Tabar A I, Acero S, Arregui C, Urdánoz M, Quirce S
Servicio de Alergología, Hospital Virgen del Camino, Pamplona.
An Sist Sanit Navar. 2003;26 Suppl 2:65-73.
Cochineal carmine, or simply carmine (E120), is a red colouring that is obtained from the dried bodies of the female insect Dactylopius coccus Costa (the cochineal insect). We have evaluated the prevalence of sensitization and asthma caused by carmine in a factory using natural colouring, following the diagnosis of two workers with occupational asthma. The accumulated incidence of sensitization and occupational asthma due to carmine in this factory are 48.1% and 18.5% respectively, figures that make the introduction of preventive measures obligatory. Occupational asthma caused by inhaling carmine should be considered as a further example of the capacity of certain protein particles of arthropods (in this case cochineal insects) to act as aeroallergens. Carmine should be added to the list of agents capable of producing occupational asthma, whose mechanism, according to our studies, would be immunological mediated by IgE antibodies in the face of diverse allergens of high molecular weight, which can vary from patient to patient. Nonetheless, given the existence of different components in carmine, it cannot be ruled out that substances of low molecular weight, such as carminic acid, might act as haptenes. Besides, since we are dealing with a colouring that is widely used as a food additive, as a pharmaceutical excipient and in the composition of numerous cosmetics, it is not surprising that allergic reactions can appear both through ingestion and through direct cutaneous contact. We find ourselves facing a new example of an allergen that can act through both inhalation and digestion, giving rise to an allergolical syndrome that can show itself clinically with expressions of both respiratory allergy and alimentary allergy.
胭脂虫红,或简称为胭脂红(E120),是一种从雌性昆虫胭脂虫(Dactylopius coccus Costa)干燥的虫体中提取的红色素。在诊断出两名工人患有职业性哮喘后,我们对一家使用天然色素的工厂中由胭脂红引起的致敏和哮喘患病率进行了评估。该工厂中由胭脂红引起的致敏和职业性哮喘的累积发病率分别为48.1%和18.5%,这些数据使得采取预防措施成为必要。吸入胭脂红引起的职业性哮喘应被视为节肢动物某些蛋白质颗粒(在这种情况下为胭脂虫)作为空气变应原的能力的又一个例子。胭脂红应被列入能够引发职业性哮喘的物质清单,根据我们的研究,其机制是面对不同的高分子量变应原时由IgE抗体介导的免疫反应,不同患者的变应原可能有所不同。然而,鉴于胭脂红中存在不同成分,不能排除低分子量物质,如胭脂红酸,可能作为半抗原起作用。此外,由于我们处理的是一种广泛用作食品添加剂、药物赋形剂以及众多化妆品成分的色素,通过摄入和直接皮肤接触都可能出现过敏反应也就不足为奇了。我们面临着一个新的变应原例子,它可以通过吸入和消化两种途径起作用,引发一种变应性综合征,在临床上可能表现为呼吸道过敏和食物过敏症状。