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Abstract

Allergologie, Jahrgang 16, Nr. 3/1993, S. 87-90

Aspergillus-Amylase (Asp o I) als Bäckerallergen

Ingrid Sander, X. Baur, S. Isringhausen-Bley und P. Rozynek

Berufsgenossenschaftliches Forschungsinstitut für Arbeitsmedizin (BGFA), Institut an der Ruhr-Universität Bochum
Untersuchungen an einem Patientenkollektiv von an Mehlstauballergie erkrankten Bäckern zeigen, daß neben den im Mehl natürlich vorkommenden Bestandteilen auch die zugemischten Backmittel relevante Inhalationsallergene sein können. Insbesondere das stärkeabhauende Enzym α-Amylase aus Aspergillus oryzae, Hauptbestandteil zahlreicher Backmittel, zeigt in 16% der Fälle eines Kollektivs von 89 Bäckern spezifische IgE-Antikörper an. Mittels Immunoblot und Jodstärkefärbung konnten wir nachweisen, daß die α-Amylase selbst das Hauptallergen ist. Es wurde von uns nach IUIS-Nomenklatur mit Asp o I benannt. Die Aminosäuresequenz und Röntgenstrukturanalyse der α-Amylase ist bekannt. Die vorhandenen Strukturdaten wurden für ein Molekülmodell der α-Amylase mit dem Programm Insight II (Biosym) benutzt. Die Lage der Disulfidbrücken, der Glykosilierungsstelle, Ca2+- und Substratbindungsstellen konnte graphisch erfaßt werden. Zusätzlich wurde unter Verwendung der Vorhersagealgorithmen von Jameson und Wolf [9] die Lage möglicher B-Zell-Epitope analysiert.Correspondence to:
Dr. phil. Nat. Ingrid Sander, Gilsingstraße 14, W–4630 Bochum 1

Abstract

Unusual allergen in a butcher with respiratory symptoms

Ingrid Sander¹, Claus Keller², Christina Czibor¹, Ursula Meurer¹, Rolf Merget¹ and Monika Raulf¹

¹Institute for Prevention and Occupational Medicine of the German Social Accident Insurance, Institute of the Ruhr University Bochum (IPA), Bochum, and ²Medical Practice for Pulmonary and Bronchial Medicine, Allergology and Environmental Medicine, Frankfurt am Main, Germany
A 37-year-old butcher developed respiratory symptoms during sausage and chicken production in a large company. In addition to various spices, the enzyme transglutaminase was a possible cause. The lung function test showed mild partial reversible airway obstruction and severe bronchial hyperresponsiveness. The IgE test showed sensitizations to various spice mixtures, coriander (0.74 kU/L), and to the ImmunoCAPbound transglutaminase preparation from the workplace (7.12 kU/L). The skin prick tests with this transglutaminase were also positive. In the immunoblot of this preparation, a 40-kD protein reacted with the patient’s IgE and was identified as transglutaminase from Streptomyces mobaraensis by inhibition experiments. This is the first case of a butcher with an allergy to transglutaminase. After moving to a small enterprise without enzyme use, his symptoms improved. Sensitization and the course of the symptoms indicate a dominant role of transglutaminase in the patient’s allergic asthma.Correspondence to:
Dr. Ingrid Sander, Institute for Prevention and Occupational Medicine of the German Social Accident Insurance, Institute of the Ruhr University Bochum, Center of Allergology/Immunology, Bürkle-de-la-Camp-Platz 1, 44789 Bochum, Germany
Email: [email protected]

Abstract

Allergologie select, Vol. 5/2021 (77-81)

Occupational immediate type allergy to soapnut and quillaja bark

Rolf Merget, Monika Raulf, and Ingrid Sander

Institute for Prevention und Occupational Medicine of the German Social Accident Insurance, Institute of the Ruhr University Bochum (IPA), Germany
A 58-year-old non-atopic chemical worker complained about work-related asthma and rhinoconjunctivitis about 4 years after exposure to quillaja bark and soapnut. Bronchial hyperresponsiveness was demonstrated after withdrawal of medication for 12 hours. Skin prick tests with extracts from quillaja bark and soapnut from the workplace were positive, but ImmunoCAP was positive only with quillaja bark, probably due to the low protein content of the extract from soapnut. Sensitizations to quillaja bark and soapnut, but not to saponin were demonstrated by immunoblot. An inhalation test with a dosimeter was positive with the soapnut extract. A link between disease and exposure was documented by serial measurements of exhaled nitric oxide at and off work, despite preventive measures. A diagnosis of occupational allergy due to quillaja bark and soapnut was made. Further exposure reduction was recommended.Correspondence to:
Prof. Dr. med. Rolf Merget, Institut für Prävention und Arbeitsmedizin der Deutschen Gesetzlichen Unfallversicherung, Institut der Ruhr-Universität Bochum, Bürkle-de-la-Camp-Platz 1, 44789 Bochum, Germany
Email: [email protected]

