiveness both before and after the SIC and (2) a postchallenge increase of 3% or more in sputum eosinophils. The subjects who fulfilled these criteria were compared with 226 subjects with a negative SIC and 30 subjects with a positive SIC who failed to show baseline nonspecific bronchial hyperresponsiveness.RESULTS: An isolated increase in postchallenge sputum eosinophils was documented in 33 of 259 subjects (13%) with a negative SIC. These subjects reported significantly more often an isolated cough at work compared with the negative and positive SIC controls. When compared with positive SIC controls, the subjects with OEB experienced less frequently work-related wheezing and reported a shorter duration of symptoms at work. The sensitivity of the post-SIC increase in fractional exhaled nitric oxide in identifying OEB among subjects with a negative SIC was low, ranging from 43% to 24% using cutoff values of 8 ppb to 17.5 ppb, whereas the specificity was high (90%-97%).CONCLUSIONS: This study highlights the relevance of induced sputum analysis in the investigation of work-related asthma symptoms to identify isolated increases in sputum eosinophils that are consistent with a diagnosis of OEB.
U2 - 10.1016/j.jaip.2020.08.056
DO - 10.1016/j.jaip.2020.08.056
M3 - SCORING: Journal article
C2 - 32920064
VL - 9
SP - 937-944.e4
JO - J ALLER CL IMM-PRACT
JF - J ALLER CL IMM-PRACT
SN - 2213-2198
IS - 2
ER -