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International Archives of Occupational and Environmental Health

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Open Access 01-05-2013 | Original Article

Is specific IgE antibody analysis feasible for the diagnosis of methylenediphenyl diisocyanate-induced occupational asthma?

Authors: Lygia Therese Budnik, Alexandra M. Preisser, Hjalmar Permentier, Xaver Baur

Published in: International Archives of Occupational and Environmental Health | Issue 4/2013

Abstract

Purpose

Early recognition improves the prognosis of isocyanate asthma. A major unanswered question is whether IgE-dependent mechanisms are of diagnostic value? Our objective was to appraise serological methods using various methylenediphenyl diisocyanate (MDI)-albumin conjugates and weigh up the data versus the outcome of standardized comprehensive clinical diagnostics to evaluate the viability of immunological analysis in supportive MDI-asthma diagnosis (OA_I).

Methods

Specific IgE (sIgE) and IgG (sIgG) binding was measured with fluorescence enzyme immunoassay in 43 study subjects (using conjugates prepared in-vapor, in-solution and commercial preparations). The differential clinical diagnosis included standardized measurement of pulmonary function, non-specific bronchial hyper-responsiveness, specific MDI-prick test (MDI-SPT) and specific inhalation challenge (MDI-SIC).

Results

Detailed diagnostic scheme allows the differential OA_I and MDI-induced hypersensitivity pneumonitis (P_I). The presumed OA_I diagnoses were confirmed in 84 % (45 % cases having demonstrable sIgE antibodies) with RR 5.7, P > 0.001, when OA_I diagnosis is correlated with MDI-SIC/MDI-SPT (RR 1.28 for MDI-SIC alone); sIgG antibodies were clinically relevant for P_I and not for the OA diagnosis. MDI-specific IgE data generated with commercial ImmunoCAP preparations show high correlation with our in-vapor generated MDI conjugates.

Conclusions

Isocyanate-specific IgE antibodies are not always detectable but their presence is strongly predictive of OA_I and supportive for the diagnosis. MDI-SPT can be a valuable parameter differentiating OA_I and P_I. We have confirmed and extended published data showing that isocyanate-albumin conjugates perform better in specific antibody assays when prepared with volatile phase formulations and would like to stress additionally the necessity for further refinements and standardization in clinical diagnostics procedures.

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Title: Is specific IgE antibody analysis feasible for the diagnosis of methylenediphenyl diisocyanate-induced occupational asthma?
Authors: Lygia Therese Budnik
Alexandra M. Preisser
Hjalmar Permentier
Xaver Baur
Publication date: 01-05-2013
Publisher: Springer-Verlag
Published in: International Archives of Occupational and Environmental Health / Issue 4/2013
Print ISSN: 0340-0131
Electronic ISSN: 1432-1246
DOI: https://doi.org/10.1007/s00420-012-0772-6

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Is specific IgE antibody analysis feasible for the diagnosis of methylenediphenyl diisocyanate-induced occupational asthma?

Abstract

Purpose

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

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