Asthma caused by cochineal dust


Asthma caused by natural dyes

 
Occupations
  • Biologist
  • Cosmetics industry
  • Dyeing industry
  • Food industry
  • Pharmaceutical industry
  • Textile industry
Agents
Carminic acid, Cochineal, Monascus rubber.
 
Incidence
Incidence: very low. Atopy does not play an important role. The mechanism is possibly IgE-dependent.
 
Conditions
Sensitization occurs during the fabrication of the colouring agent prepared from the dried Coccus cactus flower and the female cochineal sensitization to Monascus rubber occurs during preparation of asian foods containing colourants (red or yellow). The colouration is derived from the action of the fungus Monascus rubber on Chinese "red rice".
 
Symptoms
Classical asthma during working hours, as well as rhinitis and conjunctivitis. Ingestion of foodstuffs containing the colouring agent such as red coloured drinks may trigger the illness , and 2 cases of anaphylactic reactions following ingestion of carmin have been reported.
 
Diagnostic methods
Skin prick tests using the whole dried insect, made into a solution in PBS may be performed, as well as using, carminic acid and cochineal powder.
 
A specific assay of IgE for RAST has been suggested.
 
A bronchial provocation test (in hospital) with the suspect allergen is definitive.
 
For "red rice" and Monascus rubber, skin prick tests have been performed but these are not commercially available. Specific IgEs are not measured routinely, but in the case of carmin, a major allergen has been identified using SDS PAGE (Phadia). Three major allergens have been described, these being carmin, cochineal and carminic acid.

References

  1. J. Allergy Clin. Immunol. 2000,105:1241 Vandenplas O. et al.
  2. Ann. Allergy 1997,79:415 Baldwin J.L. et al.
  3. Ann. Allergy 1995,74:427 Beauduoin E. et al.
  4. J. Allergy Clin. Immunol. 1994, 93:44
  5. J. Allergy Clin. Immunol. 1991,87:643
  6. Arch. Mal. Prof. 1987,48,7:569
  7. Rev. Fr. Mal. Resp. 1983,11:486
  8. Clin. Allergy 1979,9:185

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