Muñoz Xavier, Culebras Mario, Cruz Maria-Jesus, Morell Ferran
Departamento de Biología Celular, Fisiología e Inmunología, Facultad de Medicina, Universidad Autónoma de Barcelona, Barcelona, Spain.
Ann Allergy Asthma Immunol. 2006 Mar;96(3):494-6. doi: 10.1016/S1081-1206(10)60920-9.
More than 400 agents are recognized as causes of occupational asthma, a work-related disease that can be induced by an immunologic or a nonimmunologic mechanism.
To describe a 57-year-old man employed in the pharmaceutical industry who developed bronchial asthma while working with products such as Plantago ovata and aescin, an active ingredient with anti-inflammatory and venotonic properties.
Various tests were performed, including radiography, total serum IgE titer measurements, skin tests against common pneumoallergens and Plantago species, pulmonary function studies, a methacholine test, and specific inhalation challenge with P. ovata and aescin.
The results of these tests, including specific inhalation challenge, confirmed the diagnosis of occupational asthma due to aescin exposure, whereas the results of specific challenge with P. ovata, a known cause of occupational asthma, were negative.
Aescin may represent a new causative agent of occupational asthma in personnel working in the pharmaceutical industry. The mechanism by which aescin can produce asthma is unknown, but analysis of the characteristics of our patient suggests a non-IgE immunologic mechanism, although an irritative mechanism secondary to long-term low-level exposure to aescin, a possible irritant, cannot be ruled out.
超过400种物质被认为是职业性哮喘的病因，职业性哮喘是一种与工作相关的疾病，可由免疫或非免疫机制诱发。
描述一名57岁受雇于制药行业的男性，他在使用如卵叶车前子和七叶皂苷（一种具有抗炎和静脉张力作用的活性成分）等产品时患上了支气管哮喘。
进行了各种检查，包括放射照相、血清总IgE滴度测量、针对常见气传变应原和车前子属植物的皮肤试验、肺功能研究、乙酰甲胆碱试验以及用卵叶车前子和七叶皂苷进行特异性吸入激发试验。
这些检查结果，包括特异性吸入激发试验，证实了因接触七叶皂苷而导致职业性哮喘的诊断，而卵叶车前子（职业性哮喘的已知病因）特异性激发试验结果为阴性。
七叶皂苷可能是制药行业工作人员职业性哮喘的一种新的致病因素。七叶皂苷引发哮喘的机制尚不清楚，但对我们患者特征的分析提示一种非IgE免疫机制，不过长期低水平接触七叶皂苷（一种可能的刺激物）继发的刺激机制也不能排除。
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