Onset of asthma in a hairdresser

Background: Hairdressers, performing hair bleaching treatments and using hair spray, are exposed to risk of asthma. The precise underlying mechanisms, however are unclear, and little is known about the use of biomarkers in the clinical setting to predict treatment outcome and subsequent disease evolution. Objective: To describe a case of asthma onset in an atopic hairdresser, after years of occupational exposure, and to evaluate the relationship between clinical symptoms and several markers of eosinophil and mast cell activation. Methods: We studied retrospectively: symptoms, diagnostic tests and laboratory data collected at each visit. Results: The causative role of occupational exposure on the onset of asthma was demonstrated by the case history. High values of eosinophil cationic protein (ECP) and tryptase in serum were consistent with a prominent role of eosinophils and mastcells in the active inflammatory process; expression of IL-5 cytokine was also enhanced at the time of exacerbations. Conclusion: The relationship between clinical manifestations and mediators of cellular activation suggest their possible role as biomarkers to predict a response to steroid therapy or disease progression.