Baker's asthma due to xylanase and cellulase without sensitization to alpha-amylase and only weak sensitization to flour.

BACKGROUND

The baking additives xylanase and cellulase were described as baking additives causing baker's asthma. It is not known whether monosensitization to these enzymes may occur.

METHODS

We present a case report of a baker with work-related asthma evaluated by skin prick test (SPT), enzyme-linked immunosorbent assay (EAST), immunoblot, EAST and immunoblot inhibition, and specific bronchial challenge. Fungal xylanase and alpha-amylase were measured by two-site enzyme immunoassays in products used by the patient at work.

RESULTS

Allergy to xylanase and cellulase was demonstrated by SPT, EAST, immunoblot and specific bronchial challenge (for xylanase only). No sensitization to alpha-amylase could be demonstrated, but there was a weak flour allergy as documented by EAST and immunoblot and a positive occupational-type challenge with high concentrations of rye flour. Four baking additives contained measurable amounts of fungal alpha-amylase and xylanase, without a correlation between these enzymes.

CONCLUSIONS

We conclude that occupational asthma due to the baking additives xylanase and cellulase may occur without concomitant sensitization to alpha-amylase and only weak sensitization to flour.