Glues and gums are occasional causes of human allergy. Impure gelatin is the adhesive obtained from the bones and hides of terrestrial animals and fish bones. Other natural glues are made from casein, rubber, and gum arabic. Synthetic adhesives recently have minimized the glue allergy problem, although the amine hardeners used in the manufacture of epoxies have caused asthma and rhinitis in factory workers. In addition to gum arabic, other vegetable gums (acacia, chicle, karaya, and tragacanth) have been reported to cause allergy by inhalation or ingestion. These are used in candies, chewing gum, baked goods, salad dressings, laxatives, and dentifrices. They also are used as excipients in medications. Guar gum is a vegetable gum that recently has been shown to induce IgE-mediated asthma. This gum is used in the carpet industry and affects about 2% of workers in carpet-manufacturing plants. The gum is used to fix colors to carpeting. It is also used in ice cream and salad dressings and as a hardener in the manufacture of tablets in the pharmaceutical industry. Guar gum is obtained from Cyanopsis tetragonoolobus, a vegetable grown in India (250).
In hair-setting preparations, gums have been largely replaced by polyvinylpyrrolidine, which is not allergenic. Parenthetically, most cases of chronic pulmonary disease attributed to "hair spray allergy" or "hair spray thesaurosis" have turned out to be sarcoidosis, with no basis for attributing the cause to hair spray.
Inhalation of soap-bark dust has caused occupational asthma. This wood dust is a product of the Quillaja tree and is used in the manufacture of saponin, a surface-reducing agent. Soap-bark is chemically related to acacia and tragacanth, and these gums showed cross-reactivity in the soap-bark RAST ( 251).
Enzymes used in laundry detergents to enhance cleaning ability may sensitize both the workers where the product is made and the consumer who uses it ( 252). The enzyme subtilisin (or subtilin) is proteolytic and is derived from Bacillus subtilis, where it plays a role in sporulation. It may produce rhinitis, conjunctivitis, and asthma, associated with precipitating antibodies and Arthus-type reactions on skin testing. Many cases reported did not involve atopic individuals. Enzyme-containing detergents currently are not commonly used because of their sensitizing potential. Other enzymes, cellulase and macerozyme, are used to digest cell wall structures of plants. Laboratory workers have been shown to develop IgE-mediated symptoms from inhaling these enzymes (253). Papain, a cysteine protease, is obtained from the fruit of the papaya tree. It is used as a meat tenderizer, clearing agent in the production of beer, contact lens cleaner, and component of some tooth powders, laxatives, and skin lotions. Asthma has been induced by inhalation of papain, and antipapain IgE and IgG antibodies have been demonstrated in a worker in a meat tenderizer factory. In this case, the IgE-RAST result was not positive until after the other classes of immunoglobulins had been absorbed from the sera ( 254).
Grain mill dust and baker's flour have long been recognized as causes of occupational asthma. Positive skin test results to extracts of grain mill dust often are seen in patients who have never worked in granaries. It is generally agreed that allergens are responsible for the symptoms resulting from inhaling these substances, but it is not known if these allergens are primarily from the grains themselves or from organisms that infest them, such as molds, mites, or weevils. Enzymes have been implicated in baker's asthma. a-Amylase from Aspergillus oryzae (Asp o 2) and xylanase from Apergillus niger are two enzymes that are used together to increase bread volume. Bakers can have IgE reactions to both of these as well as several other Aspergillus niger enzymes (255,256). Flours also can produce reactions separate from the enzymes. Wheat flour (64%), rye flour (52%), and soybean flour (25%) were all more common than a-amylase in a series of bakers with workplace-related respiratory symptoms (257).
Garlic has caused asthma by inhalation (258) and ingestion (259). Both cases were documented immunologically, and one was documented by inhalation challenge. In one case (259), the capacities of onion and asparagus, other members of the Liliacee family, to inhibit the garlic RAST were two and one half to four times higher than the homologous garlic extract.
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