What is the role of genetics in occupational asthma?

Dipartimento di Medicina Clinica e Sperimentale, Università degli Studi di Ferrara, Via Fossato di Mortara 64 B, 44100 Ferrara, Italy. .
European Respiratory Journal (Impact Factor: 7.13). 04/2009; 33(3):459-60. DOI: 10.1183/09031936.00183508
Source: PubMed
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    ABSTRACT: The purpose of this article is to critically review the available evidence pertaining to occupational, environmental, and individual factors that can affect the development of occupational asthma (OA). Increasing evidence suggests that exploration of the intrinsic characteristics of OA-causing agents and associated structure-activity relationships offers promising avenues for quantifying the sensitizing potential of agents that are introduced in the workplace. The intensity of exposure to sensitizing agents has been identified as the most important environmental risk factor for OA and should remain the cornerstone for primary prevention strategies. The role of other environmental co-factors (e.g., non-respiratory routes of exposure and concomitant exposure to cigarette smoke and other pollutants) remains to be further delineated. There is convincing evidence that atopy is an important individual risk factor for OA induced by high-molecular-weight agents. There is some evidence that genetic factors, such as leukocyte antigen class II alleles, are associated with an increased risk of OA; however, the role of genetic susceptibility factors is likely to be obscured by complex gene-environment interactions. OA, as well as asthma in general, is a complex disease that results from multiple interactions between environmental factors and host susceptibilities. Determining these interactions is a crucial step towards implementing optimal prevention policies.
    Allergy, asthma & immunology research 07/2011; 3(3):157-67. DOI:10.4168/aair.2011.3.3.157 · 3.08 Impact Factor
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    ABSTRACT: Work-related asthma (WRA) includes occupational asthma and work-exacerbated asthma. WRA is by definition preventable. This chapter discusses available tools for prevention of WRA, divided into primary and secondary prevention. For each tool, the available evidence for the effectiveness of the tool is summarized, and examples are provided. Primary prevention addresses healthy workers or persons with asthma due to causes unrelated to work. The principal tool is control of occupational exposure, reached by elimination or reduction in exposure, but vocational guidance and pre-employment screening are also regarded as primary prevention tools. Secondary prevention addresses early detection of work-related sensitization or WRA to prevent further progression. The principal tool for secondary prevention is medical surveillance. Prediction models represent a promising new tool in medical surveillance; this tool is described here in general and by an example. To set priorities for the prevention of WRA, the monitoring of occurrence in populations as well as in specific industries is crucial, and this chapter therefore briefly describes different sources for surveillance data including sentinel reporting systems, population studies, and occupational disease registers. In the future, focus should be on well-conducted intervention studies, improved exposure assessment, improved medical surveillance (e.g., using prediction models) and good quality national surveillance programs.
    02/2011: pages 281-298;
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    ABSTRACT: For more than a century, clinicians have attempted to subdivide asthma into different phenotypes based on triggers that cause asthma attacks, the course of the disease, or the prognosis. The first phenotypes that were described included allergic asthma, intrinsic or nonallergic asthma, infectious asthma, and aspirin-exacerbated asthma. These phenotypes are being reviewed elsewhere in this issue of the journal. The present article focuses on developing and emerging clinical asthma phenotypes. First, asthma phenotypes that are associated with environmental exposures (occupational agents, cigarette smoke, air pollution, cold dry air); second, asthma phenotypes that are associated with specific symptoms or clinical characteristics (cough, obesity, adult onset of disease); and third, asthma phenotypes that are based on biomarkers. This latter approach is the most promising because it attempts to identify asthma phenotypes with different underlying mechanisms so that therapies can be better targeted toward disease-specific features and disease outcomes can be improved.
    11/2014; DOI:10.1016/j.jaip.2014.09.007


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