Chicken serum proteins

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Code: e219
Latin name: Gallus domesticus
Source material: Serum
Family: Phasianidae
Common names: Chicken, Hen, Cock, Cockerel
Direct or indirect contact with bird allergens may cause sensitisation. Bird allergens may be major components of house dust.

Allergen Exposure

Geographical distribution
The Chicken (which probably originated as a jungle fowl in southwestern Asia) was one of the earliest animals to be domesticated, possibly as early as 4000 BC. They were popular in China and among the Greeks and Romans, and are now distributed virtually throughout the world. They form by far the most important class of poultry, raised principally for their meat and eggs. The current trend is towards specialisation, with some Chicken raisers producing hatching eggs, others eggs for table use, and others raising Chickens to market as meat. Many distinct Chicken breeds have been combined through selective breeding into a few relatively standard types that are notably efficient converters of feed into meat or eggs. The dominant meat Chicken today is a cross between the fast-growing female White Plymouth Rock Chicken and the deep-breasted male Cornish Chicken. The predominant egg-laying type in the United States today is the White Leghorn Chicken.
 
Environment
Breeders as well as workers in the Chicken food processing industry are examples of groups with high risk of exposure. Other means of exposure are pillows made with Chicken feathers, arts and crafts that include Chicken feathers, and wing feathers used in fletching arrows. A few breeds of Chicken are raised chiefly for their ornamental appearance or as pets.
 
Allergens
Allergen exposure may occur from contact with Chicken feather, Chicken serum or Chicken droppings. Chicken serum may contain, similarly to Pigeon serum, the main source of clean soluble antigens. The major antigens are gamma-globulin proteins, e.g., IgA and IgA fragments. Serum also contains the major protein albumin, which is cross-reactive with albumin from other avian species, and with other serum proteins.
 
Gal d 5 (1) serum albumin (alpha-livetin) Mw 69 kD
 
Gal d 5 is a partially heat-labile allergen; IgE reactivity to Chicken albumin was reduced by 88% after heating at 90 degrees C for 30 min. This allergen can become airborne and was found in house dust (1).
 
Well-defined major allergenic bands with molecular mass of 20-30 kDa and 67 kDa have been detected and identified in IgE immunoblots with feather extracts as well as with serum proteins of Budgerigar, Parrot, Pigeon, Canary, and Hen. Inhalable feather dust was shown to contain several allergenic components, which cross-react with serum allergens/antigens of the same as well as of other bird species (2).

Potential Cross-Reactivity

As noted above, inhalable feather dust contains several allergenic components, which cross-react with serum allergens/antigens of the same as well as of other bird species (2).
 
Cross-reactivity between Chicken and other phylogenetically related bird species may be expected, and in Chicken-allergic patients, significant IgE titers to Parrot, Budgerigar, Chicken, Pigeon, Goose and Duck have been reported (3-4), even in patients without known exposure (2).
 
In Bird-Egg Syndrome, cross-reactivity to Hen's egg occurs (3-4). IgE from patients with Bird-Egg Syndrome was shown to recognise a 70 kDa protein in egg yolk and some major allergens in bird feather extract. Chicken serum albumin is the same protein as that designated alpha-livetin in egg yolk. The sera of patients with Bird-Egg Syndrome, pooled with Budgerigar or Hen feather extract and egg yolk extract, led to complete blocking of IgE binding to allergens in egg yolk and bird feather extract. However, IgE from patients with egg white allergy did not react with allergens in egg yolk and bird feather extract, despite strong IgE binding to egg white allergens. These results indicate common epitopes of Budgerigar and Hen feather and egg yolk alpha-livetin, and researchers suggest that alpha-livetin leads to cross-sensitisation and consequently to Bird-Egg Syndrome (5-7).
This adult type of egg intolerance must be distinguished from the common egg white allergy of atopic children.
 
ELISA inhibition demonstrated only partial cross-reactivity between Chicken albumin and conalbumin (1).

