Overview of diisocyanate occupational asthma
Overview of diisocyanate occupational asthma
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DOI：
10.1016/0300-483x(96)03375-6
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发表时间：
1996-07-17
期刊：
影响因子：
4.5
通讯作者：
Bernstein, JA
中科院分区：
文献类型：
--
作者：
Bernstein, JA
世界各地建立的监测项目已经确定二异氰酸酯化学品是职业性哮喘的最常见原因。在美国，每年大约有10万工人在工作场所接触到这些化合物，其中5-10%的工人会患上职业性哮喘。目前还没有已知的可靠的危险因素或生物标记物可用于预测暴露于二异氰酸酯的工人会患职业性哮喘。二异氰酸酯-职业性哮喘工人在特定支气管刺激后表现出特征性的生理反应，这与气道的病理改变有关。然而，二氰酸盐职业性哮喘的机制仍不清楚。这些工人中只有10-30%产生针对二异氰酸酯的特异性IgE抗体。支气管活检和支气管肺泡灌洗证实了这些工人气道中t淋巴细胞和嗜酸性粒细胞的存在，这表明t细胞介导的免疫反应更可能在这种疾病中发挥核心作用。必须尽早诊断二异氰酸酯职业性哮喘，以预防或减少与持续长期暴露于这些化学品相关的显著哮喘发病率。选择的治疗方法是使工人不再进一步接触。对暴露于二异氰酸酯的大量工人进行前瞻性研究，对更好地了解二异氰酸酯职业性哮喘的发病机制和自然过程至关重要。
Surveillance programs established around the world have determined that diisocyanate chemicals are the most common cause of occupational asthma. In the United States approximately 100 000 workers are exposed to these chemical compounds in the workplace each year and 5-10% of these workers will develop occupational asthma. There are no known reliable risk factors or biomarkers which can be used to predict which exposed worker will develop diisocyanate-occupatonal asthma. Diisocyanate-occupational asthma workers manifest characteristic physiologic responses after specific bronochoprovocation which correlate with pathologic changes in their airways. However, the mechanism(s) for diiocyanate-occupational asthma remains unclear. Specific IgE antibody production to diisocyanates is found in only 10-30% of these workers. Bronchial biopsies and bronchoalveolar lavage have confirmed the presence of T-lymphocytes and eosinophils in the airways of these workers suggesting that T-cell mediated immune responses are more likely to play a central role in this disease. It is essential to diagnose diisocyanate-occupational asthma as early as possible in order to prevent or reduce the significant asthma morbidity associated with continuous long term exposure to these chemicals. Treatment of choice is removal of the worker from further exposure. Prospective studies evaluating larger populations of diisocyanate-exposed workers is essential for a better understanding of the pathogenesis and natural course of diisocyanate-occupational asthma.