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Occupational asthma in a grain worker due to Lepidoglyphus destructor , assessed by bronchial provocation test and induced sputum
Author(s) -
Alvarez Mj,
Castillo R,
Ortega N,
Blanco C,
Carrillo T,
Rey A
Publication year - 1999
Publication title -
allergy
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.363
H-Index - 173
eISSN - 1398-9995
pISSN - 0105-4538
DOI - 10.1034/j.1398-9995.1999.00059.x
Subject(s) - methacholine , medicine , sputum , provocation test , eosinophil cationic protein , asthma , bronchial hyperresponsiveness , eosinophil , occupational asthma , immunology , allergy , tryptase , allergen , respiratory disease , mast cell , lung , tuberculosis , pathology , alternative medicine
Background: Occupational asthma (OA) can be a debilitating disease even when removal from the workplace is achieved. Today, the “gold standard” in the assessment of OA is the bronchial provocation test (BPT). Induced sputum is a noninvasive method of exploring airway inflammation which can provide additional information about such challenges and thus could be applied in OA diagnosis and monitoring. Methods: We report the study carried out in a grain worker sensitized to Lepidoglyphus destructor (Ld), who suffered from mild asthma at the workplace. Skin prick test and specific serum IgE were measured. Ld‐BPT was performed, and the changes in eosinophil rates, and ECP and tryptase levels in induced sputum were studied 30 min and 18 h after Ld‐BPT. We also determined the changes in nonspecific bronchial hyperresponsiveness (NSBH), given as PD 20 values. To assess the specificity of the changes, we also carried out sputum induction and methacholine challenge after barley‐BPT. Results: An isolated immediate response was obtained with Ld‐BPT, while barley‐BPT was negative. Induced sputum showed higher tryptase levels 30 min after Ld‐BPT, and higher eosinophil and epithelial cell percentages and ECP levels 18 h after Ld‐BPT. There was also a decrease in methacholine PD 20 values after Ld‐BPT. Those changes were not observed after barley‐BPT. Conclusions: The study of eosinophilic and mast‐cell markers in induced sputum provides additional knowledge about the inflammatory process occurring in the airways, suggesting that the study of induced sputum should be considered in the assessment of OA.