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Shiitake mushroom (Lentinus edodes): a poorly known allergen in Western countries responsible for severe work-related
Valerio Pravettoni1, Laura Primavesi, Marta Piantanida
1Clinical Allergy and Immunology Unit, Foundation IRCCS Ca'Granda Ospedale Maggiore Policlinico, Milan, Italy.
Objectives:
The aim of this study was to investigate the IgE-mediated pathogenesis of severe asthma presented by a patient only after handling shiitake (Lentinus edodes) mushrooms (SM).
Material And Methods:
Skin tests were performed using in-house extracts from mushrooms that the patient usually handled, i.e., shiitake, porcini, oyster and black fungus mushroom varieties. Specific IgE to champignons and various molds were determined. Sodium dodecyl sulfate polyacrylamide gel electrophoresis (SDS-PAGE) immunoblotting was performed to detect IgE-binding components. Four negative controls were included in the study.
Results:
Skin prick tests performed with in-house mushroom extracts from varieties other than shiitake were completely negative, in contrast to the positive test obtained for shiitake mushrooms. Serum specific IgE levels for common molds and champignons were all negative. SDS-PAGE revealed many protein bands in the four mushroom extracts. Immunoblotting using the patient's serum showed allergenic bands at about 15 and 24 kDa exclusively for SM that were not shared with negative controls. Another faint band was detectable at approximately 37 kDa for SM and porcini varieties.
Conclusions:
Here, we present the first European case of SM-induced occupational asthma, a disease more frequently occurring in Asia. Asthma attacks stopped when the patient avoided contact with shiitake mushrooms. No skin reactions and no IgE-binding proteins by immunoblotting were detectable with the other mushrooms tested. The positive skin test with shiitake mushrooms and IgE-binding components in the shiitake extract confirmed the IgE-mediated etiology of the reaction.
Insights
This study identifies shiitake mushroom (Lentinus edodes) as a cause of occupational asthma. Allergy to shiitake mushrooms was confirmed via skin tests and IgE-binding components, with symptoms resolving upon avoidance.
Area of Science:
- Allergy and Immunology
- Occupational Health
- Mycology
Background:
- Occupational asthma can be triggered by various environmental exposures.
- Mushroom handling is a potential, though less common, occupational hazard.
- Investigating specific allergens is crucial for managing occupational respiratory diseases.
Observation:
- A patient developed severe asthma symptoms exclusively after handling shiitake mushrooms (Lentinus edodes).
- Skin prick tests showed a positive reaction only to shiitake mushroom extract.
- Specific IgE tests for common molds and champignons were negative.
Findings:
- Immunoblotting identified specific IgE-binding components in shiitake mushroom extract at approximately 15 kDa and 24 kDa.
- These allergenic components were unique to shiitake mushrooms and not found in other tested varieties.
- Avoidance of shiitake mushroom handling led to the cessation of asthma attacks.
Implications:
- This case highlights shiitake mushrooms as a novel allergen causing occupational asthma in Europe.
- Early identification and avoidance of the causative agent are key to managing shiitake mushroom-induced asthma.
- Further research into mushroom-derived allergens may reveal more occupational health risks.
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