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귀뚜라미 분말에 의한 직업성천식 1예

Occupational asthma due to cricket powder in a cricket breeder

  • 전현섭 (아주대학교 의과대학 알레르기내과학교실) ;
  • 강상록 (더 숨 내과) ;
  • 양은미 (아주대학교 의과대학 알레르기내과학교실) ;
  • 박해심 (아주대학교 의과대학 알레르기내과학교실)
  • Hyun-Seob Jeon (Department of Allergy and Clinical Immunology, Ajou University School of Medicine) ;
  • Sang Roc Kang (The Soom Clinic) ;
  • Eun Mi Yang (Department of Allergy and Clinical Immunology, Ajou University School of Medicine) ;
  • Hae-Sim Park (Department of Allergy and Clinical Immunology, Ajou University School of Medicine)
  • 투고 : 2023.08.07
  • 심사 : 2023.09.18
  • 발행 : 2024.01.30

초록

Allergy to crickets is uncommon and usually reported from workers who breed, manufacture, or consume them as food for either pets or for themselves. Although there are several reports of hypersensitivity reactions to crickets in other countries, there has been few published reports in this country. Here we report a case of a 20-year-old Korean male who had been exposed for a year in his workplace and developed occupational asthma and rhinitis sensitized to Gryllus bimaculatus (GB). The patient developed respiratory and cutaneous symptoms whenever he was exposed to or came into contact with GBs or dust from the cage storing the GBs. To identify the causative allergen in his workplace, soluble GB extracts were prepared with phosphate-buffered saline and was used for skin prick test (SPT) and immunologic studies. The patient showed positive results to GB extracts as well as to house dust mite (HDM) on SPT, while negative responses were noted in 3 unexposed controls. Higher level of serum GB-specific IgE by enzyme-linked immunosorbent assay (ELISA) was noted in the patient compared to those of 18 unexposed controls. The IgE-ELISA Inhibition test showed significant inhibitions with serial additions of GB extracts without any inhibitions with HDM extracts. Sodium dodecyl sulphate-polyacrylamide gel electrophoresis and IgE-immunoblot analysis demonstrated several IgE binding components (range, 60-75 kDa). The patient was asked to avoid cricket exposure, and symptoms improved with the application of inhaled corticosteroids. Herein, we report a case of occupational asthma and rhinitis due to GB in an exposed worker.

키워드

참고문헌

  1. Baur X, Sigsgaard T, Aasen TB, Burge PS, Heederik D, Henneberger P, et al. Guidelines for the management of work-related asthma. Eur Respir J 2012;39:529-45.
  2. Kim JL, Henneberger PK, Lohman S, Olin AC, Dahlman-Hoglund A, Andersson E, et al. Impact of occupational exposures on exacerbation of asthma: a population-based asthma cohort study. BMC Pulm Med 2016;16:148.
  3. Cartier A. New causes of immunologic occupational asthma 2014-2020. Curr Opin Allergy Clin Immunol 2021;21:110-3.
  4. Cullinan P, Vandenplas O, Bernstein D. Assessment and management of occupational asthma. J Allergy Clin Immunol Pract 2020;8:3264-75.
  5. Sastre J, Vandenplas O, Park HS. Pathogenesis of occupational asthma. Eur Respir J 2003;22:364-73.
  6. Kim JH, Choi GS, Kim JE, Ye YM, Park HS. Three cases of rice-induced occupational asthma. Ann Allergy Asthma Immunol 2010;104:353-4.
  7. Jo W, Seo KW, Jung HS, Park CY, Kang BJ, Kang HH, et al. Clinical importance of work-exacerbated asthma: findings from a prospective asthma cohort in a highly industrialized city in Korea. Allergy Asthma Immunol Res 2021;13:256-70.
  8. Bagenstose AH 3rd, Mathews KP, Homburger HA, Saaveard-Delgado AP. Inhalant allergy due to crickets. J Allergy Clin Immunol 1980;65:71-4.
  9. Bartra J, Carnes J, Munoz-Cano R, Bissinger I, Picado C, Valero AL. Occupational asthma and rhinoconjunctivitis caused by cricket allergy. J Investig Allergol Clin Immunol 2008;18:141-2.
  10. Kamemura N, Sugimoto M, Tamehiro N, Adachi R, Tomonari S, Watanabe T, et al. Cross-allergenicity of crustacean and the edible insect Gryllus bimaculatus in patients with shrimp allergy. Mol Immunol 2019;106:127-34.
  11. Raulf M. Occupational respiratory allergy: risk factors, diagnosis, and management. Handb Exp Pharmacol 2022;268:213-25.
  12. Linares T, Hernandez D, Bartolome B. Occupational rhinitis and asthma due to crickets. Ann Allergy Asthma Immunol 2008;100:566-9.
  13. de Las Marinas MD, Cerda JC, Lopez-Matas MA, Gonzalez-Ruiz A, Martorell C, Felix R, et al. Hexamerin-like protein 2, a cricket allergen involved in occupational and food allergy. Clin Exp Allergy 2021;51:858-60.
  14. Srinroch C, Srisomsap C, Chokchaichamnankit D, Punyarit P, Phiriyangkul P. Identification of novel allergen in edible insect, Gryllus bimaculatus and its cross-reactivity with Macrobrachium spp. allergens. Food Chem 2015;184:160-6.
  15. Pali-Scholl I, Meinlschmidt P, Larenas-Linnemann D, Purschke B, Hofstetter G, Rodriguez-Monroy FA, et al. Edible insects: cross-recognition of IgE from crustacean- and house dust mite allergic patients, and reduction of allergenicity by food processing. World Allergy Organ J 2019;12:100006.
  16. Witteman AM, Akkerdaas JH, van Leeuwen J, van der Zee JS, Aalberse RC. Identification of a cross-reactive allergen (presumably tropomyosin) in shrimp, mite and insects. Int Arch Allergy Immunol 1994;105:56-61.
  17. Vandenplas O, Suojalehto H, Cullinan P. Diagnosing occupational asthma. Clin Exp Allergy 2017;47:6-18.
  18. Barber CM, Cullinan P, Feary J, Fishwick D, Hoyle J, Mainman H, et al. British Thoracic Society Clinical Statement on occupational asthma. Thorax 2022;77:433-42.
  19. Lau A, Tarlo SM. Update on the management of occupational asthma and work-exacerbated asthma. Allergy Asthma Immunol Res 2019;11:188-200.