Table of Contents

Whole Allergen

o1 Cotton, crude fibers

o1 Cotton, crude fibers Scientific Information

Type:

Whole Allergen

Display Name:

Cotton, crude fibers

Route of Exposure:

Inhalation

Family:

Malvaceae

Species:

G. hirsutum, G. barbadense, G. herbaceum, G. arboreum

Latin Name:

Gossypium hirsutum

Other Names:

Cotton, crude fibers from cotton plants in genus Gossypium

Summary

The cotton industry is large, employing an estimated 150 million people across 75 countries. Workers in the cotton textile industry may experience both non-specific lung disease (such as chronic bronchitis) and the specific syndrome called byssinosis. In extremely rare cases, immediate skin reactions can occur. Reactions are more commonly late-onset IgE-dependent asthma. Typically, symptoms of sensitization to cotton include bronchitis, bronchial asthma, or byssinosis. There has been much debate about the cause of reaction to cotton dust, whether it is pharmacological, immunological or due to endotoxins/microbial contaminants.

Allergen

Nature

The cotton industry employs an estimated 150 million people across 75 countries. In 2018 and 2019, the largest-producing countries were China and India, respectively, each accounting for around 25% of the world’s total cotton. High-production countries also include Brazil and USA (producing approximately 25 % of the world’s total together) as well as Pakistan and Turkey (1).

Taxonomy

*Taxonomic tree of Gossypium hirsutum* (2)**
Domain	Eukaryota
Kingdom	Plantae
Phylum	Spermatophyta
Subphylum	Angiospermae
Class	Dicotyledonae
Order	Malvales
Family	Malvaceae
Genus	Gossypium

Epidemiology

Worldwide distribution

Prevalence rates of lung diseases as a result of occupational exposure to cotton may range from 0.8% to as high as 40% (3).

Route of Exposure

Main

Inhalation (4).

Detection

Main methods

There are many methods employed to extract cotton dust including the Prausnitz method, the New York method, Rimington’s method, Morgan’s method, and extraction with citric acid and phosphate buffer (5).

Clinical Relevance

Workers in the cotton textile industry may experience both non-specific lung disease (such as chronic bronchitis) and the specific syndrome called byssinosis (3). In extremely rare cases, immediate skin reactions can occur (6). Reactions are more commonly late-onset IgE-dependent asthma (7).

Typically, symptoms of sensitization to cotton include bronchitis, bronchial asthma, or byssinosis (4). Patients with IgE-mediated hypersensitivity to cotton dust or its contaminants may be misdiagnosed as byssinotic (7).

There has been much debate about the cause of reactions to cotton dust. Historically, allergy to cotton has been correlated with multiple factors; occupational asthma, byssinosis due to exposure to aerosolized cotton dust, or obstruction of the airways due to materials resulting from the processing of cotton and the natural contaminants of cotton, such as bacteria, endotoxins and molds (6). This has led to at least three hypotheses of the cause as pharmacological, endotoxin-related, or immunological. In the immunological theory, byssinosis is attributed to a type III immune mechanism, as a consequence of specific antigens in the cotton dust, or bacterial/fungal contaminants. However, it may also be as a result of type I, IgE-mediated immune reactions provoked by mast cells and basophils (3). Another study supported the hypothesis that the key mediator of the immunological response to cotton dust in due to fungal contamination (7). There are many bacterial (including Enterobacter, Pseudomonas, Klebsiella, and Clostridium) and fungal contaminants (Aspergillus, Fusarium and Alternaria) of cotton plants, cotton dust or the air in textile mills (7). There is also a case for irritation caused by the dust (8). While immune reactions such as elevated IgE levels have been identified in textile workers, they correlate poorly with respiratory symptoms and function (9).

