Addressing Molecular Diagnosis of Occupational Allergies

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Abstract

Purpose of Review

Numerous clinically relevant allergenic molecules enhance the performance of specific (s) IgE tests and improve the specificity of allergy diagnosis. This review aimed to summarize our current knowledge of the high-molecular-weight allergens involved in the development of occupational asthma and rhinitis and to critically analyze the contribution of component-resolved diagnosis in the management of these conditions.

Recent Findings

There is a lack of standardization and validation for most available extracts of occupational agents, and assessment of sIgE reactivity to occupational allergen components has been poorly investigated, with the notable exception of natural rubber latex (NRL) and wheat flour. In the case of NRL, the application of recombinant single allergens and amplification of natural extracts with stable recombinant allergens improved the test sensitivity. IgE-sensitization profile in patients with baker’s asthma showed great interindividual variation, and extract-based diagnostic is still recommended. For other occupational allergens, it remains necessary to evaluate the relevance of single allergen molecules for the sensitization induced by occupational exposure.

Summary

Progress has been made to characterize occupational allergens especially NRL and wheat, although there is still an unmet need to increase the knowledge of occupational allergens, to include standardized tools into routine diagnostic, and to evaluate their usefulness in clinical practice.

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Most cited references 83

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Allergy to Aspergillus-derived enzymes in the baking industry: identification of beta-xylosidase from Aspergillus niger as a new allergen (Asp n 14).

C Lohaus, X Baur, Joachim Meyer … (1998)

Aspergillus-derived enzymes are used in dough improvers in bakeries. Some of these enzymes are identified as causing IgE-mediated sensitization in up to 25% of bakers with workplace-related symptoms. The aim of this study was to compare the frequency of sensitization to Aspergillus xylanase, cellulase, and glucoamylase with the sensitization to alpha-amylase (Asp o 2) and to identify IgE-reactive proteins in enzyme preparations. Sensitization to Aspergillus-derived enzymes and cross-reactivity were retrospectively studied by enzyme allergosorbent test (EAST) and EAST-inhibition experiments. IgE-reactive proteins were detected by electrophoretic separation and immunoblotting. Liquid chromatography with electrospray ionization mass spectrometry and Edman degradation of tryptic protein fragments were used for the biochemical identification of an unknown IgE-binding protein. Twenty-three percent of 171 tested bakers had specific IgE to alpha-amylase, 8% reacted to glucoamylase, 13% reacted to cellulase, and 11% reacted to xylanase. Xylanase and cellulase preparations, each containing at least 6 different proteins, showed cross-reactivity in the range of 80%. The main IgE-binding protein in the xylanase preparation recognized in 7 of 8 xylanase-positive subjects was a protein of about 105 kd. This protein was identified as beta-xylosidase by peptide mass spectrometric fingerprinting. The identification was confirmed by matching 12 peptide sequences obtained by N-terminal and mass spectrometric sequencing to this protein. Beta-Xylosidase from Aspergillus niger is an occupational allergen present in currently used baking additives, which causes sensitization in at least 4% of symptomatic bakers. According to the International Union of Immunological Societies nomenclature, we suggest the term Asp n 14 for this allergen.

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Glucoamylase: another fungal enzyme associated with baker's asthma.

Santiago Quirce, Mar Fernández-Nieto, Borja Bartolome … (2002)

Aspergillus-derived enzymes are widely used as dough additives in the baking industry. These enzymes may give rise to immunoglobulin (Ig)E-mediated sensitization and occupational asthma. Glucoamylase (or amyloglucosidase) is an important industrial enzyme obtained from Aspergillus niger and used to provide fermentable sugars for yeast to improve loaf volume and texture. The aim of our study was to investigate the potential allergenic role of glucoamylase in baker's asthma. We report four subjects with work-related allergic respiratory symptoms who were exposed to glucoamylase and other starch-cleaving enzymes used as baking additives. The causative role of glucoamylase in work-related asthma was investigated by immunologic tests and specific inhalation challenges (SIC). Glucoamylase allergenic components were characterized by sodium dodecyl sulfate-polyacrylamide gel electrophoresis and immunoblotting. Skin prick tests to glucoamylase (10 mg/mL) gave a positive response in all patients. Further, a positive skin prick test to alpha-amylase was obtained in the four patients and to hemicellulase in two of them. SIC to glucoamylase elicited isolated early asthmatic responses in the three patients tested, and SIC to alpha-amylase elicited early asthmatic responses in two patients and a dual asthmatic response in another patient. Immunoblotting with glucoamylase showed several IgE-binding bands with molecular masses between 33 and 96 kD. IgE-inhibition assays showed scarce to moderate allergenic cross-reactivity between glucoamylase and alpha-amylase. These bakers had developed IgE-mediated occupational asthma to glucoamylase and alpha-amylase. Fungal glucoamylase is widely used as a baking additive and this enzyme may give rise to allergic respiratory reactions among exposed workers.

