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Acid anhydrides

Reactive chemicals which can cause asthma and other respiratory disease (hypersensitivity pneumonias and pulmonary hemorrage) in exposed workers and population. Phthalic anhydride has been known to cause asthma and allergic rhinitis since 1939 [1]. In 1976, specific IgE antibody to phthalic anhydride human serum albumin was demonstrated. It was demonstrated that IgE antibody can be directed against the phthalic group acting as a hapten or against new antigenic determinants that arise when phthalic anhydride combines with human serum albumin. Phthalic anhydride can induce immediate and late asthmatic reaction. Trimellitic anhydride (TMA) can cause classic immediate-onset asthma (rhinitis mediated by IgE antibody).

This syndrome requires a latent period of exposure before the onset of symptoms; however, once sensitized, symptoms will occur immediately with exposure. The syndrome has been found to be mediated by IgE antibody directed against a variety of trimellityl (TM) - modified human protein conjugates. The IgE antibody is directed not only againstTM acting as a hapten, but against new antigenic determinants that arise when TMA couples with self-proteins. Dykiewitz and coworkers have been able to passively transfer a IgE mediated, immediate onset asthma by the aerosolization of human serum containing IgE to TM-HSA to the airway of a rhesus monkey with subsequent challenge by TM-HSA. This established the pathogenic importance of IgE antibody to TMA workers with asthma/rhinitis.

Hexahydrophthalic anhydride (industrial exposure to electrical transformer production) can induce IgE mediated and late asthma/rhinitis reaction. Himic anhydride (Fire retardant production industry) can induce IgE mediated immediate and late asthma/rhinitis reaction. Tetrachlorophthalic anhydride (epoxy resin production) can induce IgE mediated early and late asthma/rhinitis response[2]

Contact urticaria may be more common than previously believed. Prick tests with HSA-acid anhydride conjugates were a useful test method for detecting immediate sensitization to acid anhydrides. The determination of the specific IgE gave almost equal results. The open application test often had to be performed with the undiluted anhydride product to obtain a positive test result[3]

References

1. Dykewicz MS, Patterson R, Harris KE. Induction of antigen-specific bronchial reactivity to trimellityl-human serum albumin by passive transfer of serum from humans to rhesus monkeys. J Lab Clin Med. 1988 Apr;111(4):459-65.

2. Zeiss, C.R.: Reactive chemicals in industrial asthma. In Postgraduate Education Course Syllabus. A.A.A.I. 46th Annual Meeting, Baltimore, Maryland, March 23-28, 1990.

3. Helaskoski E, Kuuliala O, Aalto-Korte K. Occupational contact urticaria caused by cyclic acid anhydrides. Contact Dermatitis. 2009 Apr;60(4):214-21.