猕猴桃和无花果中木瓜蛋白酶所致职业性哮喘
2016/05/26
摘要
木瓜蛋白酶是一种蛋白水解酶，广泛应用于食品业、制药和化妆品领域。职业性的和非职业性的木瓜蛋白酶过敏先前已被报道；然而，与其相关水果过敏的报道很少。在这里，我们报告一例职业性的IgE介导的猕猴桃和无花果中的木瓜蛋白酶过敏。一个53岁的男子患有多年的鼻炎，其发病症状开始的时候他正好在一个香肠加工厂开始工作，这个香肠加工厂里木瓜蛋白酶作为嫩肉剂使用。在五年前刚开始工作后，他开始出现胸闷、呼吸急促和喘息的症状。
而且，他经历了几次摄入猕猴桃和无花果之后出现口腔瘙痒、舌及口咽部血管性水肿的情况。患者有过敏性结膜炎、过敏性鼻炎和儿童哮喘。
猕猴桃、木瓜蛋白酶和木瓜凝乳蛋白酶（分别为2.95 kUA/L, >100 kUA/L,和 95.0 kUA/L）的特异性免疫球蛋白IgE阳性。在木瓜蛋白酶和猕猴桃提取物的印迹试验中发现了类似的10-15 kDa条带。患者对木瓜蛋白酶过敏和对猕猴桃过敏之间的存在潜在关联。我们也回顾了13例木瓜蛋白酶过敏的文献，有85%（11/13）的患者通过呼吸道致敏， 40%（4 /11）的患者具有过敏体质。我们需要进一步致力于研究木瓜蛋白酶及其有关的水果之间有交叉反应的过敏原。并且，对木瓜蛋白酶过敏的患者，其食物过敏的患病率也应该在一个相对比较大的队列基础上进行研究。
（苏欣 审校）
Allergy Asthma ImmunolRes. 2016 Mar;8(2):170-3.doi:10.4168/aair.2016.8.2.170. Epub 2015 Nov 2.
Papain Induced Occupational Asthma with Kiwi and Fig Allergy.
Jiang N1, Yin J1, Wen L2.
Author information
Abstract
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.
KEYWORDS:Occupational asthma; cross reactivity; kiwifruit allergy; papain
Allergy Asthma ImmunolRes. 2016 Mar;8(2):170-3.doi:10.4168/aair.2016.8.2.170. Epub 2015 Nov 2.
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