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Masthoff LJ, van Hoffen E, de Reus A, Boonacker CW, Bruijnzeel-Koomen CA, Pasmans SG, Knulst AC. Hazelnut allergy differs between children and adults in frequency of severity, aetiology and relevance of diagnostic parameters. Clin Exp Allergy 2014; 44:1539-45. [DOI: 10.1111/cea.12440] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2013] [Revised: 08/25/2014] [Accepted: 09/02/2014] [Indexed: 11/30/2022]
Affiliation(s)
- L. J. Masthoff
- Department of Dermatology/Allergology; University Medical Center Utrecht; Utrecht The Netherlands
| | - E. van Hoffen
- Department of Dermatology/Allergology; University Medical Center Utrecht; Utrecht The Netherlands
| | - A. de Reus
- Department of Dermatology/Allergology; University Medical Center Utrecht; Utrecht The Netherlands
| | - C. W. Boonacker
- Julius Center for Health Sciences and Primary Care; University Medical Center Utrecht; Utrecht The Netherlands
| | - C. A. Bruijnzeel-Koomen
- Department of Dermatology/Allergology; University Medical Center Utrecht; Utrecht The Netherlands
| | - S. G. Pasmans
- Department of Dermatology/Allergology; University Medical Center Utrecht; Utrecht The Netherlands
- Center for Paediatric Allergology; Wilhelmina Children's Hospital; University Medical Center Utrecht; Utrecht The Netherlands
| | - A. C. Knulst
- Department of Dermatology/Allergology; University Medical Center Utrecht; Utrecht The Netherlands
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52
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Scientific Opinion on the evaluation of allergenic foods and food ingredients for labelling purposes. EFSA J 2014. [DOI: 10.2903/j.efsa.2014.3894] [Citation(s) in RCA: 72] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
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Costa J, Carrapatoso I, Oliveira MBPP, Mafra I. Walnut allergens: molecular characterization, detection and clinical relevance. Clin Exp Allergy 2014; 44:319-41. [PMID: 24382327 DOI: 10.1111/cea.12267] [Citation(s) in RCA: 54] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Food-induced allergies have been regarded as an emergent problem of public health. Classified as important allergenic ingredients, the presence of walnut and other nuts as hidden allergens in processed foods constitutes a risk for sensitized individuals, being a real problem of allergen management. Attending to the increasing importance dedicated to walnut allergy, this review intends to provide the relevant and up-to-date information on main issues such as the prevalence of walnut allergy, the clinical threshold levels, the molecular characterization of walnut allergens and their clinical relevance, as well as the methodologies for walnut allergen detection in foods. As the walnut used in human diet comes from Juglans regia and Juglans nigra, the molecular characterization of the allergens from both species included in the prolamins (Jug r 1, Jug n 1 and Jug r 3), cupins (Jug r 2, Jug n 2 and Jug r 4) and profilins (Jug r 5), together with respective clinical relevance, were compiled in this review. The most recent progresses on walnut allergen detection techniques (protein- and DNA-based) are described and critically compared, including the emergent multitarget approaches.
