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Occupational asthma and rhinitis caused by multiple herbal agents in a pharmacist
1Department of Allergy and Clinical Immunology, Ajou University School of Medicine, Suwon, Korea.
Summary
Occupational asthma and rhinitis were caused by six herbal agents in a pharmacist. Three herbs induced IgE-mediated responses, while another caused direct histamine release, leading to bronchoconstriction.
Area of Science:
- Allergy and Immunology
- Occupational Health
- Pharmacology
Background:
- Herbal agents are widely used in Asia, with rare reports of occupational allergies.
- This study investigates a pharmacist experiencing occupational asthma and rhinitis due to exposure to six specific herb materials.
Observation:
- The patient exhibited strong positive skin prick test responses to Chunkung, Banha, Sanyak, Kangwhal, Danggui, and Kunkang extracts.
- Bronchoprovocation tests indicated an early asthmatic response to Danggui extract.
- Specific IgE antibodies were detected for Chunkung, Banha, and Sanyak, but not for Kangwhal, Danggui, or Kunkang.
Findings:
- SDS-PAGE and IgE immunoblotting identified specific IgE-binding components in Chunkung, Banha, and Sanyak extracts.
- Basophil histamine release tests showed Danggui extract induced greater histamine release in the patient compared to a healthy control.
- Chunkung, Banha, and Sanyak appear to induce IgE-mediated bronchoconstriction.
Implications:
- Danggui may cause bronchoconstriction through direct histamine release from mast cells in sensitized individuals.
- This case highlights the potential for occupational respiratory allergies from specific herbal agents.
- Understanding the immunological mechanisms is crucial for managing and preventing occupational hypersensitivity to herbal products.