Bush R K, Schroeckenstein D, Meier-Davis S, Balmes J, Rempel D
Allergy Section, William S. Middleton Veterans Hospital, Madison, Wis. 53705.
J Allergy Clin Immunol. 1988 Aug;82(2):251-5. doi: 10.1016/0091-6749(88)91007-x.
A 43-year-old woman developed asthma 6 years after beginning work in a food-processing plant in which soybean flour was used as a protein extender. Symptoms of sneezing, coughing, and wheezing would begin within minutes of exposure to soybean flour and resolve 2 hours after exposure ceased. Skin tests were positive to a soy extract prepared from the flour. Airway hyperreactivity was confirmed by a positive bronchial challenge to methacholine. Bronchial challenge with soybean flour produced an immediate increase in specific airway resistance from 5.0 to 22.7 L. cm of H2O/L/sec. There was no response to challenge with lactose. The patient's allergic response to soy-flour extract was further characterized by several immunologic methods. IgE binding to soy-flour protein by direct RAST was 5.98 times that of a normal control serum. The soy-flour extract was separated by dodecyl sulfate-polyacrylamide gel electrophoresis. Twenty-four protein bands were detected in the crude soy-flour extract. After immunoblotting and subsequent autoradiography, nine proteins with molecular weights ranging from 54,500 to 14,875 were found. Cross-reactivity studies with other legumes demonstrated apparent immunologic identity between a component in green pea extract and a soybean protein with a molecular weight of 17,000. The clinical significance of this cross-reactivity is not known. We conclude that in this case of occupational asthma to soybean flour, multiple allergens were involved. Immunoblotting may be useful in identifying the allergens involved in occupational asthma.
一名43岁女性在一家使用大豆粉作为蛋白质增量剂的食品加工厂工作6年后患上哮喘。接触大豆粉后几分钟内就会出现打喷嚏、咳嗽和喘息症状,停止接触2小时后症状缓解。皮肤试验对用该面粉制备的大豆提取物呈阳性。对乙酰甲胆碱的支气管激发试验呈阳性,证实气道高反应性。用大豆粉进行支气管激发试验使特异性气道阻力立即从5.0增加到22.7L·cmH₂O/L/秒。对乳糖激发试验无反应。通过几种免疫学方法进一步对患者对大豆粉提取物的过敏反应进行了表征。直接放射变应原吸附试验显示,IgE与大豆粉蛋白的结合是正常对照血清的5.98倍。大豆粉提取物通过十二烷基硫酸钠-聚丙烯酰胺凝胶电泳进行分离。在粗大豆粉提取物中检测到24条蛋白带。经过免疫印迹和随后的放射自显影,发现了9种分子量在54500至14875之间的蛋白质。与其他豆类的交叉反应性研究表明,青豆提取物中的一种成分与分子量为17000的大豆蛋白之间存在明显的免疫学一致性。这种交叉反应性的临床意义尚不清楚。我们得出结论,在这种大豆粉职业性哮喘病例中,涉及多种过敏原。免疫印迹法可能有助于识别职业性哮喘中涉及的过敏原。