Cereal alpha-amylase inhibitors cause occupational sensitization in the wood industry

Background Cereal flours are used in the wood industry to improve the quali ty of the glues necessary to produce veneer panels. However, up to now, no cases of sensitization to cereal flour in this kind of industry have been r eported. Cereal alpha-amylase inhibitors have been previously described as important occupational allergens responsible for baker's asthma. Objective To determine whether cereal allergens were responsible for occupa tional sensitization in three wood industry workers. Methods The diagnosis was made by clinical questionnaire, physical examinat ion, skin-prick tests to cereals, CAP and immunoblotting. Results The three patients had positive skin prick tests and CAP to cereal flours. An IgE-immunoblotting revealed that only low molecular weight prote ins (under 20 kDa) were detected by the three sera. These main IgE-binding proteins were members of the alpha-amylase inhibitor family which have been described as one of the group of main allergenic proteins in rye, barley a nd wheat. The three patients changed their workplace and remain asymptomati c in spite of the fact that they are still in contact with different woods and exposed to high concentrations of wood dust and other chemicals such as formaldehyde. Conclusion Proteins from cereal flours are important occupational allergens in some wood industries.