Abstract

Allergologie select, Vol. 8/2024 (51-63)

Animal exposure, sensitization, and allergic symptoms in first-year veterinary medicine students

Eva Zahradnik, Christoph Nöllenheidt, Ingrid Sander, Alexandra Beine, Martin Lehnert, Frank Hoffmeyer, and Monika Raulf

Institute for Prevention and Occupational Medicine of the German Social Accident Insurance, Institute of the Ruhr-Universität Bochum (IPA), Bochum, Germany
The AllergoVet study longitudinally examines the influence of animal exposure on the development of sensitization and allergic diseases among veterinary medicine students. In this group, contact to animals usually existed long before the study began. Therefore, the aim of this analysis was to investigate lifelong animal species-specific exposure and the prevalence of sensitizations and allergic symptoms already existing before the start of the study. Questionnaire data, including exposure history, were summarized to determine the duration and intensity of animal-related exposure as well as the prevalence of allergic symptoms to animals. Serologically, specific IgE was determined against ubiquitous inhalant allergens (atopy screen sx1) and against animal allergens using ImmunoCAP. The association between animal-specific sensitization, allergic symptoms, and exposure was analyzed using Fisher’s exact test or Cochran-Armitage trend test. All study participants (n = 313) had previous contact with animals, with dogs mentioned most frequently (91.1%) followed by cats (89.5%) and horses (72.2%). Sensitization to ubiquitous allergens (positive sx1 value) was detected in 38.4% of subjects. Approximately 11%, 7%, and 5% were sensitized to cats, dogs, and horses, respectively. Only a small proportion of these sensitizations were associated with self-reported symptoms (41% for cat, 9% for dog, and 13% for horse). While no significant association between animal-specific exposure and sensitization was found for cats and horses, a clear trend emerged for dogs. With increasing duration of exposure to dogs, the number of dog-specific sensitizations decreased significantly (p = 0.0069). Furthermore, a decreasing trend in sx1 sensitization was noted with increasing cat (p = 0.0288) and dog (p = 0.0107) exposure. None of the subjects who grew up on a farm (n = 40) had any sensitization to animals. The sensitization prevalence determined among first-year students in veterinary medicine roughly corresponds to that in the general population. Most animal sensitizations were not clinically relevant. In this collective, a protective effect of increasing exposure to animals in childhood and adolescence was found on sensitization, which was particularly pronounced during contact with dogs.Correspondence to:
Eva Zahradnik, Dipl. Biol., Institute for Prevention and Occupational Medicine of the German Social Accident Insurance, Institute of the Ruhr-Universität Bochum (IPA), Bürkle-de-la-Camp-Platz 1, 44789 Bochum, Germany
Email: [email protected]

Abstract

Allergologie select, Vol. 8/2024 (238-250)

Procedure for a standardized preparation of skin prick test solutions for the diagnosis of occupational type I allergies in the absence of commercial extracts

Sabine Kespohl¹, Robin Jost², Silke Maryska¹, Lena-Maria Altin³, Ingrid Sander¹, Stefan Schülke², Kathrin E. Paulus-Tremel², Andreas Bonertz², Thomas Klose³, Vera Mahler², and Monika Raulf¹