Clinical Experience

IgE mediated reactions
Asthma, allergic rhinitis and allergic conjunctivitis may result following exposure to Chicken feathers, epithelial cells or droppings. The allergic manifestations may present as Bird Fancier´s Asthma and as so-called Bird-Egg Syndrome with symptoms such as rhinitis, urticaria and angioedema (3), and also gastro-intestinal problems (4). Contact with Chicken has been reported as a common cause of occupational asthma and allergic rhinitis (8-10).
 
Contact with Chicken is a significant cause of sensitisation in poultry workers. Asthma prevalence in farmers has been found by means of a questionnaire survey to be higher for Horse breeders/groomers, Pig farmers, poultry farmers, and those working with Oats. Up to 17.4% of poultry farmers reported symptoms of asthma (11). In an avian slaughterhouse, workers may be exposed to Chicken feathers, as well as to serum and droppings allergens (12). Sensitisation in these individuals may also occur to Chicken feed (13).
 
Chicken serum albumin (alpha-livetin) has been implicated as the causative allergen of Bird-Egg Syndrome. Specific bronchial challenge to Chicken albumin elicited early asthmatic responses in 6 patients with asthma. An oral challenge with Chicken albumin provoked digestive and systemic allergic symptoms in the 2 patients challenged, thus demonstrating that Chicken serum albumin may cause both respiratory and food-allergy symptoms in patients with Bird-Egg Syndrome (1).
 
Extrinsic allergic alveolitis, also known as hypersensitivity pneumonitis, Bird Fancier's Lung and Farmer's Lung, is a disease of inflammation of the lung parenchyma in the terminal bronchioles and alveoli. Symptoms may start soon after exposure to bird allergens or after many years, and may include breathlessness, cough, occasional chills, and fever. Death may also result.
 
The disease occurs after exposure to organic dust, especially after close contact with Chickens (13-14) or other birds such as Pigeons, Budgerigars, Parrots, Canaries, Parakeets, Cockatiels, Doves or Finches. Exposure results in the development of immunoglobulin antibodies including IgE (2) , IgM (15), IgA and various IgG subclasses (16-18). The antibodies may be found in the sera and saliva of patients (19).
 
The allergenic proteins may be found in bird serum, droppings, and feathers. Contact may result from handling birds, cleaning their cages, or exposure to the organic dust drifting from where the birds reside.
 
Diagnosis is based on a characteristic clinical picture and a typical x-ray pattern, accompanied by the presence of specific IgG antibodies (20).
 
The measurement of specific IgG using IgG tracer technology has been shown to be a sensitive and specific assay for the routine diagnostic testing of extrinsic allergic alveolitis (21).
 
A case of allergy to Chicken intestines has been reported (22). (Whether the reaction was due to meat allergen or serum allergens was not determined.)
Other reactions

Contact urticaria from handling meat and fowl has been reported (23).
 