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Affiliation(s)
- J Costa
- REQUIMTE, Departamento de Ciências Químicas, Faculdade de Farmácia, Universidade do Porto, Porto, Portugal
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Faber MA, De Graag M, Van Der Heijden C, Sabato V, Hagendorens MM, Bridts CH, De Clerck LS, Ebo DG. Cor a 14: Missing Link in the Molecular Diagnosis of Hazelnut Allergy? Int Arch Allergy Immunol 2014; 164:200-6. [DOI: 10.1159/000365050] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2014] [Accepted: 06/02/2014] [Indexed: 11/19/2022] Open
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55
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Smith M, Jäger S, Berger U, Šikoparija B, Hallsdottir M, Sauliene I, Bergmann KC, Pashley CH, de Weger L, Majkowska-Wojciechowska B, Rybníček O, Thibaudon M, Gehrig R, Bonini M, Yankova R, Damialis A, Vokou D, Gutiérrez Bustillo AM, Hoffmann-Sommergruber K, van Ree R. Geographic and temporal variations in pollen exposure across Europe. Allergy 2014; 69:913-23. [PMID: 24816084 DOI: 10.1111/all.12419] [Citation(s) in RCA: 90] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/25/2014] [Indexed: 11/27/2022]
Abstract
BACKGROUND The EC-funded EuroPrevall project examined the prevalence of food allergy across Europe. A well-established factor in the occurrence of food allergy is primary sensitization to pollen. OBJECTIVE To analyse geographic and temporal variations in pollen exposure, allowing the investigation of how these variations influence the prevalence and incidence of food allergies across Europe. METHODS Airborne pollen data for two decades (1990-2009) were obtained from 13 monitoring sites located as close as possible to the EuroPrevall survey centres. Start dates, intensity and duration of Betulaceae, Oleaceae, Poaceae and Asteraceae pollen seasons were examined. Mean, slope of the regression, probability level (P) and dominant taxa (%) were calculated. Trends were considered significant at P < 0.05. RESULTS On a European scale, Betulaceae, in particular Betula, is the most dominant pollen exposure, two folds higher than to Poaceae, and greater than five folds higher than to Oleaceae and Asteraceae. Only in Reykjavik, Madrid and Derby was Poaceae the dominant pollen, as was Oleaceae in Thessaloniki. Weed pollen (Asteraceae) was never dominant, exposure accounted for >10% of total pollen exposure only in Siauliai (Artemisia) and Legnano (Ambrosia). Consistent trends towards changing intensity or duration of exposure were not observed, possibly with the exception of (not significant) decreased exposure to Artemisia and increased exposure to Ambrosia. CONCLUSIONS This is the first comprehensive study quantifying exposure to the major allergenic pollen families Betulaceae, Oleaceae, Poaceae and Asteraceae across Europe. These data can now be used for studies into patterns of sensitization and allergy to pollen and foods.
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Affiliation(s)
- M. Smith
- University Department of Ear, Nose and Throat Diseases; Medical University of Vienna; Vienna Austria
| | - S. Jäger
- University Department of Ear, Nose and Throat Diseases; Medical University of Vienna; Vienna Austria
| | - U. Berger
- University Department of Ear, Nose and Throat Diseases; Medical University of Vienna; Vienna Austria
| | - B. Šikoparija
- Laboratory for Palynology; Department of Biology and Ecology; Faculty of Sciences; University of Novi Sad; Novi Sad Serbia
| | - M. Hallsdottir
- Icelandic Institute of Natural History; Reykjavik Iceland
| | | | - K-C. Bergmann
- Charité - Universitätsmedizin Berlin; Berlin Germany
| | - C. H. Pashley
- Department of Infection, Immunity and Inflammation; Institute for Lung Health; University of Leicester; Leicester UK
| | - L. de Weger
- Department of Pulmonology; Leiden University Medical Center; Leiden the Netherlands
| | | | - O. Rybníček
- Faculty of Medicine; Masaryk University; Brno Czech Republic
| | - M. Thibaudon
- Réseau National de Surveillance Aérobiologique (R.N.S.A.); Brussieu France
| | - R. Gehrig
- Federal Office of Meteorology and Climatology Meteo Swiss; Zürich Switzerland
| | | | - R. Yankova
- Clinical Center of Allergology; University Hospital Sofia; Sofia Bulgaria
| | - A. Damialis
- University of Ioannina; Ioannina Greece
- Department of Ecology; Aristotle University of Thessaloniki; Thessaloniki Greece
| | - D. Vokou
- Department of Ecology; Aristotle University of Thessaloniki; Thessaloniki Greece
| | - A. M. Gutiérrez Bustillo
- Departamento de Biología Vegetal II; Facultad de Farmacia; Universidad Complutense de Madrid; Madrid Spain