¹Institute for Prevention and Occupational Medicine of the DGUV, Ruhr-University Bochum (IPA), Bochum, ²Division Allergology, Paul-Ehrlich-Institut, Langen, and ³Sonnenschein Apotheke, Koblenz, Germany
In order to ensure valid diagnostics for occupational test allergen solutions despite the ongoing reduction in the availability of commercial test extracts, a plan B was initiated for the possible production of skin prick test (SPT) solutions in public pharmacies. For important occupational allergen sources (wheat and rye, storage mites, animal epithelia, mold material) laboratory extraction methods were analyzed in comparison to pharmacy compatible extraction methods regarding protein quantity and quality in SDS-PAGE combined with silver staining. Subsequently, using the example of bovine epithelia, adapted extraction procedures as well as in-process and final product controls were transferred to a public pharmacy. Allergen sources with a high protein content, such as wheat and rye grains as well as storage mites, showed good comparability of the extractable protein quantity and protein pattern, regardless of the applied extraction method. In contrast, allergen source materials with a low total protein content, such as animal epithelia and molds, can benefit from laboratory extraction conditions such as mechanical disruption and specific buffer additives. In the qualitative protein silver staining, characteristic protein patterns were identified for each allergen source. Depending on the extraction method, only minor differences in total protein patterns were observed in animal epithelia and molds. Using source materials from two suppliers, the resulting allergen extracts displayed clear differences in protein content in storage mites and quantitative and qualitative differences in molds. A practical preparation attempt of SPT solutions in a public pharmacy was successful. SPT solutions prepared with adapted pharmacy extraction methods showed a comparable protein and Bos d 2 allergen content and equivalent qualities in the protein pattern compared to a previously available commercial SPT solution. Accordingly, it can be assumed that standardized SPT solutions with sufficient allergen quality for occupational allergen sources can be prepared in public pharmacies if certified allergen sources with appropriate protein content are available.Correspondence to:
Dr. Sabine Kespohl, Institute for Prevention and Occupational Medicine of the German Social Accident Insurance, Institute of the Ruhr-Universität Bochum (IPA), Department Competence Center Allergology/Immunology, Bürkle-de-la-Camp-Platz 1, 44789 Bochum, Germany
Email: [email protected]

Abstract

Allergologie select, Vol. 8/2024 (251-264)

Possible manufacture of test allergens in public pharmacies for the diagnosis of type I allergies: Legal aspects

Robin Jost¹,², Sabine Kespohl³, Kathrin E. Paulus-Tremel¹, Julia Zimmer¹, Andreas Bonertz¹, Ingrid Sander³, Thomas Klose⁴, Lena-Maria Altin⁴, Simone Heller⁴, Ralph Heimke-Brinck⁵, Frank Dörje⁵, Susanne Philippus⁶, Matthias Meyer⁷, Sabrina Segebrecht⁸, Torsten Wessel⁹, Dieter Starke¹⁰, Stefan Schülke¹, Monika Raulf³, and Vera Mahler¹,²

¹Allergology Division, Paul-Ehrlich-Institut (PEI), Langen (Hesse), ²Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, ³Institute for Prevention and Occupational Medicine of the German Social Accident Insurance (DGUV), Institute of the Ruhr-Universität Bochum (IPA), Bochum, ⁴Sonnenschein Apotheke, Koblenz, ⁵Pharmacy Department, Erlangen University Hospital, Erlangen, ⁶Thuringian State Authority for Consumer Protection, Department Pharmacy, Bad Langensalza, ⁷Bundeswehr Commissioner for the Surveillance of Medicinal Products, Supervisory Agency for Public Law Tasks of the Bundeswehr Medical Service South, Munich, ⁸Drug Supervision, State Social Services Agency of Land Schleswig-Holstein, Neumünster, ⁹Pharmacy Inspector, Local inspectorate for pharmacies, District of Wesel, Moers, and ¹⁰ State Agency for Social Affairs, Youth and Care, Rhineland-Palatinate, Koblenz, Germany
The availability of high-quality skin test allergens is a prerequisite for the reliable diagnosis of occupational type I allergies. Due to the withdrawal of existing marketing authorizations (MAs) by pharmaceutical companies and the lack of new MAs for commercial test allergens, there is an increasing diagnostic gap in Germany and other EU member states, which makes it necessary to investigate alternative ways of providing in vivo diagnostics. The German Medicinal Products Act (Arzneimittelgesetz = AMG) allows for the possibility of preparing medicinal products in pharmacies without the need for an MA or a manufacturing authorization pursuant to Section 13 (2) No. 1 in conjunction with Section 13 (2a) Sentence 2 No. 3 AMG. This also includes test allergens. In addition to the AMG, the requirements of the German Ordinance on the Operation of Pharmacies (Apothekenbetriebsordnung – ApBetrO) and the European Pharmacopoeia apply in particular. Medicolegal and practical challenges, as well as potentials of manufacturing skin prick test solutions in public pharmacies are presented based on examples of different allergen source materials.Correspondence to:
Prof. Dr. Vera Mahler, Paul-Ehrlich-Institut, Paul-Ehrlich-Straße 51-59, 63225 Langen, Germany
Email: [email protected]

