Phenotyping Occupational Asthma Caused by Acrylates in a Multicenter Cohort Study
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Phenotyping Occupational Asthma Caused by Acrylates in a Multicenter Cohort Study. / Suojalehto, Hille; Suuronen, Katri; Cullinan, Paul; Lindström, Irmeli; Sastre, Joaquin; Walusiak-Skorupa, Jolanta; Munoz, Xavier; Talini, Donatella; Klusackova, Pavlina; Moore, Vicky; Merget, Rolf; Svanes, Cecilie; Mason, Paola; dell'Omo, Marco; Moscato, Gianna; Quirce, Santiago; Hoyle, Jennifer; Sherson, David; Preisser, Alexandra; Seed, Martin; Rifflart, Catherine; Godet, Julien; de Blay, Frédéric; Vandenplas, Olivier; European network for the PHenotyping of OCcupational ASthma (E-PHOCAS).
In: J ALLER CL IMM-PRACT, Vol. 8, No. 3, 03.2020, p. 971-979.e1.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
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TY - JOUR
T1 - Phenotyping Occupational Asthma Caused by Acrylates in a Multicenter Cohort Study
AU - Suojalehto, Hille
AU - Suuronen, Katri
AU - Cullinan, Paul
AU - Lindström, Irmeli
AU - Sastre, Joaquin
AU - Walusiak-Skorupa, Jolanta
AU - Munoz, Xavier
AU - Talini, Donatella
AU - Klusackova, Pavlina
AU - Moore, Vicky
AU - Merget, Rolf
AU - Svanes, Cecilie
AU - Mason, Paola
AU - dell'Omo, Marco
AU - Moscato, Gianna
AU - Quirce, Santiago
AU - Hoyle, Jennifer
AU - Sherson, David
AU - Preisser, Alexandra
AU - Seed, Martin
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 © 2019 American Academy of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.
PY - 2020/3
Y1 - 2020/3
N2 - BACKGROUND: While acrylates are well-known skin sensitizers, they are not classified as respiratory sensitizers although several cases of acrylate-induced occupational asthma (OA) have been reported.OBJECTIVE: To evaluate the characteristics of acrylate-induced OA in a large series of cases and compare those with OA induced by other low-molecular-weight (LMW) agents.METHODS: Jobs and exposures, clinical and functional characteristics, and markers of airway inflammation were analyzed in an international, multicenter, retrospective cohort of subjects with OA ascertained by a positive inhalation challenge to acrylates (n = 55) or other LMW agents (n = 418) including isocyanates (n = 125).RESULTS: Acrylate-containing glues were the most prevalent products, and industrial manufacturing, dental work, and beauty care were typical occupations causing OA. Work-related rhinitis was more common in acrylate-than in isocyanate-induced asthma (P < .001). The increase in postchallenge fractional exhaled nitric oxide was significantly greater in acrylate-induced OA (26.0; 8.2 to 38.0 parts per billion [ppb]) than in OA induced by other LMW agents (3.0; -1.0 to 10.0 ppb; P < .001) or isocyanates (5.0; 2.0 to 16.0 ppb; P = .010). Multivariable models confirmed that OA induced by acrylates was significantly and independently associated with a postchallenge increase in fractional exhaled nitric oxide (≥17.5 ppb).CONCLUSIONS: Acrylate-induced OA shows specific characteristics, concomitant work-related rhinitis, and exposure-related increases in fractional exhaled nitric oxide, suggesting that acrylates may induce asthma through different immunologic mechanisms compared with mechanisms through which other LMW agents may induce asthma. Our findings reinforce the need for a reevaluation of the hazard classification of acrylates, and further investigation of the pathophysiological mechanisms underlying their respiratory sensitizing potential.
AB - BACKGROUND: While acrylates are well-known skin sensitizers, they are not classified as respiratory sensitizers although several cases of acrylate-induced occupational asthma (OA) have been reported.OBJECTIVE: To evaluate the characteristics of acrylate-induced OA in a large series of cases and compare those with OA induced by other low-molecular-weight (LMW) agents.METHODS: Jobs and exposures, clinical and functional characteristics, and markers of airway inflammation were analyzed in an international, multicenter, retrospective cohort of subjects with OA ascertained by a positive inhalation challenge to acrylates (n = 55) or other LMW agents (n = 418) including isocyanates (n = 125).RESULTS: Acrylate-containing glues were the most prevalent products, and industrial manufacturing, dental work, and beauty care were typical occupations causing OA. Work-related rhinitis was more common in acrylate-than in isocyanate-induced asthma (P < .001). The increase in postchallenge fractional exhaled nitric oxide was significantly greater in acrylate-induced OA (26.0; 8.2 to 38.0 parts per billion [ppb]) than in OA induced by other LMW agents (3.0; -1.0 to 10.0 ppb; P < .001) or isocyanates (5.0; 2.0 to 16.0 ppb; P = .010). Multivariable models confirmed that OA induced by acrylates was significantly and independently associated with a postchallenge increase in fractional exhaled nitric oxide (≥17.5 ppb).CONCLUSIONS: Acrylate-induced OA shows specific characteristics, concomitant work-related rhinitis, and exposure-related increases in fractional exhaled nitric oxide, suggesting that acrylates may induce asthma through different immunologic mechanisms compared with mechanisms through which other LMW agents may induce asthma. Our findings reinforce the need for a reevaluation of the hazard classification of acrylates, and further investigation of the pathophysiological mechanisms underlying their respiratory sensitizing potential.
U2 - 10.1016/j.jaip.2019.10.017
DO - 10.1016/j.jaip.2019.10.017
M3 - SCORING: Journal article
C2 - 31678289
VL - 8
SP - 971-979.e1
JO - J ALLER CL IMM-PRACT
JF - J ALLER CL IMM-PRACT
SN - 2213-2198
IS - 3
ER -
