Asthma caused by bromelin inhalation

Area of Science:

• Allergology
• Pulmonology
• Enzymology

Background:

• Bromelain is a proteolytic enzyme derived from pineapple, used for its anti-inflammatory properties in various medicinal applications.
• Occupational asthma is a significant concern, often triggered by inhaled allergens in the workplace or through medicinal exposure.

Observation:

• Two cases of bronchial asthma are presented, linked to the inhalation of bromelain.
• Patients exhibited immediate hypersensitivity reactions upon exposure to bromelain.

Findings:

• Skin prick tests with bromelain extract yielded positive results in both cases.
• Inhalation challenge tests demonstrated immediate asthmatic responses.
• These immediate reactions were effectively inhibited by sodium cromoglycate.
• Corticosteroids did not prevent the immediate asthmatic reactions induced by bromelain.

Implications:

• This highlights bromelain as a potential occupational or medicinal allergen causing asthma.
• The findings suggest a role for mast cell stabilization (e.g., with sodium cromoglycate) in managing acute bromelain-induced asthma.
• Further investigation into the immunological mechanisms of bromelain hypersensitivity is warranted.