Ashley N Newton1, Meghan Davis1, Kirsten Koehler1, Wayne Shreffler2, Sharon Ahluwalia3, Nervana Metwali4, Peter S Thorne4, Beverly J Paigen5, Elizabeth C Matsui6. 1. Department of Environmental Health Sciences, Johns Hopkins Bloomberg School of Public Health. 2. Massachusetts General Hospital, Harvard Medical School. 3. Walter Reed National Military Medical Center, Allergy, Immunology and Immunizations. 4. Department of Occupational and Environmental Health, University of Iowa. 5. The Jackson Laboratory. 6. Division of Pediatric Allergy and Immunology, Johns Hopkins School of Medicine.
Abstract
BACKGROUND: Exposure to endotoxin is known to trigger airway inflammation and symptoms, and atopy may modify the relationship between endotoxin exposure and symptom development. OBJECTIVE: To test the a priori hypothesis that atopic status modifies the relationship between endotoxin exposure and respiratory symptom development. METHODS: A prospective study of laboratory workers at The Jackson Laboratories was conducted. Allergy skin testing was performed and population demographic and clinical information was obtained at baseline. Personal exposure assessments for airborne endotoxin and surveys of self-reported symptoms were performed every 6 months. Cox proportional hazards models were used to examine the relationship between endotoxin exposure and development of mouse-associated symptoms and multivariate regression was used to test for interaction. RESULTS: Overall, 16 (9%) of 174 worker-participants developed mouse-associated rhinoconjunctivitis symptoms by 24 months and 8 (5%) developed mouse-associated lower respiratory symptoms by 24 months. Among workers with endotoxin exposure above the median (≥2.4 EU m-3), 5 (6% of 80) atopics reported mouse-associated rhinoconjunctivitis symptoms at 24 months as compared to 3 (3% of 94) non-atopics. Among workers below the median endotoxin exposure (<2.4 EU m-3), 1 (1% of 80) atopic reported mouse-associated rhinoconjunctivitis symptoms at 24 months as compared to 7 (7% of 94) non-atopics. For the combination of symptoms, the adjusted hazard ratio was 6.8 (95% confidence interval: 0.7-67.2) for atopics and 0.07 (95% confidence interval: 0.01-0.5) for non-atopics. CONCLUSION: In this occupational cohort, atopic workers may be more susceptible to, and non-atopic workers protected from, endotoxin-associated upper and lower respiratory symptoms.
BACKGROUND: Exposure to endotoxin is known to trigger airway inflammation and symptoms, and atopy may modify the relationship between endotoxin exposure and symptom development. OBJECTIVE: To test the a priori hypothesis that atopic status modifies the relationship between endotoxin exposure and respiratory symptom development. METHODS: A prospective study of laboratory workers at The Jackson Laboratories was conducted. Allergy skin testing was performed and population demographic and clinical information was obtained at baseline. Personal exposure assessments for airborne endotoxin and surveys of self-reported symptoms were performed every 6 months. Cox proportional hazards models were used to examine the relationship between endotoxin exposure and development of mouse-associated symptoms and multivariate regression was used to test for interaction. RESULTS: Overall, 16 (9%) of 174 worker-participants developed mouse-associated rhinoconjunctivitis symptoms by 24 months and 8 (5%) developed mouse-associated lower respiratory symptoms by 24 months. Among workers with endotoxin exposure above the median (≥2.4 EU m-3), 5 (6% of 80) atopics reported mouse-associated rhinoconjunctivitis symptoms at 24 months as compared to 3 (3% of 94) non-atopics. Among workers below the median endotoxin exposure (<2.4 EU m-3), 1 (1% of 80) atopic reported mouse-associated rhinoconjunctivitis symptoms at 24 months as compared to 7 (7% of 94) non-atopics. For the combination of symptoms, the adjusted hazard ratio was 6.8 (95% confidence interval: 0.7-67.2) for atopics and 0.07 (95% confidence interval: 0.01-0.5) for non-atopics. CONCLUSION: In this occupational cohort, atopic workers may be more susceptible to, and non-atopic workers protected from, endotoxin-associated upper and lower respiratory symptoms.
Authors: O Michel; J Kips; J Duchateau; F Vertongen; L Robert; H Collet; R Pauwels; R Sergysels Journal: Am J Respir Crit Care Med Date: 1996-12 Impact factor: 21.405
Authors: Karin A Pacheco; Cecile S Rose; Lori J Silveira; Michael V Van Dyke; Kelly Goelz; Kristyn MacPhail; Lisa A Maier Journal: J Allergy Clin Immunol Date: 2010-06-25 Impact factor: 10.793
Authors: F Lieutier-Colas; P Meyer; F Pons; G Hedelin; P Larsson; P Malmberg; G Pauli; F De Blay Journal: Clin Exp Allergy Date: 2002-10 Impact factor: 5.018
Authors: Karin A Pacheco; Charles McCammon; Andrew H Liu; Peter S Thorne; Marsha E O'Neill; John Martyny; Lee S Newman; Richard F Hamman; Cecile S Rose Journal: Am J Respir Crit Care Med Date: 2003-04-01 Impact factor: 21.405
Authors: Roger D Peng; Beverly Paigen; Peyton A Eggleston; Karol A Hagberg; Mary Krevans; Jean Curtin-Brosnan; Cristy Benson; Wayne G Shreffler; Elizabeth C Matsui Journal: J Allergy Clin Immunol Date: 2011-06-22 Impact factor: 10.793
Authors: Peter S Thorne; Angelico Mendy; Nervana Metwali; Päivi Salo; Caroll Co; Renee Jaramillo; Kathryn M Rose; Darryl C Zeldin Journal: Am J Respir Crit Care Med Date: 2015-12-01 Impact factor: 21.405
Authors: Angelico Mendy; Jesse Wilkerson; Päivi M Salo; Richard D Cohn; Darryl C Zeldin; Peter S Thorne Journal: J Allergy Clin Immunol Pract Date: 2018-04-21