Grammer L, Shaughnessy M, Kenamore B, Utility of antibody in identifying individuals who have or will develop anhydride-induced respiratory disease, Chest, 1998;114:1199-1202,

BOHRF Original Authors' Main Conclusions

The original authors' main conclusions are taken from Abstract, Results and Discussion. They are decided upon by the authors of the BOHRF occupational asthma guidelines and form part of the guidelines.

Study aimed to define the utility of serum antibody against trimellitic anhydride (TMA) in predicting development of TMA-asthma. In 1990, 181 subjects exposed to TMA for at least 1 year were studied clinically and immunologically. 119 subjects were then followed for 5 years. Of 16 individuals with IgE against TMA in 1990, 3 had immediate asthma and another 6 developed asthma during the follow-up. Of 165 individuals without IgE against TMA, none had immediate asthma in 1990 and only 1 of 102 individuals followed-up developed asthma. Of 44 subjects with IgG against TMA, 6 had immunologic respiratory disease in 1990 and 2 more developed it during follow-up. Of 137 subjects without IgG against TMA, none had an immunologic respiratory disease in 1990 and none developed it. Authors conclude that development of antibody against TMA (IgE and IgG) is predictive of subjects who have/will develop immunological respiratory disease due to TMA exposure. The absence of antibody is a potent negative predictor.

BOHRF Associated Evidence Statements

The BOHRF occupational asthma guidelines state that this reference is associated with the following evidence statements

** 2+ Both skin prick and serological tests are sensitive for detecting specific IgE and occupational asthma caused by acid anhydrides and some reactive dyes; but have a lower specificity for diagnosing asthma.

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