Comparison of high- and low-molecular-weight sensitizing agents causing occupational asthma: an evidence-based insight.

IF 3.9 3区 医学 Q2 IMMUNOLOGY Expert Review of Clinical Immunology Pub Date : 2024-06-01 Epub Date: 2024-01-22 DOI:10.1080/1744666X.2024.2306885
Virginie Doyen, Denyse Gautrin, Olivier Vandenplas, Jean-Luc Malo
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Abstract

Introduction: The many substances used at the workplace that can cause sensitizer-induced occupational asthma are conventionally categorized into high-molecular-weight (HMW) agents and low-molecular-weight (LMW) agents, implying implicitly that these two categories of agents are associated with distinct phenotypic profiles and pathophysiological mechanisms.

Areas covered: The authors conducted an evidence-based review of available data in order to identify the similarities and differences between HMW and LMW sensitizing agents.

Expert opinion: Compared with LMW agents, HMW agents are associated with a few distinct clinical features (i.e. concomitant work-related rhinitis, incidence of immediate asthmatic reactions and increase in fractional exhaled nitric oxide upon exposure) and risk factors (i.e. atopy and smoking). However, some LMW agents may exhibit 'HMW-like' phenotypic characteristics, indicating that LMW agents are a heterogeneous group of agents and that pooling them into a single group may be misleading. Regardless of the presence of detectable specific IgE antibodies, both HMW and LMW agents are associated with a mixed Th1/Th2 immune response and a predominantly eosinophilic pattern of airway inflammation. Large-scale multicenter studies are needed that use objective diagnostic criteria and assessment of airway inflammatory biomarkers to identify the pathobiological pathways involved in OA caused by the various non-protein agents.

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比较引起职业性哮喘的高分子量和低分子量致敏剂:基于证据的见解。
导言:工作场所使用的许多物质都可能引起致敏剂诱发的职业性哮喘,这些物质通常被分为高分子量(HMW)致敏剂和低分子量(LMW)致敏剂,这意味着这两类致敏剂具有不同的表型特征和病理生理机制:作者对现有数据进行了循证审查,以确定 HMW 和 LMW 致敏剂之间的异同。作者使用关键词 "职业性哮喘 "和 "分子量 "对截至 2023 年 8 月 31 日的数据进行了 PubMed 搜索,并在作者的个人数字书目图书馆中进行了额外的特定搜索:专家意见:与低分子量制剂相比,高分子量制剂具有一些明显的临床特征(即与工作相关的并发鼻炎、即时哮喘反应的发生率和接触后呼出一氧化氮分数的增加)和风险因素(即过敏症和吸烟)。然而,一些 LMW 制剂可能表现出 "类似 HMW "的表型特征,这表明 LMW 制剂是一个异质性制剂组,将它们归为一个单一组别可能会产生误导。无论是否存在可检测到的特异性 IgE 抗体,HMW 和 LMW 制剂都与 Th1/Th2 混合免疫反应和以嗜酸性粒细胞为主的气道炎症模式有关。需要进行大规模的多中心研究,利用客观的诊断标准和气道炎症生物标志物评估来确定各种非蛋白制剂引起的 OA 所涉及的病理生物学途径。
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来源期刊
CiteScore
7.60
自引率
2.30%
发文量
221
审稿时长
6-12 weeks
期刊介绍: Expert Review of Clinical Immunology (ISSN 1744-666X) provides expert analysis and commentary regarding the performance of new therapeutic and diagnostic modalities in clinical immunology. Members of the International Editorial Advisory Panel of Expert Review of Clinical Immunology are the forefront of their area of expertise. This panel works with our dedicated editorial team to identify the most important and topical review themes and the corresponding expert(s) most appropriate to provide commentary and analysis. All articles are subject to rigorous peer-review, and the finished reviews provide an essential contribution to decision-making in clinical immunology. Articles focus on the following key areas: • Therapeutic overviews of specific immunologic disorders highlighting optimal therapy and prospects for new medicines • Performance and benefits of newly approved therapeutic agents • New diagnostic approaches • Screening and patient stratification • Pharmacoeconomic studies • New therapeutic indications for existing therapies • Adverse effects, occurrence and reduction • Prospects for medicines in late-stage trials approaching regulatory approval • Novel treatment strategies • Epidemiological studies • Commentary and comparison of treatment guidelines Topics include infection and immunity, inflammation, host defense mechanisms, congenital and acquired immunodeficiencies, anaphylaxis and allergy, systemic immune diseases, organ-specific inflammatory diseases, transplantation immunology, endocrinology and diabetes, cancer immunology, neuroimmunology and hematological diseases.
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