Phenotypes de l'asthme professionnel dans le cadre des cohortes E-PHOCAS et EGEA

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.