Papain Induced Occupational Asthma with Kiwi and Fig Allergy.
Papain Induced Occupational Asthma with Kiwi and Fig Allergy.
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DOI：
10.4168/aair.2016.8.2.170
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发表时间：
2016-03
期刊：
影响因子：
--
通讯作者：
Wen L
中科院分区：
文献类型：
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作者：
Jiang N;Yin J;Wen L
木瓜蛋白酶是一种蛋白水解酶，广泛应用于食品工业、医药和化妆品。职业性和非职业性木瓜蛋白酶过敏先前已被记录;然而，关于木瓜蛋白酶过敏及其相对水果过敏的出版物有限。在这里，我们提出了一个职业性的情况下，IgE介导的木瓜蛋白酶过敏与猕猴桃和无花果水果过敏。一名53岁的男子患有鼻炎多年，他的症状发作与他开始在香肠加工厂工作的时间一致，木瓜蛋白酶经常被用作肉类嫩化剂。5年前开始工作后不久，他就开始出现胸闷、气短和喘息的症状。此外，在注射猕猴桃和无花果后，他出现了几次口腔瘙痒、舌和口咽血管性水肿。患者有过敏性结膜炎、过敏性鼻炎和儿童哮喘的终身病史。特异性IgE对猕猴桃、木瓜蛋白酶和木瓜凝乳蛋白酶呈阳性（分别为2.95 kUA/L、>100 kUA/L和95.0 kUA/L）。木瓜蛋白酶和猕猴桃提取物的印迹在10-15 kDa处发现了相似的条带，该患者显示木瓜蛋白酶过敏和猕猴桃过敏之间的潜在联系。我们还回顾了文献中发表的13例木瓜蛋白酶过敏患者，其中85%（11/13）的患者通过呼吸道致敏，40%（4/11）的患者有特应性。进一步的研究应集中在确定木瓜蛋白酶及其水果亲属之间的交叉反应过敏原，木瓜蛋白酶过敏患者的食物过敏的患病率应在一个相对较大的队列调查。
Papain is a proteolytic enzyme which is widely used in food industry, pharmaceuticals, and cosmetics. Occupational and non-occupational papain allergies have previously been documented; however, there are limited publications about papain allergy with its relative fruit allergy. Here, we present a case of occupational, IgE-mediated papain allergy with kiwi fruit and fig fruit allergy. A 53-year-old man suffered from rhinitis for several years, with the onset of his symptoms coinciding with the time he started to work at a sausage processing plant where papain is often used as a meat tenderizer. He began to experience symptoms of chest tightness, shortness of breath and wheezing shortly after starting work 5 years ago. Furthermore, he experienced several episodes of oral itching, and tongue and oropharyngeal angioedema after injestion of kiwi fruit and fig fruit. The patient had a lifelong history of allergic conjunctivitis, allergic rhinitis, and childhood asthma. Specific IgE was positive to kiwi fruit, papain and chymopapain (2.95 kUA/L, >100 kUA/L, and 95.0 kUA/L, respectively). Similar bands at 10-15 kDa in blotting with papain and kiwi fruit extracts were found. This patient showed a potential association between papain allergy and sensitization to kiwi fruit. We also reviewed 13 patients with papain allergy published in the literature, with 85% (11/13) of the patients sensitized through the respiratory tract, and 40% (4/11) having atopy. Further studies should focus on the determination of cross-reactive allergens between papain and its fruit relatives, and the prevalence of food allergy in patients with papain allergy should be investigated in a relatively large cohort.