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Mechanisms of occupational asthma.

Piero Maestrelli, Piera Boschetto, Leonardo Fabbri … (2009)

Inhalation of agents in the workplace can induce asthma in a relatively small proportion of exposed workers. Like nonoccupational asthma, occupational asthma is probably the result of multiple genetic, environmental, and behavioral influences. It is important that occupational asthma be recognized clinically because it has serious medical and socioeconomic consequences. Environmental factors that can affect the initiation of occupational asthma include the intrinsic characteristics of causative agents as well as the influence of the level and route of exposure at the workplace. The identification of host factors, polymorphisms, and candidate genes associated with occupational asthma may improve our understanding of mechanisms involved in asthma. High-molecular-weight compounds from biological sources and low-molecular-weight chemicals cause occupational asthma after a latent period of exposure. Although the clinical, functional, and pathologic features of occupational asthma caused by low-molecular-weight agents resemble those of allergic asthma, the failure to detect specific IgE antibodies against most low-molecular-weight agents has resulted in a search for alternative or complementary physiopathologic mechanisms leading to airway sensitization. Recent advances have been made in the characterization of the immune response to low-molecular-weight agents. In contrast, the mechanism of the type of occupational asthma that occurs without latency after high-level exposure to irritants remains undetermined.

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Author and article information

Contributors

Monika Raulf: +49 234 302-4582 , raulf@ipa-dguv.de

Journal

Journal ID (nlm-ta): Curr Allergy Asthma Rep

Journal ID (iso-abbrev): Curr Allergy Asthma Rep

Title: Current Allergy and Asthma Reports

Publisher: Springer US (New York )

ISSN (Print): 1529-7322

ISSN (Electronic): 1534-6315

Publication date (Electronic): 14 February 2018

Publication date PMC-release: 14 February 2018

Publication date (Print): 2018

Volume: 18

Issue: 1

Electronic Location Identifier: 6

Affiliations

[1 ]ISNI 0000 0004 0490 981X, GRID grid.5570.7, Institute of Prevention and Occupational Medicine of the German Social accident Insurance, , Institute of the Ruhr-University Bochum (IPA), ; Bochum, Germany

[2 ]GRID grid.440081.9, Department of Allergy, , Hospital La Paz Institute for Health Research (IdiPAZ) and CIBER of Respiratory diseases (CIBERES), ; Madrid, Spain

[3 ]ISNI 0000 0001 2294 713X, GRID grid.7942.8, Centre Hospitalier Universitaire UCL Namur, Department of Chest Medicine, , Université Catholique de Louvain, ; Yvoir, Belgium

Article

Publisher ID: 759

DOI: 10.1007/s11882-018-0759-9

PMC ID: 5813088

PubMed ID: 29445888

SO-VID: 021a673c-bb6a-4840-84cc-981bb11f0198

License:

Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.

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Funding

Funded by: FundRef http://dx.doi.org/10.13039/100007355, Fondation Louvain;

Award ID: grant Pierre de Merre “Lutte contre l’asthme et les allergies”

Award Recipient : Olivier Vandenplas

Custom metadata

ScienceOpen disciplines: Immunology

Keywords: baker’s asthma,component-resolved diagnosis,ige determination,natural rubber latex,occupational allergy,wheat allergens

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ScienceOpen disciplines: Immunology

Keywords: baker’s asthma, component-resolved diagnosis, ige determination, natural rubber latex, occupational allergy, wheat allergens

Addressing Molecular Diagnosis of Occupational Allergies

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Abstract

Purpose of Review

Recent Findings

Summary

Related collections

Gamma Delta T cells

Most cited references 83

Allergy to Aspergillus-derived enzymes in the baking industry: identification of beta-xylosidase from Aspergillus niger as a new allergen (Asp n 14).

Glucoamylase: another fungal enzyme associated with baker's asthma.

Mechanisms of occupational asthma.

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Contributors

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Article

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Funding

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