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Mechanistic and Therapeutic Approaches to Occupational Exposure-Associated Allergic and Non-Allergic Asthmatic Disease

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Abstract

Purpose of Review

Occupational lung disease, including asthma, is a significant cause of disability worldwide. The dose, exposure frequency, and nature of the causal agent influence the inflammatory pathomechanisms that inform asthma disease phenotype and progression. While surveillance, systems engineering, and exposure mitigation strategies are essential preventative considerations, no targeted medical therapies are currently available to ameliorate lung injury post-exposure and prevent chronic airway disease development.

Recent Findings

This article reviews contemporary understanding of allergic and non-allergic occupational asthma mechanisms. In addition, we discuss the available therapeutic options, patient-specific susceptibility and prevention measures, and recent scientific advances in post-exposure treatment conception.

Summary

The course of occupational lung disease that follows exposure is informed by individual predisposition, immunobiologic response, agent identity, overall environmental risk, and preventative workplace practices. When protective strategies fail, knowledge of underlying disease mechanisms is necessary to inform targeted therapy development to lessen occupational asthma disease severity and occurrence.

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  1. Division of Allergy and Immunology, Department of Internal Medicine, College of Medicine, University of Nebraska Medical Center, Omaha, NE, USA

    Aaron D. Schwab & Jill A. Poole

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The National Institute for Occupational Safety and Health grant U54OH010162 (JAP, ADS) and R01OH012045 (JAP), Department of Defense #PR200793 (JAP). Central States Center of Agricultural Safety and Health (CS-CASH). JAP has received research reagent from AstraZeneca (no monies) and is a site investigator for clinical studies for Takeda, GlaxoSmithKline, and AstraZeneca (no monies).

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Schwab, A.D., Poole, J.A. Mechanistic and Therapeutic Approaches to Occupational Exposure-Associated Allergic and Non-Allergic Asthmatic Disease. Curr Allergy Asthma Rep 23, 313–324 (2023). https://doi.org/10.1007/s11882-023-01079-w

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