Occupational allergies to xylanases

The exposure against enzyme dusts have long been known to cause occupational allergies. In the 1960s an increasing number of occupational allergies in the detergent industry were observed. In this context the high sensitization potential of enzyme dusts attracted attention. The present evaluation of literature data confirms that this is also true for xylanases. These frequently used industrial enzymes belong to the hemicellulases and are mostly of fungal origin. Several cases of specific airway sensitization caused by xylanases or other hemicellulases are verified by a number of case reports and cross sectional studies. As symptoms, results of skin prick tests, detection of specific IgE-antibodies and results of specific bronchoprovocation tests are consistent, an immunologic mechanism can be assumed.     

Occupational allergies to cellulases

In the 1960s an increasing number of occupational allergies in the detergent industry against the proteolytic enzyme Subtilisin were observed. In this context the high sensitization potential of enzyme dusts attracted attention. The present evaluation of literature data confirms that this is also true for cellulases. These enzymes--mostly of fungal origin--are frequently used in biotechnology. Several cases of specific airway sensitization caused by cellulases are verified by a number of studies. As symptoms, results of skin prick tests, detection of specific IgE-antibodies and results of specific bronchoprovocation tests are consistent, an immunologic mechanism seems to be confirmed.     

Occupational respiratory tract allergies]

Professionally conditioned allergoses of the respiratory tract (BK 41) can occur in all industrial regions. The allergoses conditioned by organic dusts of vegetable or animal origin (regions food production, plant production and animal keeping) predominate. Since 1976 the BK 41 has been on the 10th rank of alases, 1977), above all conditioned by an improved establishment. Among the diagnoses bronchial asthma is in the first place. The high proportion of allergoses by cereal constituents is to be led back to the, as a rule, unproblematic allergologic clarification diagnostics. One may conclude that difficulties of the recognition in other allergens condition a considerable dark number, particularly in chemical working materials. The allergoses by cereal constituents are followed by the constituents of the animal epidermis (above all hair of laboratory animals). The remainder -- without any importance of the succession -- belongs to moulds, mites, plant pollen, parasubstituted aromates, chrome and rare allergens. Apart from the slight number of alveolitis diseases the allergoses conditioned by organic dusts belong to the type of early reaction (characteristic representatives: baker's asthma). Problematical are the allergoses of the type of the late reaction. Chemical substances of the hapten type are above all in question (characteristic representative: chrome asthma). Here is most cases expressed irritation effects are present so that this pathogenetic factor is frequently determining without proving any immune-specific effects. The report is based on forgiven criteria of decision.     

Food allergies

Adverse reactions to foods are commonly implicated in the causation of ill health. However, foreign antigens, including food proteins and commensal microbes encountered in the gastrointestinal tract, are usually well tolerated. True food allergies, implying immune-mediated adverse responses to food antigens, do exist, however, and are especially common in infants and young children. Allergic reactions to food manifest clinically in a variety of presentations involving the gastrointestinal, cutaneous, and respiratory systems and in generalized reactions such as anaphylaxis. Both IgE-mediated and non-IgE-mediated immune mechanisms are recognized. Important advances in the clinical features underlying specific food hypersensitivity disorders are reviewed.     

Food allergies

Opinion statement Food incompatibilities affect approximately 20% of the general population in Western countries. In about one quarter of the affected children and one tenth of affected adults, the incompatibility is based on an allergy, that is, on an immunologically generated incompatibility reaction. Gastrointestinal symptoms occur in a third of these cases. Food allergies are caused by IgE-dependent or Ige-independent immunologic reactions, which lead to an inflammatory reaction, in which mast cells, eosinophilic granulocytes, and other cells are involved. Both genetic and environmental causes are under consideration. New findings concerning the interaction between the innate immune system and intestinal microflora have generated innovative therapeutic concepts, including the use of probiotics to prevent food allergies. The development of recombinant allergens and varieties of allergens will improve diagnostic possibilities and bring new therapeutic options, such as hyposensitization and induction of immunologic tolerance. Food intolerances (nonimmunologic food incompatibilities often caused by specific enzyme deficiencies) must be diagnostically differentiated from food allergies.     

Skin allergies

Zum Thema Allergien k?nnen sich am Hautorgan nicht nur mit den unterschiedlichsten Krankheitsbildern manifestieren, auch k?nnen sie durch unterschiedliche allergische Reaktionstypen ausgel?st werden. Der hiermit vorliegende Beitrag beschreibt die pathogenetischen Vorg?nge und die Klassifikation der zu Grunde liegenden allergischen Reaktionen. Zus?tzlich wird die klinische Symptomatik, Diagnostik und Therapie der h?ufigsten allergisch bedingten Hauterkrankungen von der Urtikaria, dem Ekzem, über die Purpura bis zum Arzneimittelekzem dargestellt.     

