Occupational asthma pathophysiology

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief:

• Occupational asthma is characterized by variable airflow limitation and/or airway hyper-responsiveness due to causes and conditions attributable to a particular occupational environment and not stimuli encountered outside the workplace.^[1][2]

• Occupational asthma is the result of multiple genetic, environmental, and behavioral influences.

• The three main types of occupational asthma are:^[3]

• Immunologically mediated with the involvement of specific IgE,
• Immunologically mediated without the evidence of IgE involvement, and
• Non-immunologic, irritant mediated such as in reactive airways dysfunction syndrome

• Glutathione S-transferase (GSTP1 and GSTM1) and N-acetyltransferase (NAT1) genes that are involved in airway remodeling, have shown to play are role in the pathogenesis of occupational asthma.^[4][5]

• Skin exposure and inhalation of aero-allergens are the common modes of exposure in patients suffering from occupation asthma.^[6]

• Certain high and low molecular weight occupational allergens such as animal proteins and platinum salts respectively, act as antigens and induce a antigen-specific IgE response that contributes to the immunologic pathogenesis.

• Non-immunologic mechanisms that play a role in the pathogenesis include the direct inhibition of β2 agonist or elaboration of substance P by injured sensory nerves.

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