| | | | - R. van Ree
- Departments of Experimental Immunology and Otorhinolaryngology; Academic Medical Center; University of Amsterdam; Amsterdam the Netherlands
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Production and analysis of recombinant tree nut allergens. Methods 2014; 66:34-43. [DOI: 10.1016/j.ymeth.2013.07.033] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2012] [Revised: 07/15/2013] [Accepted: 07/19/2013] [Indexed: 01/08/2023] Open
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Anaphylaxis to plant-foods and pollen allergens in patients with lipid transfer protein syndrome. Curr Opin Allergy Clin Immunol 2014; 13:379-85. [PMID: 23426007 DOI: 10.1097/aci.0b013e32835f5b07] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
PURPOSE OF REVIEW Nonspecific lipid transfer protein (LTP) is the main cause of primary food allergy in adults living in the Mediterranean area. The way allergic patients get sensitized to this protein is all but established, and the clinical expression of sensitization is extremely variable, ranging from long-lasting symptomless sensitization to severe anaphylaxis. Such variability is seemingly due to the presence/absence of a number of cofactors. RECENT FINDINGS The possibility that LTP sensitization occurs via the inhalation of LTP-containing pollen particles seems unlikely; in contrast, peach particles containing the protein seem able to sensitize both via the airways and the skin. Cosensitization to pollen allergens as well as to labile plant food allergens makes LTP allergy syndrome less severe. In some LTP sensitized subjects clinical food allergy occurs only in the presence of cofactors such as exercise, NSAIDs, or chronic urticaria. SUMMARY Lipid transfer protein allergy syndrome shows some peculiarities that are unique in the primary food allergy panorama: geographical distribution, frequent asymptomatic sensitization, frequent need for cofactors, and reduced severity when pollen allergy is present. Future studies will have to address these points as the results may have favorable effects on other, more severe, types of food allergy.
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Zuidmeer-Jongejan L, Fernández-Rivas M, Winter MGT, Akkerdaas JH, Summers C, Lebens A, Knulst AC, Schilte P, Briza P, Gadermaier G, van Ree R. Oil body-associated hazelnut allergens including oleosins are underrepresented in diagnostic extracts but associated with severe symptoms. Clin Transl Allergy 2014; 4:4. [PMID: 24484687 PMCID: PMC4015814 DOI: 10.1186/2045-7022-4-4] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2013] [Accepted: 01/10/2014] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Oil body-associated allergens such as oleosins have been reported for important allergenic foods such as peanut, sesame and hazelnut. Here we investigate whether oil body associated proteins (OAPs) are linked with specific clinical phenotypes and whether they are represented in skin prick test (SPT) reagents. METHODS A hazelnut OAP fraction was characterized by mass-spectrometry (MS) to identify its major constituents. Polyclonal rabbit antibodies were generated against hazelnut OAPs. The presence of OAPs in commercially available hazelnut SPTs was studied by immunoblot and spiking experiments. OAP-specific IgE antibodies were measured in sera from patients with a convincing history of hazelnut allergy by RAST (n = 91), immunoblot (n = 22) and basophil histamine release (BHR; n = 14). RESULTS Hazelnut OAPs were analysed by MS and found to be dominated by oleosins at ~14 and ~17 kDa, and a 27 kDa band containing oleosin dimers and unidentified protein. In 36/91 sera specific IgE against hazelnut OAPs was detected, and confirmed to be biologically active by BHR (n = 14). The majority (21/22) recognized the oleosin bands at 17 kDa on immunoblot, of which 11 exclusively. These OAP-specific IgE responses dominated by oleosin were associated with systemic reactions to hazelnut (OR 4.24; p = 0.015) and negative SPT (χ2 6.3, p = 0.012). Immunoblot analysis using OAP-specific rabbit antiserum demonstrated that commercial SPT reagents are virtually devoid of OAPs, sometimes (3/9) resulting in false-negative SPT. Spiking of SPT reagents with OAP restored serum IgE binding of these false-negative patients on immunoblot at mainly 17 kDa. CONCLUSION Hazelnut allergens found in oil bodies dominated by oleosin are associated with more severe systemic reactions and negative SPT. Defatted diagnostic extracts are virtually devoid of these allergens, resulting in poor sensitivity for detection of IgE antibodies against these clinically relevant molecules.
