title: Papain-induced occupational rhinoconjunctivitis and asthma - A case report.
abstract: This report presents a case of occupational asthma, rhinitis and conjunctivitis to papain in a 50-year-old herbs and spices packer, with documented increased eosinophilia in induced sputum and in the nasal lavage fluids after a specific inhalation challenge test (SICT) and specific nasal challenge test (SNCT) with this enzyme. Immunoglobulin E-mediated (IgE) sensitization to papain was confirmed by positive results of a skin prick test with specific solution. Specific inhalation and nasal challenge tests demonstrated a direct and significant link between the exposure to this protease and the allergic response from the respiratory system. Additionally, the SNCT induced a severe reaction of the conjunctivae and a significant increase in the count of eosinophils in tears, despite the lack of direct contact of the allergen with the conjunctiva.
authors.affiliation: Nofer Institute of Occupational Medicine / Instytut Medycyny Pracy im. prof. J. Nofera, Łódź, Poland (Department of Occupational Diseases and Environmental Health / Klinika Chorób Zawodowych i Zdrowia Środowiskowego). tymoszuk@imp.lodz.pl.
authors.forename: Diana
authors.initials: D
authors.lastname: Tymoszuk
authors.affiliation: Nofer Institute of Occupational Medicine / Instytut Medycyny Pracy im. prof. J. Nofera, Łódź, Poland (Department of Occupational Diseases and Environmental Health / Klinika Chorób Zawodowych i Zdrowia Środowiskowego). martaz@imp.lodz.pl.
authors.forename: Marta
authors.initials: M
authors.lastname: Wiszniewska
authors.affiliation: Nofer Institute of Occupational Medicine / Instytut Medycyny Pracy im. prof. J. Nofera, Łódź, Poland (Department of Occupational Diseases and Environmental Health / Klinika Chorób Zawodowych i Zdrowia Środowiskowego). jolantaw@imp.lodz.pl.
authors.forename: Jolanta
authors.initials: J
authors.lastname: Walusiak-Skorupa
mesh_terms: D000485:Allergens / Q000009:adverse effects*; D001249:Asthma / Q000139:chemically induced* / Q000175:diagnosis; D003233:Conjunctivitis, Allergic / Q000139:chemically induced* / Q000175:diagnosis; D005260:Female; D006801:Humans; D007136:Immunoglobulins / Q000032:analysis*; D008875:Middle Aged; D009784:Occupational Diseases / Q000139:chemically induced* / Q000175:diagnosis; D010206:Papain / Q000009:adverse effects*; D011044:Poland; D065631:Rhinitis, Allergic / Q000139:chemically induced* / Q000175:diagnosis; D012882:Skin Tests
chemical_list: D000485:Allergens; D007136:Immunoglobulins; D010206:Papain
keywords: asthma; conjunctivitis; enzyme; occupational allergy; papain; rhinitis