Dictionary of Allergies .. Baker’s allergy

Baker's allergy

Baker's asthma is a frequent IgE-mediated occupational disorder mainly provoked by inhalation of cereal flour. IgE- mediated allergy to flour is a well-known occupational health risk for bakers. Reported symptoms often affect the airways and present as rhinitis and asthma. The skin is also exposed to flour, and IgE-mediated contact urticaria has been reported. The main occupational skin disease is hand eczema, and, according to registers on occupational injuries, bakers have an increased risk of hand eczema. An attempt by crossed immunoelectrophoresis to isolate the allergens in wheat flour causing the sensitization in occupational respiratory disease showed as many as 40 antigens. Wheat lipid transfer protein (LTP) Tri a 14 is a major allergen associated with wheat allergy.. Recombinant Tri a 14 is a potential tool for baker's asthma diagnosis, based on its physicochemical and immunological similarity with its natural counterpart.

Wheat Tri a 14 shows a high thermal stability and resistance to gastrointestinal digestion [1] Salt-soluble proteins from wheat flour have been described as main allergens associated with both baker's asthma and food allergy. However, most studies have used raw flour as starting material, thus not considering potential changes in allergenic properties induced by the heat treatment and other industrial processing to produce wheat-derived foodstuffs [2]. There is also cross-reactivity between wheat and rye flour, and between these and barley, oats, maize and rice. Several studies have shown that the responsible allergens come from wheat and rye flour, soybean, baking additives and, in a few cases storage mites. A potential association between respiratory allergy to cereal flour and allergy to kiwifruit has been disclosed. Cross-reactive carbohydrate determinants and thiol-proteaseshomologous to Act d 1 are responsible for wheat-kiwi crossreactivity in some patients [3]. Some patients have demonstrated antibodies to the baking enzyme α-amylase from Aspergillus oryzae.Þ α-amylase. Usually, the diagnosis of baker's asthma is based on inhalation challenge tests with flours. Challenge tests with flours may be avoided in strongly sensitized bakers [4].

References
Palacin A, Varela J, Quirce S, Del Pozo V, Tordesillas L, Barranco P, Fernandez-Nieto M, Sastre J, Diaz-Perales A, Salcedo G. Recombinant lipid transfer protein Tri a 14: a novel heat and proteolytic resistant tool for the diagnosis of baker's asthma. Clin Exp Allergy. 2009 May 26.
2. de Gregorio M, Armentia A, Díaz-Perales A, Palacín A, Dueñas-Laita A, Martín B, Salcedo G, Sánchez-Monge R.Salt-soluble proteins from wheat-derived foodstuffs show lower allergenic potency than those from raw flour. J Agric Food Chem. 2009 Apr 22;57(8):3325-30
3. Palacin A, Quirce S, Sánchez-Monge R, Fernández-Nieto M, Varela J, Sastre J, Salcedo G. Allergy to kiwi in patients with baker's asthma: identification of potential cross-reactive allergens. Ann Allergy Asthma Immunol. 2008 Aug;101(2):200-5.
4. van Kampen V, Rabstein S, Sander I, Merget R, Brüning T, Broding HC, Keller C, Müsken H, Overlack A, Schultze-Werninghaus G, Walusiak J, Raulf-Heimsoth M. Prediction of challenge test results by flour-specific IgE and skin prick test in symptomatic bakers. Allergy. 2008 Jul;63(7):897-902