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Endotypes of occupational asthma
Paola Mason1, Marco Biasioli, Filippo Liviero
1Department of Cardiac-Thoracic-Vascular Sciences and Public Health, University of Padova, Padova, Italy.
Current Opinion in Allergy and Clinical Immunology
|January 31, 2024
Summary
Recent findings in occupational asthma endotyping reveal key biomarkers. Monitoring sputum neutrophils, IgE, fractional exhaled nitric oxide, and microRNA-155 aids in understanding diverse inflammatory responses.
Area of Science:
- Immunology
- Occupational Medicine
- Respiratory Medicine
Background:
- Occupational asthma presents diverse immune and inflammatory patterns based on exposure to sensitizers or irritants.
- Understanding these endotypes is crucial for accurate diagnosis and management.
Approach:
- Review of recent studies on biomarkers for occupational asthma endotyping.
- Analysis of immune and inflammatory markers including sputum neutrophils, specific IgE, fractional exhaled nitric oxide (FeNO), and microRNA-155.
Key Points:
- Sputum neutrophilia is prevalent in occupational asthma from high molecular weight (HMW) agents and linked to irritant-induced asthma.
- Specific IgE is valuable for HMW agents but less so for low-molecular-weight agents.
- FeNO indicates type 2 inflammation, particularly for HMW agents, and is sensitive for intervention efficacy.
- MicroRNA-155 plays a role in toluene diisocyanate-induced asthma.
Conclusions:
- Occupational asthma is a heterogeneous condition requiring multifaceted biomarker monitoring.
- Identifying specific inflammatory pathways through biomarkers can guide targeted therapeutic strategies.
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