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Prevalence of IgE against neuromuscular blocking agents in hairdressers and bakers

机译：IgE在美发师和面包师中对神经肌肉阻滞剂的患病率

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Background: Allergic IgE-mediated reactions to neuromuscular blocking agents (NMBAs) are the main cause of immediate hypersensitivity reactions in anaesthesia; their predominant occurrence in the absence of previous exposure to NMBAs suggests a risk related to environmental exposure. Objective: To investigate the prevalence of specific IgE to quaternary ammonium ions in two populations professionally exposed to quaternary ammonium compounds, in the north-eastern France. Methods: The study had a retrospective follow-up design whereby apprentices were assessed after their 2-year training period as apprentices. The professionally exposed hairdresser populations (n = 128) were compared with baker/pastry makers (n = 108) and 'non-exposed' matched control subjects (n = 379). Results: We observed a 4.6-fold higher frequency of positive IgE against quaternary ammonium ions in hairdressers (HD), compared with baker/pastry makers (BP) and control (C) groups. The competitive inhibition of quaternary ammonium Sepharose radioimmunoassay (QAS-IgE RIA) with succinylcholine was significantly higher in HD, compared with BP and C groups, with inhibition percentage of 66.2 ± 7.4, 39.7 ± 6.0 and 43.8 ± 9.9, respectively (P 0.001). The specific IgE against quaternary ammonium ions recognized also two compounds widely used by hairdressers, benzalkonium chloride and polyquaternium-10, in competitive inhibition of IgE RIA. When considering the whole study population, hairdresser professional exposure and total IgE 100 kU/L were the two significant predictors of IgE-sensitization against quaternary ammonium ions in the multivariate analysis of a model that included age, sex, professional exposure, increased concentration of total IgE (IgE 100 kU/L) and positive IgE against prevalent allergens (Phadiatop?; P = 0.019 and P = 0.001, respectively). Conclusion and Clinical Relevance: The exposure to hairdressing professional occupational factors increases IgE-sensitization to NMBAs and quaternary ammonium ion compounds used in hairdressing. Besides the pholcodine hypothesis, our study suggests that repetitive exposure to quaternary ammonium compounds used in hairdressing is a risk factor for NMBAs sensitization.
机译：背景：过敏性IgE介导的对神经肌肉阻滞剂（NMBA）的反应是麻醉中立即发生超敏反应的主要原因。它们在没有接触过NMBA的情况下主要发生，表明存在与环境接触有关的风险。目的：研究法国东北部两个专业暴露于季铵化合物的人群中特定IgE对季铵离子的患病率。方法：该研究采用回顾性随访设计，通过对学徒进行为期两年的培训后对其进行评估。将专业暴露的美发师群体（n = 128）与面包师/糕点制作者（n = 108）和“未暴露”的匹配对照组（n = 379）进行比较。结果：与面包师/糕点制作者（BP）和对照组（C）组相比，我们发现美发师（HD）中针对季铵离子的阳性IgE阳性率高4.6倍。与BP组和C组相比，HD组对琥珀酸胆碱的季铵盐琼脂糖放射免疫分析法（QAS-IgE RIA）的竞争抑制作用显着更高，抑制率分别为66.2±7.4、39.7±6.0和43.8±9.9（P <0.001 ）。针对季铵离子的特异性IgE还公认美发师广泛使用的两种化合物竞争性抑制IgE RIA，即苯扎氯铵和Polyquaternium-10。当考虑整个研究人群时，在模型的多变量分析中，理发师的职业暴露和总IgE> 100 kU / L是对季铵离子敏感的IgE的两个重要指标，该模型包括年龄，性别，职业暴露，总IgE（IgE> 100 kU / L）和针对普遍过敏原的阳性IgE（Phadiatop ?;分别为P = 0.019和P = 0.001）。结论与临床意义：接触美发专业职业因素会增加IgE对用于美发的NMBA和季铵离子化合物的敏感性。除了有关福尔可定的假设外，我们的研究还表明，重复接触美发中使用的季铵化合物是NMBA致敏的危险因素。

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