Chicken feathers

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Code: e85
Latin name: Gallus domesticus
Source material: Feather
Family: Phasianidae
Common names: Chicken, Hen, Cock, Cockerel
Direct or indirect contact with bird allergens may cause sensitisation. Bird allergens may be major components of house dust.

Allergen Exposure

Geographical distribution
The Chicken (which probably originated as a jungle fowl in southwestern Asia) was one of the earliest animals to be domesticated, possibly as early as 4000 BC. They were popular in China and among the Greeks and Romans, and are now distributed virtually throughout the world. They form by far the most important class of poultry, raised principally for their meat and eggs. The current trend is towards specialisation, with some Chicken raisers producing hatching eggs, others eggs for table use, and others raising Chickens to market as meat. Many distinct Chicken breeds have been combined through selective breeding into a few relatively standard types that are notably efficient converters of feed into meat or eggs. The dominant meat Chicken today is a cross between the fast-growing female White Plymouth Rock Chicken and the deep-breasted male Cornish Chicken. The predominant egg-laying type in the United States today is the White Leghorn Chicken.
 
Environment
Breeders as well as workers in the Chicken food processing industry are examples of groups with high risk of exposure. Other means of exposure are pillows made of Chicken feathers, arts and crafts that include Chicken feathers, and wing feathers used in fletching arrows. A few breeds of Chicken are raised chiefly for their ornamental appearance or as pets.
 
Allergens
Well-defined major allergenic bands with molecular mass of 20-30 kDa and 67 kDa have been detected and identified in IgE immunoblots with feather extracts as well as with serum proteins of Budgerigar, Parrot, Pigeon, Canary, and Hen. Inhalable feather dust was shown to contain several allergenic components, which cross-react with serum allergens/antigens of the same as well as of other bird species (1). The allergens have not been fully characterised yet.

Potential Cross-Reactivity

As noted above, inhalable feather dust contains several allergenic components, which cross-react with serum allergens/antigens of the same as well as of other bird species (1).
 
Cross-reactivity between Chicken and other phylogenetically related bird species may be expected, and in Chicken-allergic patients, significant IgE antibody titers to Parrot, Budgerigar, Chicken, Pigeon, Goose and Duck have been reported (2-3) even in patients without known exposure (1).
 
In Bird-Egg Syndrome, cross-reactivity to Hen's egg occurs (2-3). IgE from patients with Bird-Egg Syndrome were shown to recognise a 70 kDa protein in egg yolk and some major allergens in bird feather extract. Chicken serum albumin is the same protein as that designated alpha-livetin in egg yolk. The sera of patients with Bird-Egg Syndrome, pooled with Budgerigar or Hen feather extract and egg yolk extract, led to complete blocking of IgE binding to allergens in egg yolk and bird feather extract. However, IgE from patients with egg white allergy did not react with allergens in egg yolk and bird feather extract, despite strong IgE binding to egg white allergens. These results indicate common epitopes of Budgerigar and Hen feather and egg yolk alpha-livetin, and researchers suggest that alpha-livetin (Chicken serum albumin) leads to a cross-sensitisation and consequently to "Bird-Egg Syndrome" (4-6). This adult type of egg intolerance must be distinguished from the common egg white allergy of atopic children.
 
Cross-reactivity between Hen's feather and House Dust Mite allergen extract has been reported. However the authors suggest that although this may result from cross-reacting allergens, the more probable explanation is that Chicken feather extract contained Dermatophagoides pteronyssinus allergens or at least allergens with epitopes common to D. pteronyssinus allergen (7) .

Clinical Experience

IgE mediated reactions
Asthma, allergic rhinitis and allergic conjunctivitis may result following exposure to Chicken feathers, epithelial cells or droppings. The allergic manifestations may present as Bird Fancier´s Asthma and as Bird-Egg Syndrome, with symptoms such as rhinitis, urticaria and angioedema (2); and also as gastro-intestinal problems (3). Specific IgE has been found in patients exposed to Chicken feathers, and contact with Chicken has been reported as a common cause of occupational asthma and allergic rhinitis (8-11) (20).
 
