Jacob Bell
New Member
M Mayoral,1 H Calderón,1 R Cano,1 M Lombardero2 1Allergy Clinic Dr Calderón, Granada, Spain
2Research and Development Department. ALK Abelló, SA, Madrid. Spain
Key words: Cannabis sativa pollen. Immunoglobulin-mediated allergy. Immunoblotting. Rhinoconjunctivitis.
Palabras clave: Polen de Cannabis sativa. Alergia mediada por inmunoglobulina E. Inmunodetección. Rinoconjuntivitis.
Hemp (Cannabis sativa L), a plant of Asian origin in the Cannabaceae family, is well-known for its fibers, fruit, and narcotic properties. Although it is usually cultivated, it can grow wild in some places. C sativas is an anemophilous plant, and its very light pollen can be transported over long distances. It pollinates during summer (June-July), and its allergenic capability is mild to high. We present the case of a 27-year-old Moroccan woman who developed intense perennial rhinoconjunctivitis over a period of 2 years while working with the material before consulting our clinic.
The patient-s symptoms began in Spain, where she worked in a research laboratory and was in contact with C sativa pollen. She reported that symptoms worsened in spring, that she was not a user of marijuana, and that she did not present symptoms when exposed to marijuana smoke or fumes. Skin prick tests were performed with common commercially available inhalants, including latex (ALK-Abelló, SA, Madrid, Spain), and C sativa pollen extract. The results were positive (wheal diameter larger than 3 mm) for the pollen extracts of C sativa (6 mm) and Olea europaea (4 mm). Serum specific immunoglobulin (Ig) E was determined using a radioallergosorbent test and a cutoff value of 0.35 kU/L was used. The hemp pollen allergen extract (pollen obtained from the patient) was prepared at 2% (wt/vol) in phosphate-buffered saline (PBS), at 5ºC and subjected to magnetic stirring for 90 minutes. After centrifuging, the supernatant was dialyzed against PBS and filtered through a 0.2 m membrane. The extract was 50% glycerinated for prick testing. Cyanogen-bromide—activated paper disks were sensitized with C sativa pollen extract and incubated with the patient-s serum; disks sensitized with Lolium perenne were used as a reference along with a pool of sera from grass-allergic patients previously calibrated in kU/L. We found IgE antibodies against C sativa pollen (1 1.0 kU/L) and olive tree pollen (0.4 kU/L). IgE-immunoblotting experiments after sodium dodecyl sulfate polyacrylamide gel electrophoresis (figure) showed that the patient-s IgE recognized 37 kd and 70-80 kd protein bands in the hemp pollen extract.
Although the allergic potential of hemp has been known for more than 60 years, few studies have established the clinical significance of its pollen as an aeroallergen. In this sense, Stokes and colleagues [1] carried out a study in Nebraska, in the United States, where hemp was cultivated and grew spontaneously. They observed that hemp pollen accounted for 36% of the total pollen count. In a sample of pollen-allergic patients, 78% were sensitive to C sativa pollen and 73% presented symptoms during the pollination season. However, they called for additional studies to assess the clinical relevance of this sensitization, since the patients had concomitant sensitizations to other pollens. Exposure to hemp at an industrial level has been related to a deleterious effect on the respiratory function of workers [2] .Other cases of allergy to hemp have been ascribed to the manipulation of the leaf, the ingestion of the seed as a spice, or injection [3-5].
In this report of a case of IgE-mediated allergic rhinitis and conjunctivitis due to C sativa pollen, the patient-s symptoms began after close, direct contact with the pollen. We do not rule out the possibility of a previous sensitization in the patient-s country of origin, where she had lived in a region dedicated to hemp cultivation.
We detected the presence of hemp pollen allergenic proteins of about 37 kd and 70-80 kd, in agreement with other studies carried out with nonpollen materials from C sativa [3,5], although those studies also described other allergens with smaller molecular weights (6 kd and 14-16 kd) which might be absent from the pollen material.
References
1. Stokes JR , Hartel R, Ford LB, Casale TB. Cannabis (hemp) positive skin tests and respiratory symptoms. An n Allergy Asthma Immunol. 2000;85:238-40.
2. Zuskin E, Mustajbegovic L, Schachter EN. Follow-up study of respiratory function in hemp workers. Am J In Med. 1994;26: 103-15.
3. Pajarón MJ, Bartolomé B, Orts D, CarneroL, Canto E, Alcolea MD . Alergia a planta de marihu a na. Alergol et Inmunol. 2005;20:186.
4. Perez JA. Allergic reaction associated with intravenous marijuana use. J Emerg Med. 2000; 18:260-1.
5. Stadtmauer G, Beyer K, Bardina L, Sicherer SH. Anaphylaxis to ingestion of hempseed (Cannabis sativa). J Allergy Clin Immunol. 2003;112:216-7.
