Papain Induced Occupational Asthma with Kiwi and Fig Allergy.
10.4168/aair.2016.8.2.170
- Author:
Nannan JIANG
1
,
2
;
Jia YIN
;
Liping WEN
Author Information
1. Department of Allergy, Peking Union Hospital
2. Peking Union Medical College & Chinese Academy of Medical Science, Beijing, China. wendy_wenlp@163.com
- Publication Type:Case Report
- Keywords:
Occupational asthma;
papain;
kiwifruit allergy;
cross reactivity
- MeSH:
Allergens;
Angioedema;
Asthma;
Asthma, Occupational*;
Chymopapain;
Cohort Studies;
Conjunctivitis, Allergic;
Dyspnea;
Food Hypersensitivity;
Food Industry;
Fruit;
Humans;
Hypersensitivity*;
Immunoglobulin E;
Meat;
Middle Aged;
Papain*;
Plants;
Prevalence;
Pruritus;
Respiratory Sounds;
Respiratory System;
Rhinitis;
Thorax;
Tongue
- From:Allergy, Asthma & Immunology Research
2016;8(2):170-173
- CountryRepublic of Korea
- Language:English
-
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.
