REACTIVE AIRWAYS DYSFUNCTION SYNDROME (RADS) - PERSISTENT ASTHMA SYNDROME AFTER HIGH-LEVEL IRRITANT EXPOSURES
REACTIVE AIRWAYS DYSFUNCTION SYNDROME (RADS) - PERSISTENT ASTHMA SYNDROME AFTER HIGH-LEVEL IRRITANT EXPOSURES
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DOI：
10.1378/chest.88.3.376
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发表时间：
1985-01-01
期刊：
影响因子：
9.6
通讯作者：
BERNSTEIN, IL
中科院分区：
文献类型：
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作者：
BROOKS, SM;WEISS, MA;BERNSTEIN, IL
10个人在单次暴露于高水平的挥发性蒸气、烟雾或烟雾后患上了哮喘样疾病。在大多数情况下，高水平接触是由于工作场所发生事故或该地区通风不良和空气交换有限。在所有情况下，症状都在接触后几小时内出现，通常是几分钟。这种疾病被命名为反应性气道功能障碍综合征（RADS），因为一致的生理伴随是气道高反应性。测试时，所有受试者均显示乙酰甲胆碱激发试验阳性。未发现记录的既存呼吸系统疾病，受试者也未涉及既往呼吸系统主诉。在2例受试者中，记录了特应性，但在所有其他受试者中，未发现过敏证据。在大多数病例中，呼吸道症状持续存在，气道高反应性持续超过1年，通常在事件发生后数年。致病因子各不相同，但都有一个共同的特征，即具有刺激性。在2例病例中，可获得支气管活检标本，并观察到气道炎症反应。本研究提示，急性高水平、无控制的刺激性暴露可能导致某些个体出现不同于典型职业性哮喘的哮喘样综合征。它可能导致长期后遗症和慢性气道疾病。在此综合征的发病机制中似乎无免疫机制起作用。
Ten individuals developed an asthma-like illness after a single exposure to high levels of an irrtating vapor, fume, or smoke. In most instances, the high level exposure was the result of an accident occurring in the workplace or a situation where there was poor ventilation and limited air exchange in the area. In all cases, symptoms developed within a few hours and often minutes after exposure. The illness is designated as reactive airway dysfunction syndrome (RADS) because a consistent physiologic accompainment was airways hyperreactivity. When tested, all subjects showed positive methacholine challenge tests. No documented preexisting respiratory illness was identified nor did subjects relate past respiratory complaints. In 2 subjects, atopy was documented, but in all others, no evidence of allergy was identified. In the majority of the cases, there was persistence of respiratory symptoms and continuation of airways hyperreactivity for more than 1 yr and often several years after the incident. The incriminated etiologic agent varied, but all shared a common characteristic of being irritant in nature. In 2 cases, bronchial biopsy specimens were available, and an airways inflammatory response was noted. This investigation suggest acute high level, uncontrolled irritant exposures may cause an asthma-like syndrome in some individuals which is different from typical occupational asthma. It can lead to long-term sequelae and chronic airways disease. Noimmunologic mechanisms seem operative in the pathogenesis of this syndrome.