P. Gorski et al., Nasal and bronchial responses to flour-inhalation in subjects with occupationally induced allergy affecting the airway, INT A OCCUP, 73(7), 2000, pp. 488-497
Citations number
33
Categorie Soggetti
Envirnomentale Medicine & Public Health","Pharmacology & Toxicology
Journal title
INTERNATIONAL ARCHIVES OF OCCUPATIONAL AND ENVIRONMENTAL HEALTH
Objectives: The aim of the study was to follow the similarities and differe
nces, of cellular and mediator changes and mucosal/vascular permeability in
the upper and lower airway after specific and nonspecific bronchial provoc
ation. in bakers with diagnosed occupationally induced allergy affecting th
e airway. In addition, the authors try to find whether there is a relations
hip between cellular changes in nasal and bronchoalveolar lavage, and bronc
hial hyperreactivity. Methods: The study participants were 10 bakers with o
ccupational bronchial asthma and allergic rhinitis. All patients were sensi
tized to investigated allergen-flour. Nasal- and bronchoalveolar lavage tec
hniques were used to evaluate the changes of the cellular and mediator resp
onse (tryptase, eosinophil cationic protein, ECP) and albumin level after s
pecific (flour) and placebo provocation. In addition, bronchial hyperreacti
vity for histamine, and forced expiratory volume in 1 s (FEVI) were measure
d after the challenge. Results: There was a significant increase in the per
centage of eosinophils, basophils and albumin in nasal and bronchoalveolar
lavage of occupationally sensitized bakers. A statistically significant inc
rease in the percentage of neutrophils in bronchoalveolar lavage was observ
ed only 24 h after the allergen challenge. The level of tryptase in nasal l
avage was significantly higher during the early allergic response. The leve
ls of ECP in both nasal and bronchoalveolar lavage were significantly incre
ased during the lateallergic response. There were also severe bronchial rea
ctions and increase of bronchial hyperreactivity for histamine in occupatio
nally sensitized bakers in the late phase of allergic reaction. Conclusion:
Eosinophils and basophils proved to be the predominant cells in nasal and
bronchoalveolar lavage of patients with occupationally induced bronchial as
thma and rhinitis. The prolonged increase of albumin level seems also to be
a good predictor of protracted nasal and bronchial inflammation. The resul
ts obtained confirmed that tryptase and ECP are good markers for monitoring
mast cell and eosinophil degranulation during the allergic reaction. Incre
ase of airway responsiveness reflects an eosinophil and basophil contributi
on to airway allergic response.