Moreno-Ancillo A, Domínguez-Noche C, Gil-Adrados A C, Cosmes P M
Hospital Virgen del Puerto, Plasencia, Cáceres, Spain.
J Investig Allergol Clin Immunol. 2004;14(4):346-7.
Inhalation of dust from different enzymes can be the cause of occupational asthma in exposed workers. Enzymes from different sources are being increasingly used in food. Few cases of food allergy to alpha-amylase induced by eating bread have been reported. Those cases were reported in bakery-related patients and in a pharmaceutical-industry worker. A 25-year-old farmer suffered sneezing, rhinorrhea, oropharyngeal itching, hoarseness, cough, and non-wheezy dyspnea after eating white bread. Skin prick tests (SPT) with common aeroallergens and food allergens revealed only sensitization to Olea europaea pollen. SPT response was positive to Aspergillus oryzae alpha-amylase. Specific IgE against alpha-amylase was positive. A double-blind placebo-controlled challenge with 5 mg of uncooked -amylase induced sneezing, cough, oral angioedema within 10 minutes. The provocation test with 50 g of white bread gave similar findings. This case indicates that alpha-amylase contained in bread may provoke IgE-mediated food allergy. It is worth noting that in this case, the only source of alpha-amylases sensitization was bread.
吸入来自不同酶的粉尘可能是接触工人职业性哮喘的病因。不同来源的酶在食品中的使用日益增加。据报道，因食用面包引发对α-淀粉酶的食物过敏的病例很少。这些病例见于面包店相关患者及一名制药行业工人。一名25岁农民在食用白面包后出现打喷嚏、流涕、口咽瘙痒、声音嘶哑、咳嗽和非喘息性呼吸困难。对常见气传变应原和食物变应原进行的皮肤点刺试验（SPT）仅显示对油橄榄花粉过敏。对米曲霉α-淀粉酶的SPT反应呈阳性。针对α-淀粉酶的特异性IgE呈阳性。用5毫克未煮熟的α-淀粉酶进行双盲安慰剂对照激发试验，10分钟内引发了打喷嚏、咳嗽、口腔血管性水肿。用50克白面包进行激发试验也得到了类似结果。该病例表明，面包中所含的α-淀粉酶可能引发IgE介导的食物过敏。值得注意的是，在该病例中，α-淀粉酶致敏的唯一来源是面包。
