Abstract
Introduction: Moringa oleifera is a small native tree of North West India. Many bioactive compounds of Moringa have recently been isolated, leading to industrial and medicinal uses worldwide. We report the first case of occupational asthma (OA) to Moringa.Patient, Methods and Results:A 32 year-old cosmetic factory technician (without allergy history) exposed into the workplace to a powder of Moringa seed progressively complained of rhinitis and respiratory symptoms. Initial investigations (patient still working) didn't show baseline airway obstruction (FEV1=4.15L, 96% of predicted value; FEV1/FVC%=81%), exhaled nitric oxide fraction (Feno) was increased to 91.21 ppb, methacholine challenge showed nonspecific bronchial hyperresponsiveness (22% decrease of FEV1), and the Oasys II score was 3.29. Specific inhalation challenge (SIC) to Moringa seed powder showed immediate positive reaction (21% decrease of FEV1). Sputum eosinophil counts and Feno evaluated at baseline and 24h after SIC showed an increase of eosinophils from 6% to 62%, and an increase of Feno from 32.37 to 94.34 ppb. The prick-tests to a 10% solution of Moringa seed powder was positive while we observed negative control prick tests in 4 volunteers never exposed. OA to Moringa seed was retained and the patient removed from further exposure to the implicated agent into the workplace.Conclusion: Moringa has shown numerous health benefits rapidly leading the cosmetic industry to incorporate Moringa as a compound of various products (moisturizers or skin ointment). New cases of allergy could therefore appear regarding to the increasing consumption of Moringa worldwide, as suggested by our description of the first case of OA to Moringa.