Baker's asthma due to xylanase and cellulase without sensitization to alpha-amylase and only weak sensitization to flour

Background: The baking additives xylanase and cellulase were described as b aking additives causing baker's asthma. It is not known whether monosensiti zation to these enzymes may occur. Methods: We present a case report of a b aker with work-related asthma evaluated by skin prick test (SPT), enzyme-li nked immunosorbent assay (EAST), immunoblot, EAST and immunoblot inhibition , and specific bronchial challenge. Fungal xylanase and alpha -amylase were measured by two-site enzyme immunoassays in products used by the patient a t work. Results: Allergy to xylanase and cellulase was demonstrated by SPT, EAST, immunoblot and specific bronchial challenge (for xylanase only). No sensitization to alpha -amylase could be demonstrated, but there was a weak flour allergy as documented by EAST and immunoblot and a positive occupati onal-type challenge with high concentrations of rye flour. Four baking addi tives contained measurable amounts of fungal alpha -amylase and xylanase, w ithout a correlation between these enzymes. Conclusions: We conclude that o ccupational asthma due to the baking additives xylanase and cellulase may o ccur without concomitant sensitization to a-amylase and only weak sensitiza tion to flour. Copyright (C) 2001 S. Karger AG, Basel.