OCCUPATIONAL ASTHMA CAUSED BY ALPHA-AMYLASE INHALATION - CLINICAL AND IMMUNOLOGICAL FINDINGS AND BRONCHIAL RESPONSE PATTERNS
OCCUPATIONAL ASTHMA CAUSED BY ALPHA-AMYLASE INHALATION - CLINICAL AND IMMUNOLOGICAL FINDINGS AND BRONCHIAL RESPONSE PATTERNS
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DOI：
10.1016/s0091-6749(05)80048-x
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发表时间：
1992-01-01
影响因子：
14.2
通讯作者：
MONEO, I
中科院分区：
文献类型：
--
作者：
LOSADA, E;HINOJOSA, M;MONEO, I
吸入不同酶的粉尘可能是接触工人职业性哮喘的原因。 α-淀粉酶来源于曲霉菌，是这些酶中的一种，尽管在医学文献中很少有研究涉及其过敏特性和致敏患者的临床研究。 本文介绍了在83名接触粉末状α-淀粉酶的制药工业工人中进行的一项研究中获得的结果。 通过阳性皮肤试验证实了26名工人对这种酶存在过敏。 皮试阳性者的特异性IgE值显著高于皮试阴性者（P < 0.001）。 在14名接受挑战的患者中，6名患者的α-淀粉酶支气管激发试验呈阳性，仅观察到立即支气管反应;通过鼻激发获得相同类型的反应。 其中一名工人对这种酶的口服激发有阳性反应，在摄入后几分钟出现腹部、皮肤和呼吸道症状。 因此，我们认为工人的支气管哮喘是由于一个立即型，IgE依赖性，免疫机制。
Inhalation of dust from different enzymes can be the cause of occupational asthma in exposed workers. Alpha-Amylase, derived from Aspergillus oryzae, is one of these enzymes, although there are few studies in the medical literature that refer to its allergologic properties and to clinical studies in sensitized patients. The results obtained in a study performed in 83 pharmaceutical-industry workers exposed to powdered alpha-amylase are described in this article. The existence of sensitization to this enzyme was demonstrated in 26 of the workers by positive skin tests. Specific IgE values were significantly higher in workers with positive skin tests than in workers with negative skin tests (p < 0.001). The bronchial provocation test with alpha-amylase was positive in six of the 14 patients challenged, and only immediate bronchial responses were observed; the same type of response was obtained by nasal provocation. One of the workers had a positive response to oral provocation with this enzyme, presenting abdominal, skin, and respiratory symptoms a few minutes after ingestion. Consequently, we consider that the bronchial asthma presented by the workers was due to an immediate-type, IgE-dependent, immunologic mechanism.