alpha-Amylase hypersensitivity in non-exposed millers

The spectrum of fungal allergy

Fungi can be found throughout the world. They may live as saprophytes, parasites or symbionts of animals and plants in indoor as well as outdoor environment. For decades, fungi belonging to the ascomycota as well as to the basidiomycota have been known to cause a broad panel of human disorders. In contrast to pollen, fungal spores and/or mycelial cells may not only cause type I allergy, the most prevalent disease caused by molds, but also a large number of other illnesses, including allergic bronchopulmonary mycoses, allergic sinusitis, hypersensitivity pneumonitis and atopic dermatitis; and, again in contrast to pollen-derived allergies, fungal allergies are frequently linked with allergic asthma. Sensitization to molds has been reported in up to 80% of asthmatic patients. Although research on fungal allergies dates back to the 19th century, major improvements in the diagnosis and therapy of mold allergy have been hampered by the fact that fungal extracts are highly variable in their protein composition due to strain variabilities, batch-to-batch variations, and by the fact that extracts may be prepared from spores and/or mycelial cells. Nonetheless, about 150 individual fungal allergens from approximately 80 mold genera have been identified in the last 20 years. First clinical studies with recombinant mold allergens have demonstrated their potency in clinical diagnosis. This review aims to give an overview of the biology of molds and diseases caused by molds in humans, as well as a detailed summary of the latest results on recombinant fungal allergens.

Occupational Sensitization to Fungal Enzymes Used in Animal Feed Industry

BACKGROUND

Industrial enzymes cause the increasing prevalence of occupational hypersensitivity. Our objective was to study workers occupationally exposed to fungal enzymes in 2 animal feed factories to determine if the sensitization originated in the enzymes or was caused by the microorganism used to produce the enzymes.

METHODS

Eighty-six consenting workers were studied by skin prick tests with extracts from the enzymatic products handled in their factories. Positive workers were then studied by IgE immunoblotting and basophil activation was measured by flow cytometry.

RESULTS

Eight of the 86 workers analysed (9%) tested positive and were more frequently sensitized to phytase from Trichoderma and Peniophora. Glucanase and alpha-amylase from Bacillus amyloliquefaciens did not cause sensitization in any worker. No cross-reactions were observed between Trichoderma and Peniophora sp. phytases. Workers were sensitized to the product that they handled.

CONCLUSIONS

Fungal enzymes cause occupational hypersensitivity in animal feed industries. Immunoblotting and basophil activation are useful to evaluate the effects of handling enzymes as part of the medical surveillance of enzyme-exposed workers. We describe Peniophora sp. 6-phytase as a new allergen and enzymes from Trichoderma as strong sensitizers.

Enzyme exposure and enzyme sensitisation in the baking industry

OBJECTIVES

To assess the exposure to enzymes and prevalence of enzyme sensitisation in the baking industry.

METHODS

A cross sectional study was conducted in four bakeries, one flour mill, and one crispbread factory. Sensitisation to enzymes, flours, and storage mites was examined by skin prick and radioallergosorbent (RAST) tests. 365 workers were tested. The workers were interviewed for work related respiratory and skin symptoms. Total dust concentrations were measured by a gravimetric method, and the concentration of alpha-amylase in air was measured by a catalytic method. An immunochemical method was used for measuring cellulase and xylanase in air.

RESULTS

Total measured dust concentrations were from 0.1 to 18 mg/m3, with highest values in dough making areas of bakeries. The alpha-amylase concentrations generally followed the total dust concentrations and reached the highest values < 6.6 micrograms/m3 in the same areas. Cellulase and xylanase varied with concentrations < 180 ng/m3 and < 40 ng/m3, respectively, in the flour mill and the crispbread factory. No cellulase, but concentrations of 1-200 ng/m3 xylanase, were found in the bakeries, probably indicating the natural xylanase activity of wheat. 12 workers (8%) in the bakeries, three (5%) in the flour mill, and four (3%) in the crispbread factory were skin prick positive to enzymes. The corresponding percentages of positive reactions to flours were 12%, 5%, and 8%.

CONCLUSIONS

The study confirmed that industrial enzymes in baking used as additives in a powdered form pose a risk of sensitisation. The no effect air concentrations for industrial enzymes are not known. Based on present knowledge, however, lowering exposures and eliminating short and high peaks by technical measures would lower the risk of sensitisation. This would be most effectively accomplished by shifting to non-dusty products.