engleski

Allergic disorders of the respiratory system and skin I - population studies in Croatia

Objectives: 1. Prevalence of the respiratory system and skin sensitization in general adult population and different cohorts of working population in inland and coastal Croatia 2. Longitudinal study of respiratory system and skin sensitization in young working population during pre-employment examination. 3. Study of the mechanisms and relationship between non-specific nasal (NNR) and bronchial (NBR) reactivity. Subjects and methods: The studies include general population of both sexes living in urban and rural Croatia and in patients with asthma and/or rhinitis. The exclusion criteria are acute infectious diseases, contraindications for skin prick and patch testing, nasal and bronchial challenges and antiallergic and immunosuppressive therapy. The same procedure applies for all participants: standardised questionnaire, clinical examination, skin prick test (Allergopharma, Germany), patch test (Brial, Germany), NNR and NBR to histamine (histamine solutions/Sigma, USA/0, 125-32 mg/ml), serum IgE (ELISA), serum IgG (gel- immunodiffusion), analysis of immunocompetent cells in induced sputum. Principal achievements: Skin reactivity to inhalatory allergens, total serum IgE, and NBR were examined in a random sample of 583 adult subjects (303 men and 280 women) from Zagreb region, who were divided in symptomatic and asymptomatic groups. In symptomatic smokers total IgE (G.M. IU/ml) was higher in women than in men (177.7:68.2 ; P<0.01), and in asymptomatic smokers it was higher in men than in women (50.7:33.8 ; P<0.01). Bronchial hyperreactivity was found in 20% of symptomatic men and 23% symptomatic women with positive skin reactions to inhalatory allergens and IgE >125 IU/ml. Total IgE values in asymptomatic subjects were in the range established by the ECRHS study (13.2- 62.5 kU/L) (1). Skin testing with standard contact and common inhalatory allergens, total IgE and NBR were performed in 175 adult subjects during a pre-employment examination. Patch test was positive in 12 (7%) and prick test in 38 (22%) subjects. Increased total IgE and NBR was found in 50 (29%) and 6 (3%) subjects, respectively. Between subjects with positive and negative prick test there were no significant differences in the prevalence of positive patch test (2). Non-specific nasal challenge followed by NBR challenge were performed in 80 healthy workers occupationally exposed to respiratory irritants and in 86 healthy non-exposed control subjects. Our results indicate that nasal challenge with histamine significantly decreases NBR in non-asthmatic subjects chronically exposed to respiratory irritants. We believe that a reflex mechanism is responsible for this effect, because we demonstrated that this effect was blocked by topical nasal anaesthesia with lidocain prior to nasal challenge (3). Moreover, no correlation between NNR and NBR was found in either group (4). Publications: 1. Kanceljak-Macan B, Plavec D, Pavlović M, Štilinović L. Prevalence of some markers of atopy in an adult population of the Zagreb region. Liječ Vjesn 1996 ; 118:259-263 2. Kanceljak-Macan B, Macan J, Plavec D, Milković-Kraus S. Preemployment screening for atopic respiratory and skin disorders. In: Basomba A, Hernandez F de Rojas MD, eds. XVI European Congress of Allergology and Clinical Immunology, EAACI 95, Madrid: Proceedings II. Monduzzi Editore, Bologna, 1995: 893-897 3. Godnić-Cvar J, Somogyi-Žalud E, Plavec D. Nasal challenge with histamine decreases non-specific bronchial reactivity in workers exposed to respiratory irritants. Am J Ind Med 1999 ; 35:420-425 4. Godnić-Cvar J, Plavec D, Somogyi-Žalud E, Tudorić N. Non-specific nasal and bronchial reactivity are not correlated in non-asthmatic subjects occupationally exposed to irritants and in healthy subjects. Am J Ind Med 1999 ; 35:426-431

allergy; respiratory system; skin; epidemiology; pre-employment examination; non-specific nasal reactivity; non-specific bronchial reactivity

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