Gailhofer G, Wilders-Truschnig M, Smolle J, Ludvan M
Department of Dermatology, University of Graz, Austria.
Clin Allergy. 1988 Sep;18(5):445-50. doi: 10.1111/j.1365-2222.1988.tb02894.x.
Bromelains consist of a group of proteolytic enzymes of Bromeliaceae. They are commonly used in pharmaceutical industries, food production and in diagnostic laboratories. Bromelains are known to cause IgE-mediated reactions of both the immediate type and the 'late phase reaction of immediate type reaction' with predominantly respiratory symptoms. We report four cases of occupational allergy to bromelain in workers of a blood grouping laboratory. These observations prompted us to investigate the sensitization rate to bromelain in all workers of the particular diagnostic laboratory who had contact with bromelain. These results were compared with those obtained from healthy, randomly selected individuals without evident bromelain exposure. Our findings indicate that (i) bromelain is a strong sensitizer, (ii) sensitization usually occurs due to inhalation and not to ingestion, (iii) bromelain allergy is occupationally acquired, and adequate precautions are necessary. We can further state that (iv) skin testing with relatively pure allergens such as isolated proteases like bromelain may induce systemic reactions, even at very high dilutions.
菠萝蛋白酶是凤梨科的一组蛋白水解酶。它们常用于制药行业、食品生产和诊断实验室。已知菠萝蛋白酶会引发IgE介导的即刻型反应以及以呼吸道症状为主的“即刻型反应的迟发相反应”。我们报告了4例血型实验室工作人员对菠萝蛋白酶的职业性过敏病例。这些观察结果促使我们调查该特定诊断实验室中所有接触过菠萝蛋白酶的工作人员对菠萝蛋白酶的致敏率。并将这些结果与从无明显菠萝蛋白酶接触史的健康随机选择个体中获得的结果进行比较。我们的研究结果表明：（i）菠萝蛋白酶是一种强致敏剂；（ii）致敏通常是由于吸入而非摄入引起的；（iii）菠萝蛋白酶过敏是职业性获得的，因此采取充分的预防措施是必要的。我们还可以进一步指出：（iv）用相对纯的过敏原（如像菠萝蛋白酶这样的分离蛋白酶）进行皮肤试验，即使在非常高的稀释度下，也可能引发全身反应。