Source: Allergic Rhinoconjunctivitis Caused by Cannabis sativa Pollen
2Research and Development Department. ALK Abelló, SA, Madrid. Spain
Key words: Cannabis sativa pollen. Immunoglobulin-mediated allergy. Immunoblotting. Rhinoconjunctivitis.
Palabras clave: Polen de Cannabis sativa. Alergia mediada por inmunoglobulina E. Inmunodetección. Rinoconjuntivitis.
Hemp (Cannabis sativa L), a plant of Asian origin in the Cannabaceae family, is well-known for its fibers, fruit, and narcotic properties. Although it is usually cultivated, it can grow wild in some places. C sativas is an anemophilous plant, and its very light pollen can be transported over long distances. It pollinates during summer (June-July), and its allergenic capability is mild to high. We present the case of a 27-year-old Moroccan woman who developed intense perennial rhinoconjunctivitis over a period of 2 years while working with the material before consulting our clinic.
The patient-s symptoms began in Spain, where she worked in a research laboratory and was in contact with C sativa pollen. She reported that symptoms worsened in spring, that she was not a user of marijuana, and that she did not present symptoms when exposed to marijuana smoke or fumes. Skin prick tests were performed with common commercially available inhalants, including latex (ALK-Abelló, SA, Madrid, Spain), and C sativa pollen extract. The results were positive (wheal diameter larger than 3 mm) for the pollen extracts of C sativa (6 mm) and Olea europaea (4 mm). Serum specific immunoglobulin (Ig) E was determined using a radioallergosorbent test and a cutoff value of 0.35 kU/L was used. The hemp pollen allergen extract (pollen obtained from the patient) was prepared at 2% (wt/vol) in phosphate-buffered saline (PBS), at 5ºC and subjected to magnetic stirring for 90 minutes. After centrifuging, the supernatant was dialyzed against PBS and filtered through a 0.2 m membrane. The extract was 50% glycerinated for prick testing. Cyanogen-bromide—activated paper disks were sensitized with C sativa pollen extract and incubated with the patient-s serum; disks sensitized with Lolium perenne were used as a reference along with a pool of sera from grass-allergic patients previously calibrated in kU/L. We found IgE antibodies against C sativa pollen (1 1.0 kU/L) and olive tree pollen (0.4 kU/L). IgE-immunoblotting experiments after sodium dodecyl sulfate polyacrylamide gel electrophoresis (figure) showed that the patient-s IgE recognized 37 kd and 70-80 kd protein bands in the hemp pollen extract.
Although the allergic potential of hemp has been known for more than 60 years, few studies have established the clinical significance of its pollen as an aeroallergen. In this sense, Stokes and colleagues [1] carried out a study in Nebraska, in the United States, where hemp was cultivated and grew spontaneously. They observed that hemp pollen accounted for 36% of the total pollen count. In a sample of pollen-allergic patients, 78% were sensitive to C sativa pollen and 73% presented symptoms during the pollination season. However, they called for additional studies to assess the clinical relevance of this sensitization, since the patients had concomitant sensitizations to other pollens. Exposure to hemp at an industrial level has been related to a deleterious effect on the respiratory function of workers [2] .Other cases of allergy to hemp have been ascribed to the manipulation of the leaf, the ingestion of the seed as a spice, or injection [3-5].
In this report of a case of IgE-mediated allergic rhinitis and conjunctivitis due to C sativa pollen, the patient-s symptoms began after close, direct contact with the pollen. We do not rule out the possibility of a previous sensitization in the patient-s country of origin, where she had lived in a region dedicated to hemp cultivation.
We detected the presence of hemp pollen allergenic proteins of about 37 kd and 70-80 kd, in agreement with other studies carried out with nonpollen materials from C sativa [3,5], although those studies also described other allergens with smaller molecular weights (6 kd and 14-16 kd) which might be absent from the pollen material.
References
1. Stokes JR , Hartel R, Ford LB, Casale TB. Cannabis (hemp) positive skin tests and respiratory symptoms. An n Allergy Asthma Immunol. 2000;85:238-40.
2. Zuskin E, Mustajbegovic L, Schachter EN. Follow-up study of respiratory function in hemp workers. Am J In Med. 1994;26: 103-15.
3. Pajarón MJ, Bartolomé B, Orts D, CarneroL, Canto E, Alcolea MD . Alergia a planta de marihu a na. Alergol et Inmunol. 2005;20:186.
4. Perez JA. Allergic reaction associated with intravenous marijuana use. J Emerg Med. 2000; 18:260-1.
5. Stadtmauer G, Beyer K, Bardina L, Sicherer SH. Anaphylaxis to ingestion of hempseed (Cannabis sativa). J Allergy Clin Immunol. 2003;112:216-7.
Source: Allergic Rhinoconjunctivitis Caused by Cannabis sativa Pollen