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Affiliation(s)
- Laurian Zuidmeer-Jongejan
- Department of Experimental Immunology, Academic Medical Center, Meibergdreef 9, Amsterdam 1105 AZ, The Netherlands
| | | | - Marcel GT Winter
- Department of Experimental Immunology, Academic Medical Center, Meibergdreef 9, Amsterdam 1105 AZ, The Netherlands
| | - Jaap H Akkerdaas
- Department of Experimental Immunology, Academic Medical Center, Meibergdreef 9, Amsterdam 1105 AZ, The Netherlands
| | | | - Ans Lebens
- Department Dermatology and Allergology, University Medical Centre Utrecht, Utrecht, The Netherlands
| | - André C Knulst
- Department Dermatology and Allergology, University Medical Centre Utrecht, Utrecht, The Netherlands
| | - Piet Schilte
- Department of Pediatrics, Medical Center Alkmaar, Alkmaar, TheNetherlands
| | - Peter Briza
- Christian Doppler Laboratory for Allergy Diagnosis and Therapy, Department of Molecular Biology, University of Salzburg, Salzburg, Austria
| | - Gabriele Gadermaier
- Christian Doppler Laboratory for Allergy Diagnosis and Therapy, Department of Molecular Biology, University of Salzburg, Salzburg, Austria
| | - Ronald van Ree
- Department of Experimental Immunology, Academic Medical Center, Meibergdreef 9, Amsterdam 1105 AZ, The Netherlands
- Department of Otorhinolaryngology, Academic Medical Center, Amsterdam, The Netherlands
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Masthoff LJ, Hoff R, Verhoeckx KCM, van Os-Medendorp H, Michelsen-Huisman A, Baumert JL, Pasmans SG, Meijer Y, Knulst AC. A systematic review of the effect of thermal processing on the allergenicity of tree nuts. Allergy 2013; 68:983-93. [PMID: 23889537 DOI: 10.1111/all.12185] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/11/2013] [Indexed: 12/22/2022]
Abstract
BACKGROUND Allergenicity of foods can be influenced by processing. Tree nuts are an important source of nutrition and increasingly consumed; however, processing methods are quite variable and data are currently lacking on the effects of processing on allergenicity. OBJECTIVE To perform a systematic literature review on the effects of food processing on the allergenicity of tree nuts. METHODS A systematic literature search of PubMed and Embase databases was performed, with screening of references, related articles and citations. Studies were included if they assessed the allergenicity or immunogenicity of processed nuts. RESULTS The search resulted in 32 articles suitable for analysis. Clinical studies indicate that roasting reduces the allergenicity of hazelnut in individuals with a birch pollen allergy and reactivity to raw hazelnut. Thermal processing may reduce the allergenicity of the PR-10 protein in hazelnut and almond in vitro. The majority of the in vitro studies investigating the allergenicity of nonspecific lipid transfer proteins (nsLTPs) and seed storage proteins in hazelnut, almond, cashew nut, Brazil nut, walnut, pecan nut and pistachio nut show heat stability towards different thermal processing methods. CONCLUSION Thermal processing may reduce allergenicity of PR-10 proteins in hazelnut and almond, in contrast to nsLTPs and seed storage proteins. This has important implications for source materials used for IgE testing and food challenges and diet advice.
