Brisman J, Belin L
Department of Occupational Medicine, Sahlgren Hospital, Göteborg, Sweden.
Br J Ind Med. 1991 Sep;48(9):604-8. doi: 10.1136/oem.48.9.604.
alpha-Amylase is a starch cleaving enzyme often used in the baking industry as a flour additive. It is usually of fungal origin, produced by Aspergillus oryzae. One previous report has shown IgE antibodies and positive skin prick test against alpha-amylase in asthmatic bakers. This paper describes four alpha-amylase sensitised index cases with occupational asthma or rhinitis and the results of a cross sectional study of 20 workers from the same factory who were also exposed to alpha-amylase powder. Air sampling detected airborne alpha-amylase at a concentration of 0.03 mg/m3. Significantly more work related symptoms such as rhinitis and dermatitis were found among the alpha-amylase exposed workers compared with referents. A skin prick test to alpha-amylase was positive in 30% (6/20) of the exposed workers. Most of the persons showing a positive skin prick test had work related symptoms and were also skin prick test positive to common allergens. Nasal challenge tests with amylase were performed in selected cases and validated three cases of alpha-amylase induced rhinitis. Two non-symptomatic workers had precipitins to alpha-amylase. Specific IgG antibodies were shown by two further serological techniques. The nature and relevance of these antibodies are currently being studied. It is concluded that alpha-amylase powder is a potent occupational sensitiser. Precautions should be taken when handling this allergenic enzyme.
α-淀粉酶是一种淀粉裂解酶，常用于烘焙行业作为面粉添加剂。它通常来源于真菌，由米曲霉产生。此前有一份报告显示，哮喘面包师体内存在针对α-淀粉酶的IgE抗体，皮肤点刺试验呈阳性。本文描述了4例对α-淀粉酶致敏的职业性哮喘或鼻炎指数病例，以及对同一工厂20名同样接触α-淀粉酶粉末的工人进行的横断面研究结果。空气采样检测到空气中α-淀粉酶的浓度为0.03 mg/m³。与对照组相比，接触α-淀粉酶的工人中，鼻炎和皮炎等与工作相关的症状明显更多。30%（6/20）的接触工人对α-淀粉酶的皮肤点刺试验呈阳性。大多数皮肤点刺试验呈阳性的人有与工作相关的症状，并且对常见过敏原的皮肤点刺试验也呈阳性。对选定病例进行了淀粉酶鼻激发试验，证实了3例α-淀粉酶诱发的鼻炎。两名无症状工人对α-淀粉酶有沉淀素。另外两种血清学技术显示了特异性IgG抗体。目前正在研究这些抗体的性质和相关性。得出的结论是，α-淀粉酶粉末是一种强效的职业致敏原。处理这种致敏酶时应采取预防措施。
