Occupational bronchial asthma from the perspective of molecular genetic research
Authors:   FSBEI HE Samara State Medical University of the Ministry of Health of the Russian Federation, Samara, Babanov S. A. , Lavrentieva N. E. ,   FSBEI HE Samara State Medical University of the Ministry of Health of the Russian Federation, Samara, Baykova A. G. ,   SBHI SR Samara City Hospital No. 5, Artemieva M. S. ,   FSBEI HE Samara State Medical University of the Ministry of Health of the Russian Federation, Samara, Babanov A. S. ,   Private Institution Educational Organization of Higher Education «Medical University Reaviz», Samara,
Published: January 2025

Currently, occupational bronchial asthma is considered as a phenotypically and genetically
heterogeneous disease. The assessment of clinical data, functional features, and immunopathogenesis
opens up new opportunities in assessing the development, predicting the characteristics of
the course, and working out a personalized approach to pharmacotherapy of occupational asthma,
as well as in developing an individual strategy for its prevention.
The purpose of the study is to determine clinical and immunological markers of the risk of developing
occupational asthma under conditions of exposure to sensitizing substances in various
phenotypes of this disease.
Materials and methods. The study included 170 patients with various OA phenotypes and 50 participants
in the control group. The pulmonary function test was carried out on the CareFusion MicroLab
Desktop Spirometer (Great Britain). The levels of IL-1β, IL-4, IL-6, IL-8, IL-10, IL-17, TNF-α,
vascular endothelial growth factor (VEGF), MCP-1, IFN-γ, and total IgE in blood serum were determined
by solid-phase enzyme immunoassay using kits and reagents (OOO «Protein contour»,
«Vector-Best», «Diatex-E», «DIA-plus», «Pharmacia diagnostika»). Genotyping was performed by
real-time polymerase chain reaction using primers and probes designed using PrimerQuest (Integrated
DNA Technologies, Inc.).
Results. For the first time, the features of clinical and immunological manifestations in allergic and
non-allergic OA phenotypes, as well as phenotypes of OA combination with occupational chronic
obstructive pulmonary disease and metabolic syndrome were established; the features of formation,
immunopathogenesis, and prognosis in various phenotypes of occupational bronchial asthma
were revealed. The study identified genetic markers of occupational asthma risk under conditions
of exposure to sensitizing substances: IL5 rs2069812 and TSLP rs1837253 polymorphisms. This
allows recommending the determination of these immunological parameters and genetic markers
during in-depth periodic medical examinations of workers under conditions of exposure to sensitizing
and irritating substances for differential diagnosis of various phenotypes of occupational
bronchial asthma in a specialized inpatient examination.
Limitations of the study. The study has regional (Samara Region) and professional (in terms of
detailing working conditions in the studied comparison groups) limitations.
Conclusion. The identified clinical, immunological, and genotypic features in various OA phenotypes and the established profiles of OA genotypes can optimize the approach to early diagnosis, prognosis,
prevention, and pharmacotherapy of this disease, as well as expand the list of immunological
study indicators used during preliminary and periodic medical examinations, in-depth examination
of patients with occupational bronchial asthma in occupational disease clinics and occupational pathology centers, and the application of new reliable criteria for predicting the course of the disease.