PT  - JOURNAL ARTICLE
AU  - Hung-Chang Tsui
AU  - Steven Ronsmans
AU  - Laurens De Sadeleer
AU  - Peter Hoet
AU  - Jeroen Vanoirbeek
AU  - Benoit Nemery
TI  - Low-molecular weight agents inducing airway sensitization via skin exposure: a systematic review of experimental models
AID  - 10.1183/13993003.congress-2019.PA5240
DP  - 2019 Sep 28
TA  - European Respiratory Journal
PG  - PA5240
VI  - 54
IP  - suppl 63
4099  - http://erj.ersjournals.com/content/54/suppl_63/PA5240.short
4100  - http://erj.ersjournals.com/content/54/suppl_63/PA5240.full
SO  - Eur Respir J2019 Sep 28; 54
AB  - Purpose: While the airway has been regarded as the primary exposure route of asthma, skin exposure to low-molecular weight (LMW) agents has also been linked with airway sensitization. The aim of this work is to critically evaluate LMW agents with evidence of skin exposure-induced airway sensitization in animal models.Methods: We systematically searched the PubMed and EMBASE databases to April 15, 2017. Animal studies with both skin and airway exposure to LMW agents were included. Indicators of airway response consisted of lung function measurement, analysis of bronchoalveolar lavage, histopathological changes, and analysis of lung draining lymph nodes. We synthesized the evidence level for each indicator into strong, moderate, or limited strength, and graded the summarized weight of evidence for each LMW agent to induce airway sensitization via skin exposure into high, middle, low or not possible to assess.Results: A total of 144 relevant studies were identified, 139 studies using skin sensitization to chemicals followed by airway challenge. Among the selected articles, 107 studies examined whether skin exposure induced airway sensitization. In total, 29 LMW agents were included, consisting of 20 extreme/strong dermal sensitizers, and 10 known asthmagens. Despite the variability in outcome measure, the evidence of skin exposure-induced airway sensitization exists for most reviewed agents. Airway sensitizers via skin exposure were identified in 22 agents.Conclusion: The concept of “distant sensitization” should be considered for the definition of sensitizers, and a harmonized animal model in asthma research is warranted.FootnotesCite this article as: European Respiratory Journal 2019; 54: Suppl. 63, PA5240.This is an ERS International Congress abstract. No full-text version is available. Further material to accompany this abstract may be available at www.ers-education.org (ERS member access only).