Alvarez M J, Tabar A I, Quirce S, Olaguíbel J M, Lizaso M T, Echechipía S, Rodríguez A, García B E
Sección de Alergología, Hospital Virgen de Camino, Pamplona, Spain.
Clin Exp Allergy. 1996 Feb;26(2):147-53. doi: 10.1111/j.1365-2222.1996.tb00073.x.
Occupational asthma among cereal workers is frequently due to cereals but other allergens can also be responsible.
We evaluated the allergens causing occupational asthma in the patients who had been diagnosed in our Department during the last 5 years. Specific bronchial reactivity to the implicated allergens was assessed and compared by standardized bronchial challenge.
Twenty-one patients (12 bakers, three millers and six farmers) were studied. We carried out in vivo tests (skin and challenge tests) and in vitro tests (specific IgE measurement) with cereals, enzymes, soyabean, storage mites and egg. A definitive diagnosis was established by means of specific bronchial provocation tests (BPT), except in three patients in whom it could not be carried out due to the severity of their asthma. In these cases the causative agent had to be determined by means of conjunctival challenge.
Cereals were the main sensitizers among bakers (75%) and farmers (66%). Bakers were also sensitive to alpha-amylase (41%) and soyabean (25%), and farmers, to soyabean (33%) and storage mites (33%). Occupational asthma was due to cereals, soyabean and storage mites among millers.
Besides cereals, other allergens such as enzymes, leguminous, egg and storage mites can be the causative agents of occupational asthma among cereal workers. Sensitization to different allergens in the different jobs is very likely due to differences in exposure.
谷物加工工人中的职业性哮喘通常由谷物引起，但其他过敏原也可能是病因。
我们评估了过去5年在我院确诊的职业性哮喘患者中引发哮喘的过敏原。通过标准化支气管激发试验评估并比较了对相关过敏原的特异性支气管反应性。
研究了21名患者（12名面包师、3名磨坊工人和6名农民）。我们对谷物、酶、大豆、仓储螨和鸡蛋进行了体内试验（皮肤和激发试验）和体外试验（特异性IgE测量）。除3名因哮喘严重程度无法进行特异性支气管激发试验（BPT）的患者外，其余患者均通过该试验确诊。在这些病例中，必须通过结膜激发试验确定致病因素。
谷物是面包师（75%）和农民（66%）中的主要致敏原。面包师还对α淀粉酶（41%）和大豆（25%）敏感，农民对大豆（33%）和仓储螨（33%）敏感。磨坊工人的职业性哮喘由谷物、大豆和仓储螨引起。
除谷物外，其他过敏原如酶、豆类、鸡蛋和仓储螨也可能是谷物加工工人职业性哮喘的致病因素。不同工作中对不同过敏原的致敏很可能是由于接触差异所致。
