Do Low Molecular Weight Agents Cause More Severe Asthma than High Molecular Weight Agents?
Meca, Olga (Hospital General Universitario Morales Meseguer (Múrcia))
Cruz Carmona, María Jesús (Centro de Investigación Biomédica en Red de Enfermedades Respiratorias)
Sánchez-Ortiz, Mónica (Centro de Investigación Biomédica en Red de Enfermedades Respiratorias)
González-Barcala, Francisco-Javier (Complejo Hospitalario Universitario de Santiago de Compostela)
Ojanguren, Iñigo (Centro de Investigación Biomédica en Red de Enfermedades Respiratorias)
Muñoz Gall, Xavier (Universitat Autònoma de Barcelona. Departament de Biologia Cel·lular, de Fisiologia i d'Immunologia)

Data:	2016
Resum:	The aim of this study was to analyse whether patients with occupational asthma (OA) caused by low molecular weight (LMW) agents differed from patients with OA caused by high molecular weight (HMW) with regard to risk factors, asthma presentation and severity, and response to various diagnostic tests. Seventy-eight patients with OA diagnosed by positive specific inhalation challenge (SIC) were included. Anthropometric characteristics, atopic status, occupation, latency periods, asthma severity according to the Global Initiative for Asthma (GINA) control classification, lung function tests and SIC results were analysed. OA was induced by an HMW agent in 23 patients (29%) and by an LMW agent in 55 (71%). A logistic regression analysis confirmed that patients with OA caused by LMW agents had a significantly higher risk of severity according to the GINA classification after adjusting for potential confounders (OR = 3. 579, 95% CI 1. 136-11. 280; p = 0. 029). During the SIC, most patients with OA caused by HMW agents presented an early reaction (82%), while in patients with OA caused by LMW agents the response was mainly late (73%) (p = 0. 0001). Similarly, patients with OA caused by LMW agents experienced a greater degree of bronchial hyperresponsiveness, measured as the difference in the methacholine dose-response ratio (DRR) before and after SIC (1. 77, range 0-16), compared with patients with OA caused by HMW agents (0. 87, range 0-72), (p = 0. 024). OA caused by LMW agents may be more severe than that caused by HMW agents. The severity of the condition may be determined by the different mechanisms of action of these agents.
Ajuts:	Ministerio de Economía y Competitividad CP12/03101
Drets:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Llengua:	Anglès
Document:	Article ; recerca ; Versió publicada
Publicat a:	PloS one, Vol. 11, Issue 6 (June 2016) , art. e0156141, ISSN 1932-6203

DOI: 10.1371/journal.pone.0156141
PMID: 27280473

11 p, 192.0 KB

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