Positive specific IgE tests with feather allergens have been reported in 20-60% of patients suspected to be allergic to feathers (12-14) . The clinical relevance of these results has not been fully established (20) .
 
Evidence of sensitisation to Chicken feathers is reported also in other studies. A Finnish study of 598 asthmatic children reported that 10% had specific IgE antibodies to Chicken feathers (7) .
 
Of 269 adult patients with suspected skin and respiratory allergies tested for feathers with skin-specific IgE tests, 9% of the whole group and 14% of those positive to inhalant allergens were positive to a feather allergen. Two reacted to Duck feathers, 12 to Goose and 15 to Chicken feathers. Symptoms were reported by 58% of feather skin-specific IgE-positive patients and by 55% of other skin-specific IgE-positive patients. Positive RAST-specific IgE test was surprisingly very low (20).
 
In a study of 507 asthmatic atopic children in the Chieti-Pescara area of Italy, specific IgE skin tests found that 5.9% were sensitised to feathers (15).
 
Chicken feathers are a significant cause of sensitisation in poultry workers. Asthma prevalence in farmers has been reported by means of a questionnaire survey to be higher for horse breeders/groomers, pig farmers, poultry farmers, and those working with oats. Up to 17.4% of poultry farmers reported symptoms of asthma (16). In an avian slaughterhouse, workers may be exposed to Chicken feathers, as well as to serum and droppings allergens (17). Sensitisation in these individuals may also occur to Chicken feed (18).
 
In a selected group of patients with known allergy to bird feathers, a high frequency (32%) of sensitisation to egg proteins, in particular egg yolk, suggests that in some patients feather sensitisation could trigger or somehow facilitate the later sensitisation to egg yolk proteins (Bird-Egg Syndrome) (19).
 
Clinical allergy to commercial feather products is less common than usually thought, as a result of the removal of dust, washing, and drying at 125oC. The allergens derived from unrefined feathers include bird serum proteins, bird droppings, and feather mites.
 
Extrinsic allergic alveolitis, also known as hypersensitivity pneumonitis, Bird Fancier's Lung and Farmer's Lung, is a disease of inflammation of the lung parenchyma in the terminal bronchioles and alveoli. Symptoms may start soon after exposure to bird allergens or after many years, and may include breathlessness, cough, occasional chills, and fever. Death may also result.
 
The disease occurs after exposure to organic dust, especially after close contact with Chickens (18) (21) or other birds such as Pigeons, Budgerigars, Parrots, Canaries, Parakeets, Cockatiels, Doves and Finches. Exposure results in the development of immunoglobulin antibodies including IgE (1), IgM (22), IgA and various IgG subclasses (23-25). The antibodies may be found in the sera and saliva of patients (26).
 
The allergenic proteins may be found in bird serum, droppings, and feathers. Contact may result from handling birds, cleaning their cages, or exposure to the organic dust drifting from where the birds reside.
 
Diagnosis is based on a characteristic clinical picture and a typical x-ray pattern, accompanied by the presence of specific IgG antibodies (27).
 
The measurement of specific IgG using IgG tracer technology has been shown to be a sensitive and specific assay for the routine diagnostic testing of extrinsic allergic alveolitis (28).
 
Other reactions
Farm workers handling animal feeds are exposed to a variety of chemicals, some of which may cause allergic contact dermatitis. A case of allergy to ethoxyquin (a preservative added to Chicken feed to inhibit vitamin degradation) in a Chicken farmer is reported (29).
 
