Tymoszuk Diana, Wiszniewska Marta, Walusiak-Skorupa Jolanta
Nofer Institute of Occupational Medicine / Instytut Medycyny Pracy im. prof. J. Nofera, Łódź, Poland (Department of Occupational Diseases and Environmental Health / Klinika Chorób Zawodowych i Zdrowia Środowiskowego).
Med Pr. 2016;67(1):109-12. doi: 10.13075/mp.5893.00317.
This report presents a case of occupational asthma, rhinitis and conjunctivitis to papain in a 50-year-old herbs and spices packer, with documented increased eosinophilia in induced sputum and in the nasal lavage fluids after a specific inhalation challenge test (SICT) and specific nasal challenge test (SNCT) with this enzyme. Immunoglobulin E-mediated (IgE) sensitization to papain was confirmed by positive results of a skin prick test with specific solution. Specific inhalation and nasal challenge tests demonstrated a direct and significant link between the exposure to this protease and the allergic response from the respiratory system. Additionally, the SNCT induced a severe reaction of the conjunctivae and a significant increase in the count of eosinophils in tears, despite the lack of direct contact of the allergen with the conjunctiva.
本报告介绍了一名50岁的草药和香料包装工人因接触木瓜蛋白酶而患职业性哮喘、鼻炎和结膜炎的病例。在使用该酶进行特异性吸入激发试验（SICT）和特异性鼻腔激发试验（SNCT）后，诱导痰和鼻腔灌洗液中的嗜酸性粒细胞增多得到记录。用特异性溶液进行的皮肤点刺试验结果呈阳性，证实了对木瓜蛋白酶的免疫球蛋白E介导（IgE）致敏。特异性吸入和鼻腔激发试验表明，接触这种蛋白酶与呼吸系统的过敏反应之间存在直接且显著的联系。此外，尽管过敏原未直接接触结膜，但SNCT诱发了严重的结膜反应以及泪液中嗜酸性粒细胞计数显著增加。
