title: Occupational rhinoconjunctivitis and bronchial asthma due to Acalypha wilkesiana allergy.
abstract: BACKGROUND
  Acalypha wilkesiana, or copperleaf, is a plant of the Euphorbiaceae family. Although it is widely known as an outdoor ornamental plant, no cases of A. wilkesiana allergy have been reported to date.
  
  
  OBJECTIVE
  To describe a patient with occupational respiratory allergy to A. wilkesiana.
  
  
  METHODS
  Extracts from A. wilkesiana leaves and flowers were used for skin prick testing, specific conjunctival and bronchial challenge tests, and in vitro studies. These studies range from A. wilkesiana specific IgE determination to sodium dodecyl sulfate-polyacrylamide gel electrophoresis immunodetection of A. wilkesiana protein bands in patient serum samples and immunoblot inhibition by preincubation with Salsola kali and Chenopodium album pollen extracts.
  
  
  RESULTS
  Our patient had positive skin prick test reactions to A. wilkesiana leaf and flower extracts; negative reactions were found in a control group of 20 atopic patients. On immunodetection of A. wilkesiana extracts in patient serum samples, as many as 9 different IgE-binding proteins, with apparent molecular weights of 16 to 86 kDa, were revealed. Preincubation with S. kali and C. album pollen extracts completely inhibited IgE binding to the A. wilkesiana extract. Specific bronchial challenge resulted in a spirometric 30% decline in forced expiratory volume in 1 second with respect to baseline 1 minute after 1:100 (vol/vol) A. wilkesiana extract solution inhalation; 2 atopic controls had negative bronchial challenge test results.
  
  
  CONCLUSIONS
  Acalypha wilkesiana is a new etiologic agent for IgE-mediated occupational respiratory allergy.
authors.affiliation: Sección de Alergia, Hospital Universitario de Gran Canaria Dr Negrín, Las Palmas de Gran Canaria, Spain.
authors.forename: Eva
authors.initials: E
authors.lastname: Pérez
authors.forename: Carlos
authors.initials: C
authors.lastname: Blanco
authors.forename: Borja
authors.initials: B
authors.lastname: Bartolomé
authors.forename: Nancy
authors.initials: N
authors.lastname: Ortega
authors.forename: Rodolfo
authors.initials: R
authors.lastname: Castillo
authors.forename: Antonio G
authors.initials: AG
authors.lastname: Dumpiérrez
authors.forename: Lourdes
authors.initials: L
authors.lastname: Almeida
authors.forename: Teresa
authors.initials: T
authors.lastname: Carrillo
mesh_terms: D000328:Adult; D000395:Air Pollutants, Occupational / Q000009:adverse effects / Q000276:immunology; D001249:Asthma / Q000209:etiology* / Q000276:immunology; D001985:Bronchial Provocation Tests; D003233:Conjunctivitis, Allergic / Q000209:etiology* / Q000276:immunology; D004591:Electrophoresis, Polyacrylamide Gel; D019665:Euphorbiaceae / Q000276:immunology*; D051639:Gardening; D006801:Humans; D007124:Immunoenzyme Techniques; D007073:Immunoglobulin E / Q000097:blood; D008297:Male; D009784:Occupational Diseases / Q000209:etiology* / Q000276:immunology; D016273:Occupational Exposure / Q000009:adverse effects; D012221:Rhinitis, Allergic, Perennial / Q000209:etiology* / Q000276:immunology; D012882:Skin Tests
chemical_list: D000395:Air Pollutants, Occupational; D007073:Immunoglobulin E