Working in the earlier phases of cotton manufacture, compared to the later stages, is correlated with a higher prevalence of lung disease (3). In a study of four cotton mills in the USA, sensitization by skin-prick tests in workers varied depending on the step of cotton processing and production they were primarily involved in. Around 8% of workers in the linter dust category (those who were constantly exposed to cotton fibers during cleaning, baling and hulling of the cotton) had positive skin-prick tests to cotton fibers, whereas those exposed to product dust (including oil extraction, loading or boiler room operations) were positive in approximately 5% of cases and those in the mixed dust (including both groups) had zero positive skin-prick tests. Exposure to the dust, and the presence of atopy correlated with a large mean decline in lung function in those workers exposed to cotton fiber dust who were also atopic (10).

Asthma

A link has been identified between patients with pre-existing nasobronchial allergy and sensitization to cotton dust. In a study of 48 bronchial asthma and allergic rhinitis patients, 6.25% had markedly positive skin-prick tests to cotton mill dust (11).

Prevention and Therapy

Prevention strategies

Prevention is of paramount importance to minimize the prevalence of byssinosis (12).

Molecular Aspects

Allergenic molecules

Table adapted from (13).

Allergen	Type	Mass (kDa)
Gos h 5	Profilin	14
Gos h Vicilin	Vicilin-like Globulin	33

Reactions to cotton dust may be due to strictly specific antibodies, or possibly due to cross-reactions with other textile allergens, although limited data are available (4).

Compiled By

Author: RubyDuke Communications

Reviewer: Dr.Michael Thorpe

Last reviewed: May 2022

References

FAO. Recent trends and prospects in the world cotton market and policy developments Rome2021 [cited 2021 8.11.21]. Available from: https://www.fao.org/publications/card/en/c/CB3269EN/.
CABI. Gossypium hirsutum (Bourbon cotton) Wallingford, UK2021 [cited 2021 8.11.21]. Available from: https://www.cabi.org/isc/datasheet/25797.
Petronio L, Bovenzi M. Byssinosis and serum IgE concentrations in textile workers in an Italian cotton mill. Br J Ind Med. 1983;40(1):39-44.
Popa V, Gavrilescu N, Preda N, Teculescu D, Plecias M, Cîrstea M. An investigation of allergy in byssinosis: sensitization to cotton, hemp, flax and jute antigens. Br J Ind Med. 1969;26(2):101-8.
Cayton HR, Furness GO, Maitland HB. Cotton Dust in Relation to Byssinosis: Part II: Skin Tests for Allergy with Extracts of Cotton Dust. British Journal of Industrial Medicine. 1952;9:186 - 96.
González de Olano D, Subiza JL, Civantos E. Cutaneous allergy to cotton. Ann Allergy Asthma Immunol. 2009;102(3):263-4.
Salvaggio JE, O'Neil CE, Butcher BT. Immunologic responses to inhaled cotton dust. Environ Health Perspect. 1986;66:17-23.
Uchikoshi S, Nomura K, Saitoh S, Komatsu N, Chien C, Miyake H. Nasal allergy in spinning mill workers and the possibility of allergenicity of chemical fibers and cotton linters. Tokai J Exp Clin Med. 1981;6(4):363-71.
Zuskin E, Kanceljak B, Schachter EN, Witek TJ, Mustajbegovic J, Maayani S, et al. Immunological findings and respiratory function in cotton textile workers. Int Arch Occup Environ Health. 1992;64(1):31-7.
Jones RN, Butcher BT, Hammad YY, Diem JE, Glindmeyer HW, Lehrer SB, et al. Interaction of atopy and exposure to cotton dust in the bronchoconstrictor response. British Journal of Industrial Medicine. 1980;37(2):141.
Prasad R, Verma SK, Dua R, Kant S, Kushwaha RA, Agarwal SP. A study of skin sensitivity to various allergens by skin prick test in patients of nasobronchial allergy. Lung India. 2009;26(3):70-3.
Abebe Y, Seboxa T. Byssinosis and other respiratory disorders among textile mill workers in Bahr Dar northwest Ethiopia. Ethiop Med J. 1995;33(1):37-49.
Allergome. Cotton. 2022.