Cellulase allergy and challenge tests with cellulase using immunologic assessment

Objectives This study attempted to develop and evaluate a challenge test fo r diagnosing allergic asthma and rhinitis due to cellulase. Methods Challenge tests in a chamber were performed on 11 persons sensitize d to cellulase. Four different enzyme-lactose mixtures, starting from a 0.0 3% mixture, were used. The enzyme dust was generated from a dry enzyme prep aration mixed with lactose powder, using pressurized air. The cellulase con centration in the air was measured with an immunochemical method. Results Nasal. pharyngeal, or bronchial symptoms could be elicited at cellu lase air concentrations of 1 to 1300 mu g/m(3). A dose-response relationshi p was observed for symptoms in repeated challenge tests with increasing con centrations of cellulase. For 2 persons skin symptoms could also be reprodu ced. Conclusion The challenge method proved to be a practical means with which t o simulate conditions at the worksite and elicit the specific respiratory s ymptoms of the patients.