Background: A pharmaceutical industry worker was exposed to dust of gum arabic in the tablet coating plant and complained of work-related shortness of breath, chest tightness, runny nose, itching and redness of the eyes. This case was investigated for allergy to gum arabic and compared with a control group. The aim of the study was to identify the IgE-binding components responsible for the work-related symptoms. Methods: Skin prick tests (SPTs)and specific IgE (sIgE) measurements with environmental and occupational allergens, spirometry and a specific bronchial challenge with gum arabic were performed. One hundred and nineteen control subjects underwent SPT with gum arabic and 43 controls were tested for sIgE. Crossreactivity between gum arabic and horse radish peroxidase was investigated by IgE CAP inhibition. A combined procedure of immunoblotting and periodate treatment was applied to identify the epitope nature of gum arabic. Results: Allergy to gum arabic was shown by SPT, presence of sIgE and a positive bronchial challenge with gum arabic. Sensitization to gum arabic was demonstrated by SPT or sIgE in 7 and 5 controls, respectively. The results of inhibition with horse radish peroxidase, immunoblotting and periodate treatment suggest that gum arabic sIgE of the patient and 1 SPT-positive control subject were directed to the polypeptide chains of gum arabic. In contrast, gum arabic sIgE of the other controls reacted to carbohydrate components. Conclusions: Sensitization to gum arabic carbohydrate structures occurs casually in atopic patients with pollen sensitization without obvious exposure to gum arabic. This study suggests that allergy to gum arabic is mediated preferentially by IgE antibodies directed to polypeptide chains of gum arabic.

1.
Goodrum LJ, Patel A, Leykam JF, Kieliszewski MJ: Gum arabic glycoprotein contains glycomodules of both extensin and arabinogalactan-glycoproteins. Phytochemistry 2000;54:99–106.
2.
Spielmann AD, Baldwin HS: Atopy to acacia (gum arabic). J Am Med Assoc 1933;101:444.
3.
King JH: Asthma and allergic rhinitis due to gum arabic in off-set spray. J Med 1941;2:119.
4.
Bohner CB, Sheldon JM, Trenis JW: Sensitivity to gum acacia, with a report of ten cases of asthma in printers. J Allergy 1941;12:290–294.
5.
Sprague PH: Bronchial asthma due to sensitivity to gum acacia. Canad Med Ass J 1942;47:253.
6.
Fowler PB: Printers’ asthma. Lancet 1952;ii:755–757.
7.
Ilchyshyn A, Smith AG: Gum arabic sensitivity associated with epidemic hysteria dermatologica. Contact Dermatitis 1985;13:282–283.
8.
Fötisch K, Fah J, Wüthrich B, Altmann F, Haustein D, Vieths S: IgE antibodies specific for carbohydrates in a patient allergic to gum arabic (Acacia senegal). Allergy 1998;53:1043–1051.
9.
Iacovacci P, Pini C, Afferni C, Barletta B, Tinghino R, Schinina E, Federico R, Mari A, Di Felice G: A monoclonal antibody specific for a carbohydrate epitope recognizes an IgE-binding determinant shared by taxonomically unrelated allergenic pollens. Clin Exp Allergy 2001;31:458–465.
10.
Ebo DG, Hagendorens MM, Bridts CH, De Clerck LS, Stevens WJ: Sensitization to cross-reactive carbohydrate determinants and the ubiquitous protein profilin: mimickers of allergy. Clin Exp Allergy 2004;34:137–144.
11.
van der Veen MJ, van Ree R, Aalberse RC, Akkerdaas J, Koopelman SJ, Jansen HM, van der Zee JS: Poor biologic activity of cross-reactive IgE directed to carbohydrate determinants of glycoproteins. J Allergy Clin Immunol 1997;100:327–334.
12.
Aalberse RC: Clinical relevance of carbohydrate allergen epitopes. Allergy 1998;53:54–57.
13.
Pepys J: Skin tests in diagnosis; in Gell PGH, Lachmann PJ (eds): Clinical Aspects of Immunology. Oxford, Blackwell Scientific Publishers Ltd, 1995.
14.
Standardization of spirometry – 1994 update. Am J Respir Crit Care Med 1995;152:1107–1136.
15.
Quanjer PH, Tammeling GJ, Cotes JE, Pedersen OF, Peslin R, Yernault JC: Lung volumes and forced ventilatory flows. Report Working Party Standardization of Lung Function Tests, European Community for Steel and Coal. Official Statement of the European Respiratory Society. Eur Respir J Suppl 1993;6:5–40.
16.
Baur X, Huber H, Degens PO, Allmers H, Ammon J: Relation between occupational asthma case history, bronchial methacholine challenge, and specific challenge test in patients with suspected occupational asthma. Am J Ind Med 1998;33:114–122.
17.
Bradford MM: A rapid and sensitive method for the quantitation of microgram quantities of protein utilizing the principle of protein-dye binding. Anal Biochem 1976;72:248–254.
18.
Laemmli UK: Cleavage of structural proteins during the assembly of the head of bacteriophage T4. Nature 1970;227:680–685.
19.
Sander I, Flagge A, Merget R, Halder TM, Meyer HE, Baur X: Identification of wheat flour allergens by means of two-dimensional immunoblotting. J Allergy Clin Immunol 2001;107:907–913.
20.
Vieths S, Mayer M, Baumgart M: Food allergy: specific binding of IgE antibodies from plant food sensitized individuals to carbohydrate epitopes. Food Agric Immunol 1994;6:453–463.
21.
Mari A: IgE to cross-reactive carbohydrate determinants: analysis of the distribution and appraisal of the in vivo and in vitro reactivity. Int Arch Allergy Immunol 2002;129:286–295.
22.
Wilson IBH, Harthill JE, Mullin NP, Ashford DA, Altmann F: Core alpha 1,3-fucose is a key part of the epitope recognized by antibodies reacting against plant N-linked oligosaccharides and is present in a wide variety of plant extracts. Glycobiology 1998;8:651–661.
23.
van Ree R, Cabanes-Macheteau M, Akkerdaas J, Milazzo JP, Loutelier-Bourhis C, Rayon C, Villalba M, Koppelman S, Aalberse R, Rodriguez R, Faye L, Lerouge P: Beta(1,2)-xylose and alpha(1,3)-fucose residues have a strong contribution in IgE binding to plant glycoallergens. J Biol Chem 2000;275:11451–11458.
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