Compiled by Dr Harris Steinman, harris@zingsolutions.com

References

  1. Quirce S, Maranon F, Umpierrez A, de las Heras M, Fernandez-Caldas E, Sastre J. Chicken serum albumin (Gal d 5*) is a partially heat-labile inhalant and food allergen implicated in the bird-egg syndrome. Allergy 2001 Aug;56(8):754-62
  2. Tauer-Reich I, Fruhmann G, Czuppon AB, Baur X. Allergens causing bird fancier's asthma. Allergy 1994;49(6):448-53
  3. de Maat-Bleeker F, van Dijk AG, Berrens L. Allergy to egg yolk possibly induced by sensitization to bird serum antigens. Ann Allergy 1985;54(3):245-8.
  4. van Toorenenbergen AW, Huijskes-Heins MI, Gerth van Wijk R. Different pattern of IgE binding to chicken egg yolk between patients with inhalant allergy to birds and food-allergic children. Int Arch Allergy Immunol 1994;104(2):199-203.
  5. Szepfalusi Z, Ebner C, Pandjaitan R, Orlicek F, Scheiner O, Boltz-Nitulescu G, Kraft D, Ebner H. Egg yolk alpha-livetin (chicken serum albumin) is a cross-reactive allergen in the bird-egg syndrome. J Allergy Clin Immunol 1994;93(5):932-42
  6. Mandallaz MM, de Weck AL, Dahinden CA. Bird-egg syndrome. Cross-reactivity between bird antigens and egg-yolk livetins in IgE-mediated hypersensitivity. Int Arch Allergy Appl Immunol 1988;87(2):143-50.
  7. de Blay F, Hoyet C, Candolfi E, Thierry R, Pauli G. Identification of alpha livetin as a cross reacting allergen in a bird- egg syndrome. Allergy Proc 1994;15(2):77-8.
  8. Danuser B. Respiratory health risks in working with chickens. [German] Pneumologie 2000;54(1):37-42
  9. Bar-Sela S, Teichtahl H, Lutsky I. Occupational asthma in poultry workers. J Allergy Clin Immunol 1984;73(2):271-5
  10. Bessot JC, Blaumeiser M, Kopferschmitt MC, Pauli G. Occupational asthma in an agricultural setting. [French] Rev Mal Respir 1996;13(3):205-15
  11. Kimbell-Dunn M, Bradshaw L, Slater T, Erkinjuntti-Pekkanen R, Fishwick D, Pearce N. Asthma and allergy in New Zealand farmers. Am J Ind Med 1999;35(1):51-7
  12. Chacin B, Corzo G, Montiel M. Lung function in workers in a chicken slaughterhouse in the city of Maracaibo, Venezuela. [Spanish] Invest Clin 1997;38(4):171-90
  13. Rees D, Nelson G, Kielkowski D, Wasserfall C, da Costa A. Respiratory health and immunological profile of poultry workers. S Afr Med J 1998;88(9):1110-7
  14. Korn DS, Florman AL, Gribetz I. Recurrent pneumonitis with hypersensitivity pneumonitis to hen litter. JAMA 1968;205:114
  15. Martinez-Cordero E, Aquilar Leon DE, Retana VN. IgM antiavian antibodies in sera from patients with pigeon breeder’s disease. J Clin Lab Anal 2000:14(5):201-7
  16. Yoshizawa Y, Miyashita Y, Inoue T, Sumi Y, Miyazaki Y, Sato T, et al. Sequential evaluation of clinical and immunological findings in hypersensitivity pneumonitis: serial subclass distribution of antibodies. Clin immunol Immunopathol 1994;73(3):330-7
  17. Todd A, Coan R, Allen A. Pigeon breeder’s lung; IgG subclasses to pigeon Intestinal mucin and IgA antigens. Clin Exp Immunol 1993;92(3):494-9
  18. Baldwin CI, Todd A, Bourke SJ, Allen A, Calvert JE. IgG subclass responses to pigeon intestinal mucin are related to development of pigeon fancier’s lung. Clin Exp Allergy 1998;28(3):349-57
  19. McSharry C, Macleod K, McGregor S, Speekenbrink AB, Sriram S, Boyd F, et al. Mucosal immunity in extrinsic allergic alveolitis: salivary immunoglobulins and antibody against inhaled avian antigens among pigeon breeders. Clin Exp Allergy 1999;29(7):957-64
  20. Rodriguez de Castro F, Carrillo T, Castillo R, Blanco C, Diaz F, Cuevas M. Relationship between characteristics of exposure to pigeon antigens. Clinical manifestations and humoral immune response. Chest 1993;103(4):1059-63
  21. Lopata A, Schinkel M, Andersson C, Johansson G, van Hage-Hamsten M. Quantification of IgG antibodies to bird antigens in the diagnosis of extrinsic allergic alveolitis (EAA) using the UniCAP system. (Manuscript in preparation)
  22. Danielou M. A case of allergy to chicken intestines. [French] Allerg Immunol (Paris) 1995;27(1):20, 23
  23. Fisher AA. Contact urticaria from handling meats and fowl. Cutis 1982;30(6):726, 729

As in all diagnostic testing, the diagnosis is made by the physican based on both test results and the patient history.