Reference

BOHRF Original Authors' Main Conclusions

The original authors' main conclusions are taken from Abstract, Results and Discussion. They are decided upon by the authors of the BOHRF occupational asthma guidelines and form part of the guidelines.

Only 5-10% of di-isocyanate-exposed workers develop asthma, suggestive of an underlying genetic susceptibility. Study aimed to examine whether polymorphisms in the GSTM1, GSTM3, GSTP1 and GSTT1 genes modify allergic responses to di-isocyanate exposure. The study population consisted of 182 di-isocyanate exposed workers, 109 diagnosed with di-isocyanate-induced asthma and 73 without asthma. Lack of the GSTM1 gene (null genotype) was associated with a 1.89-fold risk of di-isocyanate-induced asthma. Moreover, among the asthma patients, the GSTM1 null genotype was associated with lack of di-isocyanate-specific IgE antibodies and with late reaction in the specific bronchial provocation test. Similarly, GSTM3 AA genotype was related to late reaction in the specific bronchial provocation test. The GSTP1 Val/Val genotype, on the other hand, was related to high total IgE levels. The most remarkable effect was seen for the combination of GSTM1 null and the GSTM3 AA genotype, which was strongly associated with lack of di-isocyanate-specific IgE antibodies and with late reaction in the bronchial provocation test. Authors conclude that these results suggest, for the first time, that the polymorphic GSTs, especially the mu class GSTs, play an important role in inception of ill effects related to occupational exposure to di-isocyanates.

BOHRF Associated Evidence Statements

The BOHRF occupational asthma guidelines state that this reference is associated with the following evidence statements