Mites may also be a major allergen in poultry farmers. Northern Fowl Mite (Ornithonyssus sylviarum) residing in Chicken feathers may be the predominant allergen causing occupational allergy in poultry farmers (10) (30). The House Dust Mite, Dermatophagoides evansi, was documented in dust samples from poultry farms. Storage Mites and other predatory Mites were also found in these samples (31). Aleuroglyphus ovatus is a storage mite that has a worldwide distribution and has been found in stored bran, wheat, chicken meal, and dried fish products (32).
 
Polyester-filled pillows contain significantly more total weight of Der p 1 Mite allergen (Dermatophagoides Pteronyssinus) than feather-filled pillows (33).
 
Compiled by Dr Harris Steinman, harris@zingsolutions.com

References

  1. Tauer-Reich I, Fruhmann G, Czuppon AB, Baur X. Allergens causing bird fancier's asthma. Allergy  1994;49(6):448-53
  2. de Maat-Bleeker F, van Dijk AG, Berrens L. Allergy to egg yolk possibly induced by sensitization to bird serum antigens. Ann Allergy 1985;54(3):245-8.
  3. van Toorenenbergen AW, Huijskes-Heins MI, Gerth van Wijk R. Different pattern of IgE binding to chicken egg yolk between patients with inhalant allergy to birds and food-allergic children. Int Arch Allergy Immunol 1994;104(2):199-203.
  4. Szepfalusi Z, Ebner C, Pandjaitan R, Orlicek F, Scheiner O, Boltz-Nitulescu G, Kraft D, Ebner H. Egg yolk alpha-livetin (chicken serum albumin) is a cross-reactive allergen in the bird-egg syndrome. J Allergy Clin Immunol 1994;93(5):932-42
  5. Mandallaz MM, de Weck AL, Dahinden CA. Bird-egg syndrome. Cross-reactivity between bird antigens and egg-yolk livetins in IgE-mediated hypersensitivity. Int Arch Allergy Appl Immunol 1988;87(2):143-50.
  6. de Blay F, Hoyet C, Candolfi E, Thierry R, Pauli G. Identification of alpha livetin as a cross reacting allergen in a bird- egg syndrome. Allergy Proc 1994;15(2):77-8.
  7. Linna O, Niinimaki A, Makinen-Kiljunen S. Immunologic cross-reactivity between hen's feather and house-dust-mite allergen extracts. Allergy 1994;49(9):795-6
  8. Danuser B. Respiratory health risks in working with chickens. [German] Pneumologie 2000;54(1):37-42
  9. Potter PC, Berman D, Toerien A, Malherbe D, Weinberg EG. Clinical significance of aero-allergen identification in the western Cape. S Afr Med J 1991;79(2):80-4
  10. Bar-Sela S, Teichtahl H, Lutsky I. Occupational asthma in poultry workers. J Allergy Clin Immunol 1984;73(2):271-5
  11. Bessot JC, Blaumeiser M, Kopferschmitt MC, Pauli G. Occupational asthma in an agricultural setting. [French] Rev Mal Respir 1996;13(3):205-15
  12. Chapman J, Williams S. Aeroallergens of the southeast Missouri area: a report of skin test frequencies and air sampling data. Ann Allergy 1984;52:411-418
  13. Geller M. Respiratory atopy in Rio de Janeiro. Ann Allergy 1990;64:171-173
  14. von der Hardt H, Meiser W. Allergen testing in children with asthma bronchiale. Monatsschr Kinderkeilkd 1975;123:577-87
  15. Verini M, Rossi N, Verrotti A, Pelaccia G, Nicodemo A, Chiarelli F. Sensitization to environmental antigens in asthmatic children from a central Italian area. Sci Total Environ 2001;270(1-3):63-9
  16. Kimbell-Dunn M, Bradshaw L, Slater T, Erkinjuntti-Pekkanen R, Fishwick D, Pearce N. Asthma and allergy in New Zealand farmers. Am J Ind Med 1999;35(1):51-7
