Toshiya Kino

Allergy to insects in Japan: III. High frequency of IgE antibody responses to insects (moth, butterfly, caddis fly, and chironomid) in patients with bronchial asthma and immunochemical quantitation of the insect-related airborne particles smaller than 10 μm in diameter☆

After recognizing that moth, butterfly, caddis fly, and chironomid were the insects predominantly found in our environment, reaginic sensitivities to these insects in patients with asthma were investigated with extracts of silkworm wing for the detection of moth and/or butterfly allergy, caddis fly wing for caddis fly allergy, and chironomid whole body for chironomid allergy. At least 50% of 56 randomly selected patients with asthma had positive intracutaneous reactions to these insect extracts, and at least 80% of the skin reaction positive patients had specific IgE antibodies. An immunochemical assay of these insect-related aeroallergens in the dust collected 18.6 m above ground revealed the presence in the air of insect-related particles less than 10 microns in diameter with two peaks a year, one in the spring (silkworm wing, 3.18 ng protein equivalent to that of the crude extract per cubic meter of air; caddis fly wing, 3.08 ng/m3; and chironomid whole body, 5.21 ng/m3) and one in the autumn (silkworm wing, 8.24 ng/m3; caddis fly wing, 4.74 ng/m3; and chironomid whole body, 18.19 ng/m3). Although we have no idea whether or not such peak values are enough to cause asthmatic symptoms, seasonal fluctuations of specific IgE antibodies to these insects appeared to be similar to those of atmospheric insect allergens measured by this method. These findings suggest that insects are widespread and common inhalant allergens.

Alpha‐fetoprotein and human chorionic gonadotropin‐producing lung cancer

A 73‐year‐old man had primary lung cancer that produced both alphafetoprotein (AFP) and human chorionic gonadotropin (HCG). The preoperative serum AFP level of 1039 ng/ml decreased to the normal range 8 weeks after surgery. The preoperative serum HCG level of 11 mIU/ml, which temporarily decreased to the normal range after operation, soon increased thereafter. The serum HCG level decreased, however, to the normal range after postoperative mediastinal radiation therapy. During relapse, only the serum HCG level increased gradually to 26,000 mIU/ml 7 weeks before his death. The lung cancer was classified histologically as poorly differentiated adenocarcinoma. Immunohistochemically, AFP was detected in the mononuclear tumor cells of the primary tumor in the lung, and HCG was found in the giant cells of the subcarinal metastatic lymph node. The concanavalin A non‐reactive fraction rate for AFP was 81.3%, and appeared to differ from those of hepatocellular carcinoma and yolk sac tumor. Cancer 59:227–232, 1987.

Allergy to insects in Japan: I. The reaginic sensitivity to moth and butterfly in patients with bronchial asthma

A high frequency of reaginic sensitivity to moth and butterfly extracts was shown in 66 randomly selected patients with bronchial asthma. Thirty-seven (56.1%) of these 66 patients showed positive intradermal reactions to 1:10,000 dilution of moth allergen and 34 patients (51.5%) had positive reactions to 1:10,000 butterfly allergen. These positive responses were as frequent as those to Candida or house dust which are recognized as the most commonly reactive allergens in Japan. Radioallergosorbent tests (RAST) showed that 20 of 66 sera were positive to moth and 22 sera were positive to butterfly, which indicates that about 1/3 of patients with bronchial asthma had specific IgE to moth and butterfly in the sera. Bronchial testing revealed that skin reaction-positive and RAST-positive patients were commonly provoked by specific allergen but skin reaction-negative and RAST-negative patients were not. These data suggest that moth and butterfly emanations could cause allergy-induced bronchial asthma in certain patients. Since moths are attracted readily to artificial lights and often fly into houses, these insects are especially suspect as important factors in extrinsic asthma.

Allergy to insects in Japan. II. The reaginic sensitivity to silkworm moth in patients with bronchial asthma.

Abstract The reaginic sensitivity to extract of silkworm moth wing (silkworm wing) and to that of silkworm moth body (silkworm body) was studied in 50 randomly selected asthmatic patients. Although none of the patients had occupational exposure to silkworm moth, 34 (68.0%) of these patients showed positive reaction to silkworm wing while 28 (56.0%) patients reacted positively to silkworm body following intracutaneous injection(s). Radioallergosorbent tests (RASTs) showed that 22 (44.0%) of 50 sera were positive to silkworm wing and 11 (22.0%) sera were positive to silkworm body, with less uptake of 125 I-labeled anti-immunoglobulin E in silkworm body than in silkworm wing RASTs. This suggests that wing components are more common sensitizers than body components. A fairly high percentage of these 50 patients also showed reaginic sensitivity to the extracts of butterfly, moth, and mite. That is, 26 (52%), 22 (44%), and 32 (64%) of these 50 patients had butterfly-, moth-, and mite-specific IgE antibodies in their sera, respectively. The seasonal variations of silkworm wing-, butterfly-, moth-, and mite-specific IgE antibodies and mutual RAST inhibition tests revealed that IgE antibodies to silkworm wing, butterfly, and moth were identical but all differed from the antibody to mite. These data suggest that the extract of silkworm wing is useful for the detection of allergy to moth and butterfly and also provides a suitable allergen source of unlimited quantity and consistent quality. It was also shown that the allergy to Lepidoptera (moths and butterflies) in Japan is found as commonly as that to mite, but without cross-reactivity between them.

Hypersensitivity pneumonitis in a soy sauce brewer caused byAspergillus oryzae

In Japan the traditional diet includes soy sauce (shoyu) and bean paste (miso). The protease produced by Aspergillus oryzae has been used for many years to ferment soybeans into amino acids. Some cases of bronchial asthma (BA) and allergic bronchopulmonary aspergillosis (ABPA) have been reported as an occupational allergic disease among brewers exposed to A. oryzae by sprinkling A. oryzae on boiled soybeans.im3 However, hypersensitivity pneumonitis (HP) has not been reported in brewers until now. We present the first case of HP caused by A. otyzae.