Occupational Rhinitis Induced by Capsaicin

다국어 초록 (Multilingual Abstract)

Capsaicin is the spice component of red pepper. It can be easily inhaled, inducing a reproducible cough and provokes a secretory response from the human nasal mucosa. To date, there has been no report of occupational rhinitis (OR) caused by capsaicin. We report the case of a 44-year-old female mill worker who developed occupational rhinitis after 4 years of exposure to capsaicin. She developed nasal congestion, rhinorrhea, and itchy nose,which were all aggravated upon exposure at the workplace. The patient had negative responses to all common inhalant allergens, including capsaicin,by skin prick tests. The nasal provocation test with capsaicin showed that the nasal symptom score and eosinophil count increased 10 minutes after the provocation and decreased after 1 to 3 hours; no significant response was noted to house dust mite allergen. The patient’s work-related rhinitis improved 1 month after she relocated and started pharmacological treatment. To our knowledge, this is the first case of OR caused by capsaicin exposure in the workplace. We provide evidence suggesting that OR may be mediated by a non-immunological mechanism.

참고문헌 (Reference)

1 Thong BY, "Update on the management of antibiotic allergy" 2 : 77-86, 2010

2 Wolf G, "Treatment of nonspecific hyper-reflectory rhinopathy (vasomotor rhinitis) with capsaicin" 74 : 289-293, 1995

3 Dicpinigaitis PV., "Short- and long-term reproducibility of capsaicin cough challenge testing" 16 : 61-65, 2003

4 Didier A, "Neurogenic inflammation, vascular permeability, and mast cells. Capsaicin desensitization fails to influence IgE-anti-DNP induced vascular permeability in rat airways" 141 : 398-406, 1990

5 Barnes PJ, "Neurogenic inflammation and asthma" 29 : 165-180, 1992

6 Kim D, "Neural aspects of allergic rhinitis" 15 : 268-273, 2007

7 Roche N, "Nasal response to capsaicin in patients with allergic rhinitis and in healthy volunteers: effect of colchicine" 151 : 1151-1158, 1995

8 Philip G, "Inflammatory cellular influx follows capsaicin nasal challenge" 153 : 1222-1229, 1996

9 Sachs B, "Fluoroquinolone-associated anaphylaxis in spontaneous adverse drug reaction reports in Germany: differences in reporting rates between individual fluoroquinolones and occurrence after first-ever use" 29 : 1087-1100, 2006

10 Siracusa A, "Epidemiology of occupational rhinitis: prevalence, aetiology and determinants" 30 : 1519-1534, 2000

11 Bascom R, "Effect of intranasal capsaicin on symptoms and mediator release" 259 : 1323-1327, 1991

12 Moscato G, "EAACI position paper on occupational rhinitis" 10 : 16-, 2009

13 Sanico AM, "Dose-dependent effects of capsaicin nasal challenge: in vivo evidence of human airway neurogenic inflammation" 100 : 632-641, 1997

14 Seitz CS, "Diagnostic testing in suspected fluoroquinolone hypersensitivity" 39 : 1738-1745, 2009

15 Fujimoto S, "Characterization of capsaicin-induced, capsazepine- insensitive relaxation of ileal smooth muscle of rats" 487 : 175-182, 2004

16 Fujimoto S, "Capsaicin-induced, capsazepine-insensitive relaxation of the guinea-pig ileum" 530 : 144-151, 2006

17 Stjärne P, "Capsaicin desensitization of the nasal mucosa reduces symptoms upon allergen challenge in patients with allergic rhinitis" 118 : 235-239, 1998