Seven bakers with respiratory symptoms were evaluated by skin tests. RAST assay for specific IgE antibodies to rye and wheat, inhalation challenge with methacholine for the determination of non-specific bronchial reactivity, and bronchoprovocation with rye and wheat extracts for the determinalion of antigen-specific bronchial reactivity. An immediate asthmatic response lo antigen challenge was observed in four subjects and all of them had a high level of flour-specific igE antibodies. The serum RAST values provided a more accurate predictive value than the degree of cutaneous sensitivity determined by skin testing with respect to the bronchial response to antigenic challenge. Among those who reacted positively to antigenic bronehoprovocation. a much lower antigen dose was required to elicit a positive reaction if the subject also had an increased degree of non-specific bronchial reactivity. An elevated RAST value was not found in thirty-eight asymptomatic bakers or in ten asthmatics who had no occupational exposure to fiour. Thus, baker's asthma appears to be a form of allergic asthma to cereal fiours mediated by specific IgE antibodies. Both the level of serum IgE antibodies and the degree of non-specific bronchial reactivity are important factors which may influence a baker's bronchial response upon inhalation of cereal flours. Introduetion
The respiratory parameters of 392 white male pulpmill workers were measured by standardized procedures and compared with those of 310 white male rail yard workers. The pulpmill workers complained more frequently of wheezing and chest tightness and missed work more commonly because of chest illness as compared with the rail yard workers. Significant airflow obstruction was noted in nonsmokers who worked in the bleach plant, and it was most striking in the younger members of this group. The principal environmental contaminant in this area was chlorine at levels generally below current permissible concentrations. Members of the maintenance group--especially older members--demonstrated significantly lower forced vital capacity compared to the rail yard workers.
Summary Specific IgE antibodies were demonstrated in the sera of six bakers with respiratory symptoms of asthma or bronchitis by the radioallergosorbent (RAST) assay. The specificity of the antibodies was found to be directed not only against the common flours (rye, wheat) used in the bakeries but also against triticale, barley, oat. corn and rice in some of the bakers. By using the RAST inhibition tests, cross‐antigenicity was shown to exist between different cereal grains. The degree of cross‐reactivity closely paralleled their taxonomic relationship and appeared to be in the following order of decreasing closeness: wheat, triticale, rye. barley, oat. rice and corn. The allergenic activity in the rye and wheat extracts was found to be distributed among various fractions of different molecular weights.
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