Search

Trypsin and chymotrypsin are proteolytic pancreatic enzymes that are secreted as the inactive precursors trypsinogen and chymotrypsinogen, respectively. They have several pharmacological as well as laboratory applications, especially in protein chemistry. Exposure to enzyme dusts has long been known to cause immediate occupational hypersensitivities of the airways. Also trypsin and chymotrypsin are potential inhalable sensitizers, and clear cases of specific airway sensitization caused by trypsin- and chymotrypsin-containing products have been reported by several studies. Positive skin prick and challenge tests as well as specific IgE antibodies have been described. These results and the clinical symptoms usually matched well, suggesting an immunological mechanism of action. Immediate urticarial reactions of the skin due to contact with these enzymes are possible, but there is no clear evidence of allergic cell-mediated delayed eczematous skin reactions., (© Georg Thieme Verlag KG Stuttgart · New York.)

Rennet is a mixture of the proteolytic enzymes pepsin and chymosin (rennin), which is usually obtained from the fourth stomach of young ruminants. While pepsin is also used in the pharmaceutical industry, both enzymes (pepsin and chymosin) are used for the coagulation of milk protein in the manufacture of cheese. Additionally, microbial rennet, which is naturally produced by certain microorganisms, has been used as a substitute for natural rennet in the cheese production for decades. Exposure to enzyme dusts has long been known to cause occupational immediate hypersensitivities. The present paper reviews the results of an evaluation of the literature data concerning occupational airway sensitisation due to natural and microbial rennet. Cases of specific airway sensitisation caused by rennet could be shown clearly by several studies. Positive skin prick and challenge tests as well as specific IgE antibodies have been described, thus suggesting an immunological mechanism., (© Georg Thieme Verlag KG Stuttgart · New York.)

Background: Reactivity in the skin prick test (SPT) is related to the potency of the SPT solution used. The aim of this study was to compare SPT solutions from different manufacturers for selected occupational allergens., Patients: All patients suffered from work-related allergic complaints like rhinitis, conjunctivis or asthmatic complaints., Methods: 125 bakers and 21 subjects exposed to natural rubber latex (NRL) were examined with four flour SPT solutions and two NRL SPT solutions, respectively. By means of the maximum test efficiency (gold standard: specific IgE), the optimal cut-off was determined. Using this cut-off, sensitivities and specificities of the flour and NRL SPT solutions were calculated. Additionally, five SPT solutions for TYROPHAGUS PUTRESCENTIAE (Tp) were tested in two farmers. All SPT solutions were analysed IN-VITRO for protein and antigen content., Results: IN-VITRO analyses resulted in differences for all SPT solutions depending on the manufacturer. The optimal cut-off for the flour and NRL SPT solutions was a wheal >or= 1.5 mm. Sensitivities of flour SPT solutions ranged from 38 % to 95 %, specificities from 77 % to 98 %. Both NRL SPT solutions reached a sensitivity of 100 % and a specificity of 92 %. SPT results with the different Tp SPT solutions were variable., Conclusion: While both NRL SPT solutions exhibited a fairly good quality, the flour and Tp SPT solutions showed differences between manufacturers. As a rule solutions with higher protein and antigen contents gave better results.

Phytases are phosphatases that can break down the undigestible phytic acid (phytate). They are frequently used as an animal feed supplement - often in poultry and swine - to enhance the nutritive value of plant material by liberation of inorganic phosphate from phytate. Exposure to enzyme dusts has long been known to cause occupational allergies. The present paper reviews the results of the evaluation of literature data concerning occupational airway sensitization due to phytases. Cases of specific airway sensitization caused by phytases could be shown clearly by the presented studies. As symptoms, results of skin prick tests, detection of specific IgE-antibodies and results of specific challenge tests are consistent, an immunologic mechanism can be assumed.

The protease bromelain originating from the pineapple fruit (Ananas comosus) finds frequent use in industry. Exposure to enzyme dusts has long been known to cause occupational allergies. The present paper reviews the results of the evaluation of literature data concerning occupational airway sensitization due to bromelain. Cases of specific airway sensitization caused by bromelain could be shown clearly by the presented studies. Since the symptoms, results of skin prick tests, detection of specific IgE antibodies and results of specific bronchoprovocation tests are consistent, an immunological mechanism can be assumed.

Occupational exposure against dusts of plant, bacterial, mould, and animal enzymes is long known to be associated with a high risk of specific sensitization. The present evaluation of literature data confirms that this is also true for papain. This frequently used industrial protease is derived from papaya (Carica papaya). Several cases of specific airway sensitization caused by papain are verified by a number of case reports and cross sectional studies. As symptoms, results of skin prick tests, detection of specific IgE-antibodies and results of specific bronchoprovocation tests are consistent, an immunologic mechanism can be assumed.

The exposure against enzyme dusts have long been known to cause occupational allergies. In the 1960s an increasing number of occupational allergies in the detergent industry were observed. In this context the high sensitization potential of enzyme dusts attracted attention. The present evaluation of literature data confirms that this is also true for xylanases. These frequently used industrial enzymes belong to the hemicellulases and are mostly of fungal origin. Several cases of specific airway sensitization caused by xylanases or other hemicellulases are verified by a number of case reports and cross sectional studies. As symptoms, results of skin prick tests, detection of specific IgE-antibodies and results of specific bronchoprovocation tests are consistent, an immunologic mechanism can be assumed.

Occupational allergies of the immediate type due to metals, which are predominantly caused by nickel, platinum, chromium and cobalt, are rather rare. The present paper reviews the results of the evaluation of literature data concerning the occupational airway sensitization due to nickel, which is used in many different industrial fields - especially in the electroplating industry. Cases of specific airway sensizitation caused by nickel are verified by a number of studies, predominantly case histories. In conclusion, there is sufficient evidence that nickel may cause IgE-mediated hypersensitivity with typical symptoms.

Immediate type allergies due to metal compounds containing chromium, nickel, cobalt and platinum are rare. However, allergies to platinum salts represent a major health hazard in few precious metal refineries and catalyst productions. Sensitization can be shown with a highly specific and sensitive skin prick test. A dose-response relationship has clearly been established by prospective longitudinal studies, however the definition of a valid threshold limit is difficult due to the high variability of exposure. Smoking is a predicting factor, whereas atopy is not. Prognosis depends on the duration of symptomatic exposure in high exposure areas. Secondary prevention (medical surveillance) is effective in the prevention of persistent symptoms and bronchial hyperresponsiveness.

In the 1960s an increasing number of occupational allergies in the detergent industry against the proteolytic enzyme Subtilisin were observed. In this context the high sensitization potential of enzyme dusts attracted attention. The present evaluation of literature data confirms that this is also true for cellulases. These enzymes--mostly of fungal origin--are frequently used in biotechnology. Several cases of specific airway sensitization caused by cellulases are verified by a number of studies. As symptoms, results of skin prick tests, detection of specific IgE-antibodies and results of specific bronchoprovocation tests are consistent, an immunologic mechanism seems to be confirmed.

Since the 1960s an increasing number of occupational allergies against natural, and against modified recombinant enzymes were observed. Subtilisin, a frequently used enzyme often has been shown to cause airway sensitization. The present evaluation of clinical literature data confirms the sensitization potential of subtilisin. Several cases of specific airway hyperresponsiveness caused by subtilisin are verified by a number of studies. As symptoms, results of skin prick tests, detection of specific IgE-antibodies and results of specific bronchoprovocation tests are consistent, an immunologic mechanism is confirmed.