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“Introduction

Asthma is generally acknowledged as a critical endpoint after exposure to isocyanates (Malo and Chan-Yeung 2009; Maestrelli et al. 2009; Mapp et al. 1994), like 4,4′-methylenediphenyl diisocyanate (MDI) the most commonly used isocyanate. Individuals applying adhesives, paints, foams and other products (in construction, mining, agriculture, P505-15 the shoe and automobile industries, or in orthopedic surgery) may be exposed to various volatile forms of MDI, accounting for about 60 % of global isocyanate consumption (World-Health-Organization

2000). The unequivocal diagnosis of occupational Nintedanib (BIBF 1120) asthma after isocyanate exposure is difficult. A major unanswered question is whether IgE-dependent mechanisms are of diagnostic value or else are the available IgE tests inadequate for the purpose? Reactive volatile isocyanates can access epithelial and mucosal compartments during inhalation and produce complexes with endogenous proteins, promoting their antigenicity in vivo. To elucidate the specific immune responses to such small-molecular-weight environmental chemicals in vitro, their conjugation with a relevant carrier host protein like albumin is needed. The structure of naturally occurring conjugates might influence their biological availability, half-life and antibody-binding capacity. Inflamed see more airways characteristic of asthma may result from an allergic reaction to these conjugates, with the generation of specific IgE antibodies. From the clinical perspective, isocyanate asthma is expected to be associated with the production of isocyanate-specific IgE antibodies detectable in immunological tests. However, the existing immunodiagnostic methods detect allergen-specific IgE antibodies mostly in a minority (20–50 %) of the patients suffering from isocyanate asthma (Wisnewski and Jones 2010). The reason is still unclear.