Clinical and immunological responses to enzymes of Bacillus subtilis in factory workers and consumers

Abstract

Summary Skin (prick) and serological tests were made with enzyme preparations of Bacillus subtilis in exposed factory workers and potential ‘consumers’. Prick tests with these materials at 10 mg/ml gave positive immediate reactions in twenty‐six out of sixty‐five factory workers. Eighteen of the factory workers were classified as atopic because of allergy to common allergens and fifteen gave positive reactions to the enzymes compared with eleven out of forty‐seven non‐atopic workers. A group of eleven of the factory workers had consistent ventilatory impairment on repeated examination; all were prick test positive and seven were atopic, and four non‐atopic. Of 2500 patients attending for investigation of respiratory allergy, 40% were highly atopic, 40% moderately atopic and 20% non‐atopic. 80% were consumers of biological detergents. Only two gave weak, not clinically relevant, prick test reactions to the enzyme preparations. In radioallergosorbent (RAST) tests for specific IgE antibody against the enzyme preparations, counts in the present investigation of 600/30 sec or more corresponded best with prick test positivity, such values being found in twelve of the fifteen prick test positive atopics and in eight of the eleven workers with ventilatory impairment. Comparison of the RAST counts on sera from cord blood and from the patients who included non, light and heavy consumers showed increasingly higher specific IgE counts in these groups, although these counts were almost all below the level of 600/30 sec, which corresponded with skin test reactions and clinical relevance. Radioimmunodiffusion (RID) and radioimmunoelectrophoretic (RIEP) tests with enzyme preparations gave positive reactions only in the factory workers, of whom forty‐three had IgG and twenty‐one IgA antibody, none having only IgE antibody.

Allergy and Dermatophytes

“…True subtilisins derived from bacteria are among the best characterized of the subtilase enzyme family. Subtilisin Carlsberg (alcalase) produced by Bacillus licheniformis is frequently used in detergent formulations, and allergic respiratory reactions to alcalase have been reported among exposed factory workers (12,88). More recently, a novel subtilisin homologue with IgE antibody binding properties derived from the fungus Penicillium citrinum was identified (110).…”

Allergic Rhinitis and its Impact on Asthma (ARIA) 2008*

“…However, the enzymes originating from bacteria and used in the industrial environment (e.g. detergents) can cause asthma or rhinitis with a high prevalence (515,516).…”

“…Many other high-molecular-weight allergens can induce IgE-mediated rhinitis and asthma: agricultural mites (339-342, 347, 348, 350, 351), coffee beans (598), proteolytic enzymes (515,599,600), other enzymes (601,602), insect dust (577); plants and flowers (603,604).…”

Respiratory Allergenicity of Detergent Enzymes in the Guinea Pig Intratracheal Test: Association with Sensitization of Occupationally Exposed Individuals

“…Since that time, more than 25 years of detergent industry experience has provided much information on understanding and managing the effects to humans from exposure to enzyme materials (Pepys et al, 1973(Pepys et al, , 1985Weill et al, 1974;Zetterstrom, 1977). Control of occupational exposure to respirable enzyme dusts has greatly reduced the incidence of immediate hypersensitivity responses to enzymes and the occurrence of enzyme-associated occupational asthma among detergent workers is now a rare event (Juniper and Roberts, 1984;Flood et al, 1985;Sarlo et al, 1990).…”

“…Control of occupational exposure to respirable enzyme dusts has greatly reduced the incidence of immediate hypersensitivity responses to enzymes and the occurrence of enzyme-associated occupational asthma among detergent workers is now a rare event (Juniper and Roberts, 1984;Flood et al, 1985;Sarlo et al, 1990). In addition, a survey of several thousand consumers has shown that the use of enzymes in laundry products is safe for consumer use (Pepys et al, 1973). Based upon much of these historical data, the American Conference of Governmental and Industrial Hygienists (ACGIH) developed a threshold limit value (TLV) in the workplace for subtilisin A (Alcalase) at 60 ng protein/m 3 (ACGIH, 1990).…”