Clinical and inflammatory features of occupational asthma caused by persulphate salts in comparison with asthma associated with occupational rhinitis

Authors

  • G. Moscato,

    1. Allergy and Immunology Unit, Fondazione ‘Salvatore Maugeri’, Institute of Research and Care, Scientific Institute of Pavia, Italy
    2. Occupational Immunology and Allergy Laboratory, ISPESL, Pavia, Italy
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  • G. Pala,

    1. Allergy and Immunology Unit, Fondazione ‘Salvatore Maugeri’, Institute of Research and Care, Scientific Institute of Pavia, Italy
    2. Occupational Immunology and Allergy Laboratory, ISPESL, Pavia, Italy
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  • L. Perfetti,

    1. Allergy and Immunology Unit, Fondazione ‘Salvatore Maugeri’, Institute of Research and Care, Scientific Institute of Pavia, Italy
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  • M. Frascaroli,

    1. Allergy and Immunology Unit, Fondazione ‘Salvatore Maugeri’, Institute of Research and Care, Scientific Institute of Pavia, Italy
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  • P. Pignatti

    1. Allergy and Immunology Unit, Fondazione ‘Salvatore Maugeri’, Institute of Research and Care, Scientific Institute of Pavia, Italy
    2. Occupational Immunology and Allergy Laboratory, ISPESL, Pavia, Italy
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  • Edited by: Thomas Bieber and Hans-Uwe Simon.

G. Moscato, Servizio Autonomo di Allergologia e Immunologia Clinica, Fondazione Salvatore Maugeri, IRCCS, Via Maugeri 10, 27100 Pavia, Italy.
Tel.: +39 0382 592 541
Fax: +39 0382 592 086
E-mail: gianna.moscato@fsm.it

Abstract

To cite this article: Moscato G, Pala G, Perfetti L, Frascaroli M, Pignatti P. Clinical and inflammatory features of occupational asthma caused by persulphate salts in comparison with asthma associated with occupational rhinitis. Allergy 2010; 65: 784–790.

Abstract

Background:  The relationships between asthma and rhinitis are still a crucial point in respiratory allergy and have scarcely been analysed in occupational setting. We aimed to compare the clinical and inflammatory features of subjects with occupational asthma only (OA) to subjects with OA associated to occupational rhinitis (OAR) caused by persulphate salts.

Methods:  The clinical charts of 26 subjects diagnosed in our Unit as respiratory allergy caused by ammonium persulphate (AP), confirmed by specific inhalation challenge (SIC), were reviewed. Twenty-two out of twenty-six patients underwent pre-SIC-induced sputum challenge test (IS) and 24/26 underwent nasal secretion collection and processing.

Results:  Twelve out of twenty-six patients received a diagnosis of OA-only and 14/26 of OAR. Duration of exposure before diagnosis, latency period between the beginning of exposure and asthma symptom onset, basal FEV1, airway reactivity to methacholine and asthma severity did not differ in the two groups. Eosinophilic inflammation of upper and lower airways characterized both groups. Eosinophil percentage in IS tended to be higher in OAR [11.9 (5.575–13.925)%] than in OA-only [2.95 (0.225–12.5)%] (P = 0.31). Eosinophilia in nasal secretions was present both in subjects with OAR [55 (46–71)%] and in subjects with OA-only [38 (15–73.5)%], without any significant difference.

Discussion:  Our results indicate that OA because of ammonium persulphate coexists with occupational rhinitis in half of the patients. Unexpectedly, rhinitis did not seem to have an impact on the natural history of asthma. The finding of nasal inflammation in subjects with OA-only without clinical manifestations of rhinitis supports the united airway disease concept in occupational respiratory allergy as a result of persulphates.

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