Mollusk Shell Hypersensitivity Pneumonitis

Orriols, Ramón; Manresa, Josep-Maria; Aliaga, J.L.; Codina, Rosa; Rodrigo, María-José; Morell, Ferrán

doi:10.7326/0003-4819-113-1-80

Cited by 22 publications

(5 citation statements)

References 6 publications

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“…Chemokines and cytokines also seem to play a role in macrophage activation, granuloma formation, and fibrosis. Individual susceptibility Khoor et al, 17 Morell et al, 28 Fjallbrant et al, 56 Mukhopadhyay, 57 Cormier, 58 Katzenstein and Askin, 79 Barrera et al, 80 Emanuel et al, 81 Nakajima et al, 82 Utsugi et al, 83 Yoo et al, 84 Orriols et al, 85 Jordan and Gey, 86 and Marcer et al 87 is poorly understood. Studies suggest a genetic link to the major histocompatibility complex because certain major histocompatibility complex haplotypes increase a person's susceptibility to developing HP.…”

Section: Pathogenesismentioning

confidence: 99%

Hypersensitivity Pneumonitis A Perspective From Members of the Pulmonary Pathology Society

Miller

Allen

Barrios

et al. 2018

Archives of Pathology & Laboratory Medicine

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- As a pathologist, it is important to consider hypersensitivity pneumonitis when examining lung specimens because it is often clinically and pathologically overlooked. Recognizing the often subtle findings and correlating them with the patient's history or suggesting a thorough clinical investigation of potential exposures can be of help in identifying the underlying condition so that the patient can be appropriately managed.

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Section: Pathogenesismentioning

confidence: 99%

Hypersensitivity Pneumonitis A Perspective From Members of the Pulmonary Pathology Society

Miller

Allen

Barrios

et al. 2018

Archives of Pathology & Laboratory Medicine

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“…Snail hypersensitivity was firstly reported by Palma Carlos et al [4]in 1985, but hypersensitivity to various species belonging to different classes of Mollusca phylum has been reported for several times [5, 6, 7, 8, 9, 10, 11, 12, 13, 14]. Other studies have already indicated a connection between snails and inhalant allergens, such as house dust mites [15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25, 26, 27].…”

Section: Introductionmentioning

confidence: 99%

The <i>Helix aspersa</i> (Brown Garden Snail) Allergen Repertoire

Martins¹,

Peltre²,

Faro³

et al. 2005

Int Arch Allergy Immunol

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Background: Ingestion of snails can induce strong asthmatic or anaphylactic responses, mainly in house-dust-mite-sensitized patients. The aim of this study was to identify the Helix aspersa (Hel a), Theba pisana (The p) and Otala lactea (Ota l) allergens and the extent of their cross-reactivity with the Dermatophagoides pteronyssinus (Der p) mite. Patients and Methods: In 60 atopicpatients, skin prick tests (SPT) to snail and D. pteronyssinus, total and specific IgE, specific IgE immunoblots, RAST and immunoblot inhibition assays were performed. Results: Mean total IgE was >1,000 kU/l. Mean specific IgE (class 6 for Der p and class 2 for Hel a) SPT were positive in 44 patients for snail and in 56 for mite. Isoelectric focusing (IEF) and SDS-PAGE followed by immunoblotting of H. aspersa extract enabled the identification of 27 and 20 allergens, respectively. Myosin heavy chains from snails (molecular weight >208 kDa) disclosed two major allergens. Hel a and Der p RAST were strongly inhibited by their homologous extracts, with Hel a RAST being inhibited by the Der p extract to a much greater extent (72.6%) than the inverse (5.6%). A complete inhibition of the immunoblots by their homologous extract was obtained. However, Hel a extract did not inhibit Der p IEF separated recognition. On the other hand, mite extract extensively inhibited snail immunoblots from both IEF and SDS-PAGE separations. Immune detection on chicken, pig, rabbit, cow and horse myosins did not reveal any IgE cross recognition with snail. Conclusions: In most cases of snail allergy, mite appeared to be the sensitizing agent. Nevertheless, snails may also be able to induce sensitization by themselves. This hypothesis is supported by the finding of specific IgE to Hel a in 2 patients who did not show specific IgE to Der p, and one of them was suffering from asthma after snail ingestion.

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“…Following the discovery, in 1988, of MSHP in two subjects [4], the workers and management agreed to an investigation of the environmental conditions in the factory, as well as an evaluation of the health status of the workforce.…”

Section: Methodsmentioning

confidence: 99%

“…We have previously reported two cases of HP caused by the inhalation of dust in a factory where nacre-buttons were manufactured from sea-snail shells [4]. Following the identification of these two cases, a cross-sectional study was undertaken.…”

mentioning

confidence: 99%

High prevalence of mollusc shell hypersensitivity pneumonitis in nacre factory workers

Orriols¹,

Aliaga²,

Antó³

et al. 1997

Eur Respir J

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Following the discovery of hypersensitivity pneumonitis caused by the inhalation of mollusc shell dust in two workers from a nacre-button factory, the health status of 26 workers employed in sawing mollusc shells was investigated. The evaluation included the administration of two questionnaires and radiological, functional and immunological assessments of all workers at the outset and 1 year later, when hygienic and therapeutic measures had been taken. Six workers, in whom specific inhalation challenge test was positive, were diagnosed with mollusc shell hypersensitivity pneumonitis, thus yielding a prevalence of 23%. Evidence of diffuse lung disease and systemic symptoms was found in these patients. Nonspecific bronchial hyperreactivity was also found more frequently in patients with mollusc shell hypersensitivity pneumonitis. Specific immunoglobulin G (IgG) level and specific skin testing failed to differentiate patients with mollusc shell hypersensitivity pneumonitis from other exposed workers; whereas, nonspecific skin testing, which was impaired in the patients, did differentiate. Bronchoalveolar lavage and transbronchial biopsy performed in patients with mollusc shell hypersensitivity pneumonitis were consistent with the disease. Removal from an environment containing mollusc shell dust was followed by regression of clinical, radiological and functional changes. The clinical picture of the 20 workers who did not present mollusc shell hypersensitivity pneumonitis remained unchanged, but functional decline was observed despite improvement in the environmental conditions of the factory. This report describes the first series of patients with mollusc shell hypersensitivity pneumonitis studied, and underlines the importance of careful follow-up of workers occupationally-exposed to mollusc shell dust.

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Mollusk Shell Hypersensitivity Pneumonitis

Cited by 22 publications

References 6 publications

Hypersensitivity Pneumonitis A Perspective From Members of the Pulmonary Pathology Society

Hypersensitivity Pneumonitis A Perspective From Members of the Pulmonary Pathology Society

The <i>Helix aspersa</i> (Brown Garden Snail) Allergen Repertoire

High prevalence of mollusc shell hypersensitivity pneumonitis in nacre factory workers

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