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Affiliation(s)
- L. J. Masthoff
- Department of Dermatology/Allergology; University Medical Center Utrecht; Utrecht; The Netherlands
| | - R. Hoff
- Department of Dermatology/Allergology; University Medical Center Utrecht; Utrecht; The Netherlands
| | | | - H. van Os-Medendorp
- Department of Dermatology/Allergology; University Medical Center Utrecht; Utrecht; The Netherlands
| | - A. Michelsen-Huisman
- Department of Dermatology/Allergology; University Medical Center Utrecht; Utrecht; The Netherlands
| | - J. L. Baumert
- Food Allergy Research and Resource Program; University of Nebraska; Lincoln; NE; USA
| | | | | | - A. C. Knulst
- Department of Dermatology/Allergology; University Medical Center Utrecht; Utrecht; The Netherlands
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The management of paediatric allergy: not everybody's cup of tea--10-11th February 2012. Curr Opin Allergy Clin Immunol 2013; 13 Suppl 1:S1-50. [PMID: 23377496 DOI: 10.1097/aci.0b013e32835e8b94] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
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61
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Proteomic and immunological characterization of a new food allergen from hazelnut (Corylus avellana). J Proteomics 2013; 86:16-26. [DOI: 10.1016/j.jprot.2013.05.001] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2013] [Revised: 04/29/2013] [Accepted: 05/01/2013] [Indexed: 11/20/2022]
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62
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Sensitization to Cor a 9 and Cor a 14 is highly specific for a hazelnut allergy with objective symptoms in Dutch children and adults. J Allergy Clin Immunol 2013; 132:393-9. [PMID: 23582909 DOI: 10.1016/j.jaci.2013.02.024] [Citation(s) in RCA: 153] [Impact Index Per Article: 13.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2012] [Revised: 02/19/2013] [Accepted: 02/21/2013] [Indexed: 11/20/2022]
Abstract
BACKGROUND Component-resolved diagnosis has been shown to improve the diagnosis of food allergy. OBJECTIVE We sought to evaluate whether component-resolved diagnosis might help to identify patients at risk of objective allergic reactions to hazelnut. METHOD A total of 161 hazelnut-sensitized patients were included: 40 children and 15 adults with objective symptoms on double-blind, placebo-controlled food challenges (DBPCFCs) and 24 adults with a convincing objective history were compared with 41 children and 41 adults with no or subjective symptoms on DBPCFCs (grouped together). IgE levels to hazelnut extract and single components were analyzed with ImmunoCAP. RESULTS IgE levels to hazelnut extract were significantly higher in children with objective than with no or subjective symptoms. In 13% of children and 49% of adults with hazelnut allergy with objective symptoms, only sensitization to rCor a 1.04 was observed and not to other water-soluble allergens. Sensitization to rCor a 8 was rare, which is in contrast to rCor a 1. Sensitization to nCor a 9, rCor a 14, or both was strongly associated with hazelnut allergy with objective symptoms. By using adapted cutoff levels, a diagnostic discrimination between severity groups was obtained. IgE levels to either nCor a 9 of 1 kUA/L or greater or rCor a 14 of 5 kUA/L or greater (children) and IgE levels to either nCor a 9 of 1 kUA/L or greater or rCor a 14 of 1 kUA/L or greater (adults) had a specificity of greater than 90% and accounted for 83% of children and 44% of adults with hazelnut allergy with objective symptoms. CONCLUSION Sensitization to Cor a 9 and Cor a 14 is highly specific for patients with objective symptoms in DBPCFCs as a marker for a more severe hazelnut allergic phenotype.
