Occupational sensitization to low-molecular-weight compounds: Association between dermal and respiratory routes of sensitization and elicitation

It is taken for granted that the key route for the sensitization of asthma is the respiratory tract, but emerging evidence indicates that airway sensitization may not necessarily occur only via respiratory route. The causing agents for asthma can be classified as high- or low-molecular-weight agents. Skin exposure to low-molecular-weight agents has been recognized as one of the origins for selective airway hyper-responisiveness in some literature, but the paradigm has not been accepted widely. In addition, the association between allergic contact dermatitis and occupational asthma to specific agents has rarely been studied in clinical studies. Understanding the pathway for sensitization in asthma helps to correctly estimate the respiratory health risk in the workplace and facilitate early diagnosis. Metals are important low-molecular-weight causing agents for occupational asthma. Several metal compounds possess capability to induce both sensitization on skin and airway. However, the mechanism of occupational asthma induced by metal compounds is not well understood. Dendritic cells and innate lymphoid cells have been known to play important role in asthma, but their role in metal-induced asthma have never been studied. In this thesis, we have investigated the effect of skin exposure to low-molecular-weight (LMW) agent on asthma. We first reviewed the literature systematically and graded the evidence, focusing whether the skin exposure to LMW agents can induce the airway sensitization. Then we investigated the effect of skin exposure to cobalt chloride on airway hypersensitivity on a mouse model. Finally, we identified patients with occupational asthma in the past 10 years, and analyze whether different type of exposure was related a higher prevalence of contact dermatitis.

Jaar van publicatie:2021

Toegankelijkheid:Open