
Respiratory sensitisers are a major cause of occupational asthma, yet no OECD-approved test guideline currently exists for their prospective identification, highlighting a critical gap in hazard assessment.
The adverse outcome pathway (AOP) for respiratory sensitisation consists of four key events. This study focuses on Key Event 2 (KE2 - lung epithelial cell activation) to evaluate its potential as a measurable marker for early identification of respiratory sensitisers.
A human-relevant air–liquid interface model using Calu-3 bronchial epithelial cells was applied to simulate real-life inhalation exposure conditions.
Piperazine exposure increased IL-6 secretion in a dose-dependent manner without affecting other cellular endpoints, suggesting IL-6 may serve as an early, specific biomarker for respiratory sensitisation.
Toluene diisocyanate disrupted all tested parameters at high doses, while chloramine-T had minimal effects, indicating substance-specific cellular responses and reinforcing the importance of KE2 profiling for differentiating sensitisation potential.
Exposure to respiratory sensitizers (RSs) is the leading cause of occupational asthma. Although the prospective identification of RSs is important, there currently exists no OECD-approved test guideline for this endpoint. The adverse outcome pathway for respiratory sensitization consists of key event (KE) 1: binding of the respiratory sensitizer to a protein, KE2: activation of lung epithelial cells, KE3: activation of dendritic cells, and KE4: T-cell response. Here, we focused on KE2 by investigating whether measuring this KE could contribute to prospectively identify respiratory sensitizers. To mimic real-life exposure, cells were exposed via the air. We used an air–liquid interface model comprising the human bronchial epithelial cell line Calu-3. Exposure to the RS piperazine (3, 18, and 100 mg/m3) dose-dependently increased IL-6 production at dose levels that did not affect the other parameters tested (barrier integrity, cell metabolism, cytotoxicity, and IL-8 production). IL-6 has been linked to asthma in humans. Exposure to the RS chloramine-T (30, 300, and 3000 ng/cm2) showed only minor effects on the parameters tested. Exposure to the RS 2,4-toluene diisocyanate (10, 33, and 100 mg/m3) at the highest dose level clearly affected all parameters tested. Disrupted barrier function has been linked to asthma. In conclusion, this study may possibly suggest that different respiratory sensitizers may differentially impact KE2. Further research is needed to elucidate this.