Is the occupational asthma in laboratory animal workers with negative specific IgE due to irritation?

Studies of laboratory animal allergy have consistently shown a large number of workers with work-related asthma or rhinitis but negative IgE to rat and mouse allergens. The current study starts with the hypothesis that those with negative IgE have irritant responses to the animal allergens and can be safely redeployed to areas with some but lesser exposure. If true this is important, but I believe not yet substantiated. The cross-sectional study identified 29 with work-related symptoms and negative IgE, and found their cytokine profiles indistinguishable from workers with negative IgE and no symptoms. They did however fall into 2 subsets with raised IL17A, with and without raised IL8. The study was compromised by finding only 8 workers with positive IgE and work-related symptoms. The authors concluded that "In this unselected population of LA workers, the profile ‘irritation’ did not prove to be a valuable health surveillance tool. Low power precluded assessment of the profile ‘sensitiser’. The increased IL-17A concentration may originate from irritative constituents of organic dust. What a pitty after so much work and a good hypothesis.

References

	Lemaire M, Oppliger A, Hotz P, Renauld JC, Braun J, Maggi M, Barresi F, Schmid-Grendelmeier P, Huaux F, Dressel H., Can serum cytokine profile discriminate irritant-induced and allergen-induced symptoms? A cross-sectional study in workers mostly exposed to laboratory animals., Occup Environ Med, 2017;:,10.1136/oemed-2016-104137

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