Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0392680 (shortness of breath)
 5,217 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Seventeen out of thirty-three workers who have been exposed to airborne papain at their place of work regularly developed asthmatic symptoms such as shortness of breath, wheezing, coughing, sneezing, rhinorrhea and conjunctival irritation upon contact with this proteolytic enzyme. Investigations by RAST, skin test and bronchial provocation test proved IgE-mediated hypersensitivity to papain in fourteen symptomatic workers. Ten of these were in a screening investigation involving twenty-nine of the thirty-three workers; i.e. the incidence of IgE-mediated sensitization was 34.5% of this group. Bronchial provocation of as little as 0.001--0.5 mg of papain was shown to elicit immediate or dual asthmatic reactions in all eight tested workers with RAST values greater than 3 u/ml. On the other hand, inhalation of 0.5 mg of papain did not cause any remarkable change in non-exposed asthmatics. Occupation-related blood-stained nasal secretions and/or cutaneous flare reactions in all four heavily-exposed papain workers, of whom three had negative skin test and RAST results, suggest a direct effect of the proteolytically active enzyme on human tissue. There was a significant elevation (P less than 0.001) of serum trypsin inhibitory capacity in papain workers which seems to depend on the degree of exposure. No significant differences between symptomatic and asymptomatic workers in alpha 1-antitrypsin (Pi) phenotype subtypes were found.
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PMID:Clinical symptoms and results of skin test, RAST and bronchial provocation test in thirty-three papain workers: evidence for strong immunogenic potency and clinically relevant 'proteolytic effects of airborne papain'. 703 63

A 58-year-old man went to his physician with complaints of midepigastric pain, flatulence, belching, and shortness of breath. During a physical examination, the patient was in no acute distress. The patient underwent an ultrasound examination, which revealed cholelithiasis, a laparoscopic cholecystectomy, which revealed chronic gallbladder disease, and esophagogastroduodenoscopy, which revealed gastritis, a hiatal hernia, and a phytobezoar. To treat the bezoar, the patient was given Adolph's Meat Tenderizer 1 teaspoonful in 8 oz of water before each meal for 7 days. This product contains papain, a proteolytic enzyme, that is thought to cleave protein linkages within bezoars. The patient's symptoms resolved with no adverse events reported, and follow-up endoscopy revealed resolution of the phytobezoar. Although a few other agents are used to treat phytobezoars, little clinical data exist on their safety and effectiveness. Adolph's Meat Tenderizer appears to be a safe and effective treatment for patients with a phytobezoar.
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PMID:Resolution of a phytobezoar with Aldoph's Meat Tenderizer. 1725 20

A 52-year-old man, a current smoker (40 pack years) with unremarkable medical history, was referred to the outpatient pneumology clinic because of recent complaints of shortness of breath and wheezing, which were relieved by inhaled bronchodilators. Serial peak expiratory flow (PEF) measurements showed a clear rise in PEF during the weekend and a fall on the evening after the first day of the week. It also showed that evening values were always lower than morning values. During a holiday, a slow but persistent rise in PEF was observed. Such a pattern is highly suggestive for occupational asthma. A detailed description of his job revealed papain exposure. After a positive specific IgE and skin prick test for papain the diagnosis of papain induced asthma was made. When an allergy and serious lung function impairment is proven against products encountered in a work related situation, not improving after maximal preventive measures, the patient is advised to change job.
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PMID:Papain-induced asthma: a man with dyspnea from dawn till dust. 2396 24

Papain is a proteolytic enzyme which is widely used in food industry, pharmaceuticals, and cosmetics. Occupational and non-occupational papain allergies have previously been documented; however, there are limited publications about papain allergy with its relative fruit allergy. Here, we present a case of occupational, IgE-mediated papain allergy with kiwi fruit and fig fruit allergy. A 53-year-old man suffered from rhinitis for several years, with the onset of his symptoms coinciding with the time he started to work at a sausage processing plant where papain is often used as a meat tenderizer. He began to experience symptoms of chest tightness, shortness of breath and wheezing shortly after starting work 5 years ago. Furthermore, he experienced several episodes of oral itching, and tongue and oropharyngeal angioedema after injestion of kiwi fruit and fig fruit. The patient had a lifelong history of allergic conjunctivitis, allergic rhinitis, and childhood asthma. Specific IgE was positive to kiwi fruit, papain and chymopapain (2.95 kUA/L, >100 kUA/L, and 95.0 kUA/L, respectively). Similar bands at 10-15 kDa in blotting with papain and kiwi fruit extracts were found. This patient showed a potential association between papain allergy and sensitization to kiwi fruit. We also reviewed 13 patients with papain allergy published in the literature, with 85% (11/13) of the patients sensitized through the respiratory tract, and 40% (4/11) having atopy. Further studies should focus on the determination of cross-reactive allergens between papain and its fruit relatives, and the prevalence of food allergy in patients with papain allergy should be investigated in a relatively large cohort.
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PMID:Papain Induced Occupational Asthma with Kiwi and Fig Allergy. 2673 11