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<dc:title xml:lang="en">Phenotypes of occupational asthma Insights from E-PHOCAS and EGEA cohorts</dc:title>
<dcterms:alternative xml:lang="fr">Phenotypes de l'asthme professionnel dans le cadre des cohortes E-PHOCAS et EGEA</dcterms:alternative>
<dc:subject xml:lang="fr">Asthme professionnel</dc:subject>
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<dcterms:abstract xml:lang="fr">L'asthme est une maladie dont l'hétérogénéité a été démêlée par la caractérisation de phénotypes. L'asthme professionnel est un type d'asthme lié au travail, qui est causé par des stimuli immunologiques (allergique) et non immunologiques (asthme induit par des irritants) présents sur le lieu de travail. Afin de mieux comprendre les phénotypes de l'asthme professionnel, ce travail de doctorat visait à caractériser l'asthme professionnel en termes d'agent causal, de comorbidité et de profil d’inflammation. Les analyses ont été effectuées dans la cohorte E-PHOCAS, qui rassemble des patients atteints d'asthme professionnel identifiés par un test de provocation spécifique, et dans l'étude EGEA, une cohorte épidémiologique enrichie de participants asthmatiques. Il a été démontré que des éléments clés de la caractérisation de l'asthme non professionnel, tels que le profil inflammatoire et les comorbidités, permettent également de distinguer des phénotypes de l'asthme professionnel. En outre, il a été observé qu'un agent professionnel sensibilisant pouvait induire un asthme professionnel par différentes voies inflammatoires. Ces résultats remettent en question la classification historique de l'asthme professionnel qui repose exclusivement sur le type d'agent incriminé.</dcterms:abstract>
<dcterms:abstract xml:lang="en">Asthma is a disease whose heterogeneity has been detangled by the characterization of distinct phenotypes. Occupational asthma is a type of work-related asthma, that is caused by immunological (i.e sensitizer induced asthma) and non-immunological (i.e irritant induced asthma) stimuli present in the workplace. In order to provide better insights in occupational asthma phenotypes, this PhD work aimed to characterize occupational asthma in term of offending agent, comorbidity and inflammatory pattern. Analyses were performed in the E-PHOCAS cohort which gather occupational asthma patients ascertained by a specific inhalation challenge and in EGEA study, an epidemiological cohort enriched with participants with asthma. It has been shown that key elements of the characterization of non-occupational asthma such as inflammatory pattern, comorbidities also distinguish phenotypes in occupational asthma. Moreover, it was observed that a sensitizing occupational agent could induce occupational asthma through different inflammatory pathways. These results challenge the historical classification of occupational asthma which relies exclusively on the type of the offending agent.</dcterms:abstract>
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