Food allergies

Food incompatibilities affect approximately 20% of the general population in Western countries. In about one quarter of the affected children and one tenth of affected adults, the incompatibility is based on an allergy, that is, on an immunologically generated incompatibility reaction. Gastrointestinal symptoms occur in a third of these cases. Food allergies are caused by IgE-dependent or IgE-independent immunologic reactions, which lead to an inflammatory reaction, in which mast cells, eosinophilic granulocytes, and other cells are involved. Both genetic and environmental causes are under consideration. New findings concerning the interaction between the innate immune system and intestinal microflora have generated innovative therapeutic concepts, including the use of probiotics to prevent food allergies. The development of recombinant allergens and varieties of allergens will improve diagnostic possibilities and bring new therapeutic options, such as hyposensitization and induction of immunologic tolerance. Food intolerances (non-immunologic food incompatibilities often caused by specific enzyme deficiencies) must be diagnostically differentiated from food allergies.     

Ocular allergies

Ocular allergic disease affects not only the conjunctivae but also surrounding structures including the eyelids. Allergic diseases of the eyelid include atopic dermatitis, contact dermatitis, and urticaria/angioedema. They must be differentiated from nonallergic eyelid diseases. Allergic diseases of the conjunctivae comprise a spectrum of disorders from common, non-sight-threatening conditions such as seasonal allergic conjunctivitis, perennial allergic conjunctivitis, and giant papillary conjunctivitis to less common and potentially sight-threatening diseases such as vernal keratoconjunctivitis and atopic keratoconjunctivitis. Each of these conditions is mediated primarily by type I hypersensitivity reactions. The clinical manifestations, differential diagnosis, and treatment of these conditions are reviewed in this article.     

Immediate type allergies due to metal - nickel

Occupational allergies of the immediate type due to metals, which are predominantly caused by nickel, platinum, chromium and cobalt, are rather rare. The present paper reviews the results of the evaluation of literature data concerning the occupational airway sensitization due to nickel, which is used in many different industrial fields - especially in the electroplating industry. Cases of specific airway sensizitation caused by nickel are verified by a number of studies, predominantly case histories. In conclusion, there is sufficient evidence that nickel may cause IgE-mediated hypersensitivity with typical symptoms.     

Adverse reactions to food: allergies and intolerances

All the anomalous reactions secondary to food ingestion are defined as 'adverse reactions to food'. In 1995 the European Academy of Allergology and Clinical Immunology suggested a classification on the basis of the responsible pathogenetic mechanism; according to this classification, non-toxic reactions can be divided into 'food allergies' when they recognize immunological mechanisms, and 'food intolerances' when there are no immunological implications. The diagnostic approach to adverse reactions to food is based on accurate clinical history and objective examination, and further execution of specific tests when allergy or intolerance is suspected. The therapy for food allergies is the elimination of the food to which hypersensibility has been found; this strategy can lead, especially in pediatric age, to tolerance. If elimination diets cannot be completely performed, or if it is not possible to identify the food to eliminate, some drugs (e.g. antihistaminics, steroids, etc.) can be administered. Specific allergen immunotherapy has been recently introduced. Fundamental is food allergy prevention, especially in high-risk subjects. The therapeutic approach to secondary food intolerances is based principally on primitive disease resolution; on the other hand, some specific treatments (e.g. beta-galactosidases in lactose malabsorption) are available in case of primary intolerance.     

Les allergies alimentaires

The incidence of food allergy appears to be on the increase in industrialized societies. The reasons suggested are consumption of new products and the evolution of food technology. The public perceives food allergies differently from doctors: adverse reactions to foods are misclassified as food allergies although they are in most of the cases non-allergic food intolerance or food aversion. Indeed, in controlled studies, a low prevalence of food allergy although they are in most of the cases non-allergy has been found (1–2% in adults, 2–8% in children). Despite a number of advances in the field of diagnosis and therapy, the standard methods of diagnosis and therapy for food allergies remain the same: double-blind placebo-controlled food challenge and avoidance. Reports on the effects of food processing indicate that certain processes for certain foods can either eliminate, reduce, or not change the allergenic potential. As more food allergen identification and information on the protein structures responsible becomes available, perhaps better ways to use processing methods to reduce or remove allergenicity may become apparent and feasible.