Abstract

Allergologie select, Vol. 9/2025 (58-65)

Legumes in bread baking: A hidden risk for an IgE-mediated inhalant allergy

Sabine Kespohl¹, Christian Eisenhawer¹, Silke Maryska¹, Ingrid Sander¹, Irene Mittermann², Martina Aumayr², and Monika Raulf¹

¹Institute for Prevention and Occupational Medicine of the German Social Accident Insurance, Institute of the Ruhr University Bochum (IPA), Bochum, Germany, and ²MacroAssay Diagnostics, Vienna, Austria
New protein-rich flour blends from legumes are increasingly being processed for gluten-free bakery products, which may increase the risk of IgE-mediated sensitization through inhalation exposure. In the described case of a 29-year-old baker, work incapacity occurred due to respiratory complaints following exposure to various gluten-free baking ingredients. Occupationrelated sensitization to “chestnut pea flour” (flour from lightly roasted and ground yellow peas) was identified, while the patient showed no IgE sensitization to five other ingredients. Significant allergic respiratory reactions occurred during bronchial challenge test with “chestnut pea” extract. Based on the test results and typical workplace-related symptoms, recognition of occupational disease was recommended. Further identification of potential causal allergens using IgE blot and allergen component-resolved diagnostics revealed IgE bindings to typical storage proteins, 2S albumin and vicilin, as well as to Bet v 1 homologous of “chestnut pea” and non-specific lipid transfer proteins. This case illustrates that the processing of protein-rich legume flours can pose new sensitization risks for workers, which should be considered in the future.Correspondence to:
Dr. Sabine Kespohl, Department Competence Centre for Allergology/Immunology, Institute for Prevention and Occupational Medicine of the German Social Accident Insurance, Institute of the Ruhr University Bochum (IPA), Bürkle-de-la-Camp Platz 1, 44789 Bochum, Germany
Email: [email protected]

Abstract

Allergologie select, Vol. 9/2025 (66-74)

Airborne exposure-induced occupational type I allergy to Tenebrio molitor: Case report and studies on immunological reactivity

Laura Weißenborn¹, Sabine Kespohl², Silke Maryska², Ingrid Sander², Jakob Bickhardt³, Thomas Henle¹, and Monika Raulf²

¹Chair of Food Chemistry, Technische Universität Dresden, Dresden, ²Institute for Prevention and Occupational Medicine of the German Social Accident Insurance, Institute of the Ruhr University Bochum (IPA), Bochum, and ³Pulmonary Specialist Practice and Training Center, Dresden, Germany
This occupational case report describes a 28-year-old woman, employed since November 2020 as a research assistant working with mealworms (Tenebrio molitor), who developed symptoms of mild shortness of breath and severe redness and swelling of the eyes in early 2022, leading to the diagnosis of occupational allergic asthma due to respiratory sensitization to mealworm. Subsequent tests confirmed mono-sensitization to T. molitor and additional cross-sensitization to flour beetle (Tribolium confusum). Further studies aimed to determine the antigenic and allergenic potency of different protein fractions and rearing material isolated from T. molitor regarding protein pattern and immunological activity by T. molitor-specific polyclonal rabbit IgG and human IgE. The highest antigen content of T. molitor was measured in the rearing material, followed by mealworm flour and aqueous extraction. Allergenic proteins are particularly detected in mealworm flour and aqueous fraction at molecular weights of 24 and 11 kDa, which appear to be specific for primary airway sensitization. In addition, the airborne T. molitor antigen levels in the workplace were monitored using electrostatic dust collectors to identify hotspots of exposure. The disposal of dry insect material was shown to be responsible for the unintentional release of potential allergens. Therefore, awareness of the potential risk of a type I allergy due to the release of airborne insect allergens in the workplace should be raised.Correspondence to:
Laura Weißenborn, Technische Universität Dresden, Professur für Lebensmittelchemie, Bergstraße 66, 01062 Dresden, Germany
Email: [email protected]

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