Specific IgG, but not specific IgE, antibodies to toluene diisocyanate–human serum albumin conjugate are associated with toluene diisocyanate bronchoprovocation test results,☆☆,

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Abstract

Background: The role of specific IgG to toluene diisocyanate (TDI) in the pathogenesis of TDI-induced asthma still remains unclear. Objective: We sought to evaluate the clinical significance of serum-specific IgG to TDI-human serum albumin (HSA) conjugate in subjects with TDI-induced asthma compared with specific IgE antibody. Methods: One hundred three subjects were enrolled and divided into 4 groups according to specific bronchoprovocation test (BPT) results: 50 subjects with TDI-induced asthma with positive results on TDI BPT were defined as group 1, 13 symptomatic workers exposed to TDI with negative results on TDI BPT were defined as group 2, 20 unexposed patients with allergic asthma were defined as group 3, and 20 unexposed healthy control subjects were defined as group 4. Serum-specific IgG and IgE antibodies to TDI-HSA conjugate were detected by means of ELISA. Results: The prevalence of specific IgG antibody to TDI-HSA conjugate was significantly higher in group 1 than in group 2 (46% vs 7.7%, P = .01) or group 3 (0%, P < .01). No significant difference was noted between group 2 and group 3 (P > .05). However, the prevalence of specific IgE antibody to TDI-HSA conjugate was not significantly different between group 1 and group 2 (14% vs 7.7%, P > .05) or group 2 and group 3 (7.7% vs 0%, P > .05). There was no significant difference in prevalence of specific IgE or specific IgG according to the type of asthmatic response during the TDI BPT (P > .05). Overall, statistically significant association was noted between the prevalence of specific IgE and IgG antibodies in 103 subjects (P < .05), but no difference was noted within group 1 subjects only (P > .05). Conclusion: These findings demonstrate that the presence of serum-specific IgG is closely related to TDI BPT results, and it may contribute to the development of TDI-induced asthma. (J Allergy Clin Immunol 1999;104:847-51.)

Section snippets

Subjects

Fifty subjects with TDI-induced asthma were classified as group 1. Their bronchial sensitization was confirmed by positive responses to TDI bronchoprovocation tests (BPTs): 23 had early, 5 had late only, 9 had dual, and 13 had atypical asthmatic responses, including progressive, prolonged immediate, and square-shaped responses. Thirteen subjects who had worked in the same place with exposure to TDI and complained of lower respiratory symptoms but had negative responses on TDI BPT were

Specific IgG antibody to TDI-HSA conjugate

Fig 1 demonstrates the prevalence of specific IgG antibody to TDI-HSA conjugate in 4 different groups.

. Comparison of specific IgG bindings to TDI-HSA conjugate as determined by using ELISA in 4 different groups: group 1, patients with TDI-induced asthma; group 2, exposed subjects with asthma who had negative results on TDI BPT; group 3, unexposed subjects with allergic asthma who are sensitive to house dust mite allergen; and group 4, unexposed healthy control subjects. Statistical significance

DISCUSSION

Several groups of investigators have detected various prevalences of specific IgE antibody to TDI-HSA conjugate in the sera of workers with positive challenge results; the prevalence varied between 0% and 50% of the workers.1, 2, 5, 6 In this study 7 (14%) of the subjects with TDI-induced asthma had high specific IgE antibody levels, whereas one (7.7%) in group 2 and none in the unexposed subjects or healthy control subjects had similarly high specific IgE antibody levels. These findings

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Supported by International Isocyanate Institute grant number 145-AP-MIX (1998).

☆☆

Reprint requests: Hae-Sim Park, MD, Associate Professor, Department of Allergy and Clinical Immunology, Ajou University School of Medicine, Paldalgu Wonchondong San-5, Suwon, Korea.

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