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Updated: Aug 11, 2026
07:03
Bronchoalveolar Lavage of Murine Lungs to Analyze Inflammatory Cell Infiltration
Published on: May 4, 2017
Extrinsic allergic alveolitis from a proteolytic enzyme
1Ernest S. Bazley Asthma and Allergic Diseases Center, Department of Medicine of Northwestern Memorial Hopsital and Northwestern University Medical School, Chicago, IL, USA. a-tripathi@nmw.edu
Summary
Exposure to subtilisins, proteolytic enzymes in detergents, can cause extrinsic allergic alveolitis. This case highlights respiratory illness linked to a liquid cleaner containing these enzymes, emphasizing occupational health risks.
Area of Science:
- Occupational Medicine
- Pulmonary Immunology
- Enzyme Toxicology
Background:
- Subtilisins are bacterial proteolytic enzymes commonly found in household and industrial detergents.
- These high-molecular-weight antigens have been previously associated with respiratory conditions like allergic rhinitis and asthma.
Observation:
- A 53-year-old woman presented with respiratory symptoms directly related to her work environment involving a liquid cleaner.
- Symptoms improved when she was away from the workplace, suggesting an occupational trigger.
Findings:
- Computed tomography revealed alveolar and interstitial infiltrates, progressing to scarring.
- Pulmonary function tests indicated a restrictive pattern with impaired diffusion capacity.
- Bronchoalveolar lavage showed lymphocytosis, and serological tests detected precipitating antibodies to subtilisin.
Implications:
- This case confirms extrinsic allergic alveolitis caused by subtilisin in a liquid cleaner.
- Highlights the importance of identifying occupational allergens in respiratory diseases.
- Underscores the need for protective measures in environments where workers are exposed to enzyme-containing products.
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