  17. Chacin B, Corzo G, Montiel M. Lung function in workers in a chicken slaughterhouse in the city of Maracaibo, Venezuela. [Spanish] Invest Clin 1997;38(4):171-90
  18. Rees D, Nelson G, Kielkowski D, Wasserfall C, da Costa A. Respiratory health and immunological profile of poultry workers. S Afr Med J 1998;88(9):1110-7
  19. Anibarro Bausela B, Martin Esteban M, Martinez Alzamora F, Pascual Marcos C, Ojeda Casas JA. Egg protein sensitization in patients with bird feather allergy. Allergy 1991;46(8):614-8
  20. Kilpiö K, Mäkinen-Kiljunen S, Haahtela T, Hannuksela M. Allergy to feathers. Allergy 1998; 53(2):159-164
  21. Korn DS, Florman AL, Gribetz I. Recurrent pneumonitis with hypersensitivity pneumonitis to hen litter. JAMA 1968;205:114
  22. Martinez-Cordero E, Aquilar Leon DE, Retana VN. IgM antiavian antibodies in sera from patients with pigeon breeder’s disease. J Clin Lab Anal 2000:14(5):201-7
  23. Yoshizawa Y, Miyashita Y, Inoue T, Sumi Y, Miyazaki Y, Sato T, et al. Sequential evaluation of clinical and immunological findings in hypersensitivity pneumonitis: serial subclass distribution of antibodies. Clin immunol Immunopathol 1994;73(3):330-7
  24. Todd A, Coan R, Allen A. Pigeon breeder’s lung; IgG subclasses to pigeon Intestinal mucin and IgA antigens. Clin Exp Immunol 1993;92(3):494-9
  25. Baldwin CI, Todd A, Bourke SJ, Allen A, Calvert JE. IgG subclass responses to pigeon intestinal mucin are related to development of pigeon fancier’s lung. Clin Exp Allergy 1998;28(3):349-57
  26. McSharry C, Macleod K, McGregor S, Speekenbrink AB, Sriram S, Boyd F, et al. Mucosal immunity in extrinsic allergic alveolitis: salivary immunoglobulins and antibody against inhaled avian antigens among pigeon breeders. Clin Exp Allergy 1999;29(7):957-64
  27. Rodriguez de Castro F, Carrillo T, Castillo R, Blanco C, Diaz F, Cuevas M. Relationship between characteristics of exposure to pigeon antigens. Clinical manifestations and humoral immune response. Chest 1993;103(4):1059-63
  28. Lopata A, Schinkel M, Andersson C, Johansson G, van Hage-Hamsten M. Quantification of IgG antibodies to bird antigens in the diagnosis of extrinsic allergic alveolitis (EAA) using the UniCAP system. (Manuscript in preparation)
  29. Rubel DM, Freeman S. Allergic contact dermatitis to ethoxyquin in a farmer handling chicken feeds. Australas J Dermatol 1998;39(2):89-91
  30. Lutsky I, Bas-Sela S. Northern fowl mite (Ornithonyssus sylvarium) in occupational asthma of poultry workers. Lancet 1982;2:874-5
  31. Elbers AR, Blaauw PJ, Heijmans JF, Tielen MJ. Investigation of the mite fauna content of dust samples collected from pig and poultry farms. Report of the first finding in Western Europe of the house-dust mite Dermatophagoides evansi in dust from poultry houses. [Dutch] Tijdschr Diergeneeskd 2000;125(22):677-8
  32. Silton RP, Fernandez-Caldas E, Trudeau WL, Swanson MC, Lockey RF. Prevalence of specific IgE to the storage mite, Aleuroglyphus ovatus. J Allergy Clin Immunol  1991;88(4):595-603
  33. Kemp TJ, Siebers RW, Fishwick D, O'Grady GB, Fitzharris P, Crane J. House dust mite allergen in pillows. BMJ 1996;313:916

 

As in all diagnostic testing, the diagnosis is made by the physican based on both test results and the patient history.