J Korean Med Sci.  2008 Apr;23(2):232-235. 10.3346/jkms.2008.23.2.232.

Korean Ginseng-Induced Occupational Asthma and Determination of IgE Binding Components

• Kim KM
• Kwon HS
• Jeon SG
• Park CH
• Sohn SW
• Kim DI
• Kim SS
• Chang YS
• Kim YK
• Cho SH
• Min KU
• Kim YY

• KMID: 1713454
• DOI: http://doi.org/10.3346/jkms.2008.23.2.232

Abstract

A number of case reports on occupational asthma caused by herbal medicines have been issued, for example, on Sanyak, Chunkung, Banha, and Brazilian ginseng. Recently, cases of occupational asthma induced by Sanyak and Korean ginseng have been reported, but the pathogenic mechanisms involved are unknown. This study was carried out to evaluate the immunologic mechanism underlying Korean ginseng-induced occupational asthma. A patient engaged in Korean ginseng wholesale was referred for recurrent dyspnea, wheezing, and nasal symptoms, which were aggravated at work. Allergen bronchial provocation testing to Korean ginseng extract showed a typical immediate response, and skin prick testing to Korean ginseng extract also showed a strong positive response. Moreover, serum-specific IgE levels to Korean ginseng extract were significantly higher than in controls. Enzymelinked immunosorbent assay (ELISA) inhibition tests showed a dose-dependent inhibition by Korean ginseng, but not by Dermatophagoides farinae, wheat flour, or Chinese balloon flower. Sodium dodecylsulfate-poly-acrylamide gel electrophoresis (SDS-PAGE) and immunoblotting revealed four specific Immunoglobulin E (IgE) binding components at 26, 30, 47, and 60 kDa, which were not bound by control sera. These results strongly suggest that occupation asthma induced by Korean ginseng is induced via an IgE-mediated mechanism.

Keyword

Asthma; Hypersensitivity, Immediate; Panax; Immunoglobulin E; Occupational Diseases

MeSH Terms

Animals
Asthma/diagnosis/*etiology/*immunology
Bronchi/metabolism
Electrophoresis, Polyacrylamide Gel
Enzyme-Linked Immunosorbent Assay/methods
Flour
Flowers
Humans
Hypersensitivity/*diagnosis
Immunoglobulin E/analysis/*chemistry
Korea
Occupational Diseases/diagnosis/*etiology/*immunology
Panax/*adverse effects
Pyroglyphidae/metabolism
*Skin Tests

Figure

• 

  Fig. 1 Allergen bronchial provocation test using a 1:10 and 1:100 dilution of Korean ginseng extract. Allergen bronchial challenge testing induced a typical immediate response.

• 

  Fig. 2 Measurement of serum specific IgE antibody to ginseng. The patient's serum specific IgE levels to ginseng extract were significantly higher versus those of controls.

• 

  Fig. 3 ELISA inhibition test using Korean ginseng, Dermatophagoides farinae, wheat flour, or Chinese balloon flower extracts. ELISA inhibition testing showed dose-dependent inhibition by Korean ginseng, not by Dermatophagoides farinae, wheat flour, or Chinese balloon flower extract.

• 

  Fig. 4 SDS-PAGE (left) and immunoblot analysis (right) for Korean ginseng. Indicating four IgE binding components at 26, 30, 47, and 60 kDa. NAC, non-atopic controls; AC, atopic controls.

Reference

1. Park HS, Kim MJ, Moon HB. Occupational asthma caused by two herb materials Dioscorea batatas and Pinellia ternata. Clin Exp Allergy. 1994; 24:575–581.

2. Lee SK, Cho HK, Cho SH, Kim SS, Nahm DH, Park HS. Occupational asthma and rhinitis caused by multiple herbal agents in a pharmacist. Ann Allergy Asthma Immunol. 2001; 86:469–474.

3. Kim SH, Jeong H, Kim YK, Cho SH, Min KU, Kim YY. IgE-mediated occupational asthma induced by herbal medicine, Banha (Pinellia ternata). Clin Exp Allergy. 2001; 31:779–781.

4. Subiza J, Subiza JL, Escribano PM, Hinojosa M, Garcia R, Jerez M, Subiza E. Occupational asthma caused by Brazil ginseng dust. J Allergy Clin Immunol. 1991; 88:731–736.

5. Lee JY, Lee YD, Bahn JW, Park HS. A case of occupational asthma and rhinitis caused by Sanyak and Korean ginseng dusts. Allergy. 2006; 61:392–393.

6. Park HK, Jeon SG, Kim TB, Kang HR, Chang YS, Kim YK, Cho SH, Min KU, Kim YY. Occupational asthma and rhinitis induced by a herbal medicine, Wonji. J Korean Med Sci. 2005; 20:46–49.

7. Kiefer D, Pantuso T. Panax ginseng. Am Fam Physician. 2003; 68:1539–1542.