Occupational respiratory allergy to lettuce in lettuce farmers
Occupational respiratory allergy to lettuce in lettuce farmers
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DOI：
10.1111/cea.13682
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发表时间：
2020-07-01
影响因子：
6.1
通讯作者：
Nishimura, Yoshihiro
中科院分区：
文献类型：
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作者：
Sekiya, Reina;Nagano, Tatsuya;Nishimura, Yoshihiro
背景莴苣相关的呼吸道过敏以前从未报道过。本研究的目的是阐明莴苣相关的呼吸道过敏的临床状况，并确定诱导过敏症状的莴苣抗原。方法对1168名生菜种植户进行问卷调查，并对职业接触生菜后出现呼吸道症状的农民进行体检。我们分析了特异性IgE结合蛋白的患者血清中，通过免疫印迹分析和确定的IgE结合带的分子特征，使用液相色谱-质谱。结果932名农民（80%）完成了问卷调查。其中，7%的人在收获和包装过程中表现出与呼吸系统相关的症状。13名患者被诊断为生菜过敏，并同意接受进一步检查。与阴性对照组相比，这些患者中活化的嗜碱性粒细胞的百分比显著更高（P <0.05）。莴苣特异性IgE（ImmunoCAP（R））和皮肤点刺试验分别在46%和62%的患者中呈阳性。值得注意的是，通过特异性支气管激发试验，在1例患者中检测到职业性支气管过敏性哮喘。在>50%的患者血清中识别的IgE结合带被鉴定为表皮特异性分泌糖蛋白EP 1样（51 kDa）。结论本研究鉴定了一种新的莴苣过敏原。这种过敏原可能具有临床上有用的应用，例如特异性IgE测试和过敏原特异性免疫疗法。
Background Lettuce-associated respiratory allergy has never been reported before. The aim of this study was to clarify the clinical condition of lettuce-associated respiratory allergy and to identify the lettuce antigen which induces allergic symptoms. Methods We distributed questionnaires to 1168 lettuce farmers and performed medical examinations in those who exhibited respiratory symptoms related to occupational exposure to lettuce. We analysed specific IgE-binding proteins in the sera of patients through immunoblotting analysis and determined molecular characterization of the IgE-binding bands using liquid chromatography-mass spectrometry. Results A total of 932 farmers (80%) responded to the questionnaire. Of those, 7% exhibited lettuce-associated respiratory symptoms, during harvesting and packaging. Thirteen patients were diagnosed with allergy to lettuce and agreed to undergo further examinations. The percentage of activated basophils in these patients was significantly higher compared with that reported in negative controls (P < .05). Lettuce-specific IgE (ImmunoCAP(R)) and skin prick testing was positive in 46% and 62% of patients, respectively. Notably, occupational lettuce-allergic asthma was detected in one patient through specific bronchial provocation testing. The IgE-binding bands recognized in the sera of >50% of patients were identified as epidermis-specific secreted glycoprotein EP1-like (51 kDa). Conclusion The present analysis identified a novel lettuce allergen. This allergen may have clinically useful applications, such as specific IgE testing and allergen-specific immunotherapy.