Allergic reactions to wood dust allergens are rare, and only few in vitro diagnostic tools and information about relevant allergens are available. To differentiate between protein-based allergy and probably clinically silent glycogenic sensitization, it is helpful to characterize the relevant protein allergens and specify IgE binding. The current case report deals with the occupational softwood allergy of a carpenter exposed to different wood dusts. Skin tests and IgE tests against wood were performed with specifically tailored ImmunoCAPs and cross-reactive carbohydrate determinants. Potential allergens were identified by IgE blots and tandem mass spectrometry. The clinical relevance was verified by challenge tests. Specific IgE to softwood (spruce, pine and larch wood), beech wood, natural rubber latex (NRL) and horseradish peroxidase (HRP) were detected. Allergens in spruce wood, the dominant allergen source, were identified as peroxidases. Softwood were the strongest inhibitors. HRP reduced IgE binding to softwood to <50%, indicating predominantly proteinogenic epitopes, whereas IgE binding to NRL and beech wood was reduced to >50% by HRP, indicating predominantly glycogenic IgE epitopes. Skin and challenge tests underlined that softwoods were the source of sensitization. For the polysensitized patient, a clinically relevant softwood allergy was diagnosed, not only by challenge tests but also with specifically tailored in vitro tools.

Keywords:
Occupational allergy, Softwood, Spruce (Picea abies), In vitro diagnostics, Allergen identification
1.
Perez-Rios M, Ruano-Ravina A, Etminan M, Takkouche B: A meta-analysis on wood dust exposure and risk of asthma. Allergy 2010;65:467–473.
2.
Algranti E, Mendonca EMC, Ali SA, Kokron CM, Raile V: Occupational asthma caused by Ipe (Tabebuia spp) dust. J Invest Allergol Clin Immunol 2005;15:81–83.
3.
Eire MA, Pineda F, Losada SV, de la Cuesta CG, Villalva MM: Occupational rhinitis and asthma due to cedroarana (Cedrelinga catenaeformis Ducke) wood dust allergy. J Invest Allergol Clin Immunol 2006;16:385–387.
4.
Ferrer A, Maranon F, Casanovas M, Fernandez-Caldas E: Asthma from inhalation of Triplochiton scleroxylon (samba) wood dust. J Invest Allergol Clin Immunol 2011;11:199–203.
5.
Kespohl S, Sander I, Merget R, Petersen A, Meyer HE, Sickmann A, Brüning T, Raulf-Heimsoth M: Identification of an obeche (Triplochiton scleroxylon) wood allergen as a class I chitinase. Allergy 2005;60:808–814.
6.
Skovsted TA, Schlunssen V, Schaumburg I, Wang P, Staun-olsen P, Skov PS: Only few workers exposed to wood dust are detected with specific IgE against pine wood. Allergy 2003;58:772–779.
7.
Kespohl S, Schluenssen V, Jacobsen G, Schaumburg I, Maryska S, Meurer U, Brüning T, Sigsgaard T, Raulf-Heimsoth M: Impact of cross-reactive carbohydrate determinants on wood dust sensitization. Clin Exp Allergy 2010;40:1099–1106.
8.
Quirce S, Salcedo G: The role of cross-reactive carbohydrate determinants in the diagnosis of occupational allergy. Clin Exp Allergy 2010;40:962–964.
9.
Gonsior E, Henzgen M, Jörres RA, Kroidle FR, Merget R, Riffelmann FW, Wallenstein G: German Society of Allergology and Clinical Immunology and German Society for Immunology. Guidelines for conducting provocation tests with allergens. Pneumologie 2002;56:187–198.
10.
Raulf-Heimsoth M, Rihs HP, Rozynek P, Cremer R, Gaspar A, Pires G, Yeang HY, Arif SAM, Hamilton RG, Sander I, Lundberg M, Brüning T: Quantitative analysis of immunoglobulin E reactivity profiles in patients allergic or sensitized to natural rubber latex (Hevea brasiliensis). Clin Exp Allergy 2007;37:1657–1667.
11.
Chen ZP, Posch A, Lohaus C, Raulf-Heimsoth M, Meyer HE, Baur X: Isolation and identification of hevein as a major IgE-binding polypeptide in hevea latex. J Allergy Clin Immunol 1997;99:402–409.
12.
Jehmlich N, Schmidt F, Hartwich M, von Bergen M, Richnow HH, Vogt C: Incorporation of carbon and nitrogen atoms into proteins measured by protein-based stable isotope probing (protein-SIP). Rapid Commun Mass Spectrom 2008;22:2889–2897.
13.
Mann B, Madera M, Sheng QH, Tang HX, Mechref Y, Novotny MV: ProteinQuant Suite: a bundle of automated software tools for label-free quantitative proteomics. Rapid Commun Mass Spectrom 2008;22:3823–3834.
14.
Venturini M, Gastaminza G, Kespohl S, Bernedo N, Garmendia M, Raulf-Heimsoth M, Munoz D, Ansotequi A: Cross-reactivity between obeche wood (Triplochiton scleroxylon) and natural rubber latex. Allergy 2004;59:225–228.
15.
Marjamaa K, Kukkola EM, Fagerstedt KV: The role of xylem class III peroxidases in lignification. J Exp Botany 2009;60:367–376.
16.
Weangsripanaval T, Nomura N, Moriyama T, Ohta N, Ogawa T: Identification of suberization-associated anionic peroxidase as a possible allergenic protein from tomato. Biosci Biotechnol Biochem 2003;67:1299–1304.
17.
Kimoto M, Suzuki M, Komiyama N, Kunimoto A, Yamashita H, Hiemori M, Takahashi K, Tsuji H: Isolation and molecular cloning of a major wheat allergen, Tri a Bd 27K. Biosci Biotechnol Biochem 2009;73:85–92.
18.
Giroux F, Gazaryan I, Cano Y, Moroz N, Malandain H: Horseradish peroxidase cross-reactivity with other plant peroxidases. Allergy 2010;65(suppl 92):103.
© 2011 S. Karger AG, Basel
2011
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
You do not currently have access to this content.