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Van Kampen V.,Ruhr University Bochum | De Blay F.,University of Strasbourg | Folletti I.,University of Perugia | Kobierski P.,Rehabilitation Clinic Tobelbad | And 17 more authors.
Allergy: European Journal of Allergy and Clinical Immunology | Year: 2013

Background Skin prick testing (SPT) is an important step in the diagnosis of IgE-mediated occupational allergic diseases. The outcome of SPT is related to the quality of allergen extracts. Thus, the aim of the study was to assess different commercially available SPT solutions for selected occupational allergens. Methods SPT was performed in 116 bakers, 47 farmers and 33 subjects exposed to natural rubber latex (NRL), all with work-related allergic symptoms. The SPT solutions from different manufacturers (n = 3-5) for wheat flour, rye flour, soy, cow hair/dander, storage mites (Tyrophagus putrescentiae, Lepidoglyphus destructor, Acarus siro) and NRL were analysed with respect to their protein and antigen contents. SPT was carried out in 16 allergy centres in six European countries using standardized procedures. Specific IgE values were used as the gold standard to calculate the sensitivity and specificity of SPT solutions. The optimal cut-point for each SPT solution was determined by Youden Index. Results Protein and antigen contents and patterns of the SPT solutions varied remarkably depending on the manufacturer. While SPT solutions for wheat flour and soy reached overall low sensitivities, sensitivities of other tested SPT solutions depended on the manufacturer. As a rule, solutions with higher protein and antigen content showed higher sensitivities and test efficiencies. Conclusions There is a wide variability of SPT solutions for occupational allergens, and the sensitivity of several solutions is low. Thus, improvement and standardization of SPT solutions for occupational allergens is essential. © 2013 John Wiley & Sons A/S. Published by Blackwell Publishing Ltd.

Pignatti P.,Allergy and Immunology Unit | Frossi B.,University of Udine | Pala G.,Allergy and Immunology Unit | Negri S.,Environmental Research Center | And 4 more authors.
International Archives of Allergy and Immunology | Year: 2013

Background: Persulfate salts are components of bleaching powders widely used by hairdressers during hair-bleaching procedures. Hairdressers are at high risk for occupational asthma and rhinitis, and ammonium persulfate is the main etiologic agent. Objective: To explore the effects of ammonium persulfate on human albumin, mast cells, and basophils in order to evaluate a possible effect of ammonium persulfate oxidizing activity in the mechanism of ammonium persulfate-induced occupational asthma. Methods: High-performance liquid chromatography/mass spectrometry was performed on ammonium persulfate-incubated human albumin. The activation of LAD2 human mast cell and KU812 human basophil cell lines incubated with ammonium persulfate was evaluated. CD63 expression on persulfate-in-vitro-incubated blood basophils from nonexposed healthy controls (n = 31) and hairdressers with work-related respiratory symptoms (n = 29) was assessed by flow cytometry. Results: No persulfate-albumin conjugate was found. An oxidative process on tryptophan and methionine was detected. Ammonium persulfate induced reactive oxygen species (ROS) generation and the degranulation of LAD2 and KU812 cells. Human basophils from healthy controls, incubated in vitro with ammonium persulfate, showed increased CD63 expression and ROS production. In hairdressers with ammonium persulfate-caused occupational asthma (positive persulfate challenge), basophil-CD63 expression was higher than in those with a negative challenge and in healthy controls. Conclusions: Ammonium persulfate incubated with human albumin did not generate any adduct but oxidized some amino acids. This oxidizing activity induced human mast cell and basophil activation which might be crucial in the mechanism of persulfate-induced occupational asthma and rhinitis. Copyright © 2012 S. Karger AG, Basel.

Moscato G.,Institute of Research and Care | Rolla G.,University of Turin | Siracusa A.,University of Perugia
Current Opinion in Otolaryngology and Head and Neck Surgery | Year: 2011

Purpose of review: Work-related rhinitis is a common disease in many working groups, frequently associated with asthma. The purpose of this review is to summarize the specific literature published within the past 12 months, to discuss the diagnostic workup and to illustrate the medicolegal aspects pertaining to this disease. Recent findings: Recently, there has been a growing scientific interest in work-related rhinitis, which includes both occupational rhinitis and work-exacerbated rhinitis. The epidemiological relevance and the relationships to asthma have been evaluated. New etiologic agents and populations at risk have been identified. A new definition and classification, and a diagnostic algorithm, have been proposed. Summary: In consideration of the epidemiological relevance and of the medicolegal implications, occupational rhinitis should be considered in daily clinical practice by all physicians. In adults with late-onset rhinitis, occupational causes should be queried and patients in whom an occupational association is suspected should be referred for specific assessments. © 2011 Wolters Kluwer Health - Lippincott Williams & Wilkins.

Moscato G.,Institute of Research and Care
European Annals of Allergy and Clinical Immunology | Year: 2013

Work-related asthma, encompassing both occupational asthma and work-exacerbated asthma, accounts for 10%-25% of adult asthma in Europe and occupational asthma is currently one of the most common forms of occupational lung disease in many industrialized countries. It is cause of direct and indirect costs for the worker, the employer and the society and it is probably still underdiagnosed. Hence, the possibility of work-related asthma should be considered in all adult patients in whom asthma started or worsened during their working life. The investigation of WRA includes assessing the presence of asthma, and demonstrating its work-relatedness, that requires training and expertise. Due to the frequent association of occupational asthma and rhinitis, the presence of both upper and lower airway symptoms should be investigated. Furthermore, since is work-related asthma is a preventable disease all efforts should be made for effective prevention strategies.

Pignatti P.,Institute of Research and Care | Ragnoli B.,Spedali Civili di Brescia | Radaeli A.,Spedali Civili di Brescia | Moscato G.,Institute of Research and Care | Malerba M.,University of Brescia
Rejuvenation Research | Year: 2011

Background: Although an influence of advancing age on lung cellularity in healthy subjects has already been described, induced sputum reference values for cell counts in older healthy adults are not available. The aim of the present study was to evaluate the influence of age on the variation of sputum cell distribution in a considerable number of healthy subjects. A total of 70 nonatopic, nonsmoker healthy subjects aged ≥50 years underwent sputum induction and blood cell count. Sputum samples were processed and then were analyzed by optical microscopy. Differential cell counts were reported as percentages and amount of cells/mg. Results: Sputum cell distribution of healthy subjects aged ≥50 years was mainly composed of neutrophils. Both the percentage and the amount of sputum neutrophils correlated with the subjects' age, r=0.5, p=0.00001 and r=0.32, p=0.007, respectively. This correlation was more evident in women (n=35) than in men (n=35). No correlation was found between blood neutrophils and age. The increase in sputum neutrophils was not secondary to an increase in blood neutrophils. Conclusions: In the studied subjects, aging was associated, particularly in women, with an increase in sputum neutrophils not related to an increase of blood neutrophils. These results could be useful in clinical and experimental settings as reference values to compare with data from subjects aged over 50 years. These data showed that sputum neutrophila can be dissociated from airway symptoms and could create a favorable background for the development of age-related lung diseases. © 2011 Mary Ann Liebert, Inc.

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