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Cellulase allergy and challenge tests with cellulase using immunologic assessment
M Vanhanen1, T Tuomi, O Tupasela
1Finnish Institute of Occupational Health, Helsinki. markku.vanhanen@occuphealth.fi
Objectives:
This study attempted to develop and evaluate a challenge test for diagnosing allergic asthma and rhinitis due to cellulase.
Methods:
Challenge tests in a chamber were performed on 11 persons sensitized to cellulase. Four different enzyme-lactose mixtures, starting from a 0.03% mixture, were used. The enzyme dust was generated from a dry enzyme preparation mixed with lactose powder, using pressurized air. The cellulase concentration in the air was measured with an immunochemical method.
Results:
Nasal, pharyngeal, or bronchial symptoms could be elicited at cellulase air concentrations of 1 to 1300 microg/m3. A dose-response relationship was observed for symptoms in repeated challenge tests with increasing concentrations of cellulase. For 2 persons skin symptoms could also be reproduced.
Conclusion:
The challenge method proved to be a practical means with which to simulate conditions at the worksite and elicit the specific respiratory symptoms of the patients.
