Occupational respiratory allergy to lettuce in lettuce farmers

Reina Sekiya, Tatsuya Nagano, Tatsuya Moriyama, Toshiyuki Kishi, Haruko Shinke, Erika Yano, Naoya Hatano, Masahiro Katsurada, Kanoko Umezawa, Naoko Katsurada, Suya Hori, Nobuko Hazeki, Atsushi Fukunaga, Masatsugu Yamamoto, Hiroshi Kamiryo, Masakazu Shinohara, Kazuyuki Kobayashi, Yoshikazu Kotani, Yoshihiro Nishimura

Research output: Contribution to journalArticlepeer-review

1 Citation (Scopus)


Background: Lettuce-associated respiratory allergy has never been reported before. The aim of this study was to clarify the clinical condition of lettuce-associated respiratory allergy and to identify the lettuce antigen which induces allergic symptoms. Methods: We distributed questionnaires to 1168 lettuce farmers and performed medical examinations in those who exhibited respiratory symptoms related to occupational exposure to lettuce. We analysed specific IgE-binding proteins in the sera of patients through immunoblotting analysis and determined molecular characterization of the IgE-binding bands using liquid chromatography-mass spectrometry. Results: A total of 932 farmers (80%) responded to the questionnaire. Of those, 7% exhibited lettuce-associated respiratory symptoms, during harvesting and packaging. Thirteen patients were diagnosed with allergy to lettuce and agreed to undergo further examinations. The percentage of activated basophils in these patients was significantly higher compared with that reported in negative controls (P <.05). Lettuce-specific IgE (ImmunoCAP®) and skin prick testing was positive in 46% and 62% of patients, respectively. Notably, occupational lettuce-allergic asthma was detected in one patient through specific bronchial provocation testing. The IgE-binding bands recognized in the sera of >50% of patients were identified as epidermis-specific secreted glycoprotein EP1-like (51 kDa). Conclusion: The present analysis identified a novel lettuce allergen. This allergen may have clinically useful applications, such as specific IgE testing and allergen-specific immunotherapy.

Original languageEnglish
Pages (from-to)932-941
Number of pages10
JournalClinical and Experimental Allergy
Issue number8
Publication statusPublished - Aug 1 2020
Externally publishedYes


  • IgE
  • immunologic tests
  • lettuce
  • occupational allergies

ASJC Scopus subject areas

  • Immunology and Allergy
  • Immunology


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