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63
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Pascal M, Muñoz-Cano R, Reina Z, Palacín A, Vilella R, Picado C, Juan M, Sánchez-López J, Rueda M, Salcedo G, Valero A, Yagüe J, Bartra J. Lipid transfer protein syndrome: clinical pattern, cofactor effect and profile of molecular sensitization to plant-foods and pollens. Clin Exp Allergy 2013; 42:1529-39. [PMID: 22994350 DOI: 10.1111/j.1365-2222.2012.04071.x] [Citation(s) in RCA: 127] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND Multiple plant-food sensitizations with a complex pattern of clinical manifestations are a common feature of lipid transfer protein (LTP)-allergic patients. Component-resolved diagnosis permits the diagnosis of the allergen sensitization profile. OBJECTIVE We sought to clinically characterize and describe the plant-food and pollen molecular sensitization profile in patients with LTP syndrome. METHODS Forty-five subjects were recruited, after being diagnosed with multiple plant-food allergies sensitized to LTP, but not to any other plant-food allergen, according to the molecular allergen panel tested (Pru p 3 (LTP), Pru p 1 (Bet v 1-like), Pru p 4 (profilin) and those included in a commercial microarray of 103 allergenic components). IgE-mediated food-allergy symptoms and pollinosis were collected. Patients were skin prick tested with a plant-food and pollens panel, and specific IgE to Tri a 14 was evaluated. RESULTS A heterogeneous group of plant-foods was involved in local and systemic symptoms: oral allergy syndrome (75.6%), urticaria (66.7%), gastrointestinal disorders (55.6%) and anaphylaxis (75.6%), 32.4% of which were cofactor dependent (Non-Steroidal Anti-inflammatory Drugs, exercise). All tested subjects were positive to peach and Pru p 3, Tri a 14 and to some of the LTPs included in the microarray. Pollinosis was diagnosed in 75.6% of subjects, with a broad spectrum of pollen and pollen-allergen sensitization. Plane tree and mugwort were the statistically significant pollens associated with Pru p 3. CONCLUSIONS AND CLINICAL RELEVANCE Several plant-foods, taxonomically unrelated, independent of peach involvement, are implicated in LTP syndrome. Local symptoms should be evaluated as a risk marker for anaphylaxis because they are frequently associated with cofactor-dependent anaphylaxis. The association of these symptoms with pollinosis, especially plane tree pollinosis, could be part of this syndrome in our area.
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Affiliation(s)
- M Pascal
- Servei d'Immunologia, Centre de Diagnòstic Biomèdic, Hospital Clínic, Barcelona, Spain
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Standardizing double-blind, placebo-controlled oral food challenges: American Academy of Allergy, Asthma & Immunology-European Academy of Allergy and Clinical Immunology PRACTALL consensus report. J Allergy Clin Immunol 2013. [PMID: 23195525 DOI: 10.1016/j.jaci.2012.10.017] [Citation(s) in RCA: 503] [Impact Index Per Article: 45.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Garino C, Locatelli M, Coïsson JD, D'Andrea M, Cereti E, Travaglia F, Arlorio M. Gene transcription analysis of hazelnut (Corylus avellanaL.) allergens Cor a 1, Cor a 8 and Cor a 11: a comparative study. Int J Food Sci Technol 2013. [DOI: 10.1111/ijfs.12079] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Cristiano Garino
- Dipartimento di Scienze del Farmaco; Drug & Food Biotechnology Center, Università del Piemonte Orientale “A. Avogadro”; largo Donegani 2; 28100; Novara; Italy
| | - Monica Locatelli
- Dipartimento di Scienze del Farmaco; Drug & Food Biotechnology Center, Università del Piemonte Orientale “A. Avogadro”; largo Donegani 2; 28100; Novara; Italy
| | - Jean Daniel Coïsson
- Dipartimento di Scienze del Farmaco; Drug & Food Biotechnology Center, Università del Piemonte Orientale “A. Avogadro”; largo Donegani 2; 28100; Novara; Italy
| | - Matteo D'Andrea
- Dipartimento di Scienze del Farmaco; Drug & Food Biotechnology Center, Università del Piemonte Orientale “A. Avogadro”; largo Donegani 2; 28100; Novara; Italy
| | - Elisabetta Cereti
- Dipartimento di Scienze del Farmaco; Drug & Food Biotechnology Center, Università del Piemonte Orientale “A. Avogadro”; largo Donegani 2; 28100; Novara; Italy
| | - Fabiano Travaglia
- Dipartimento di Scienze del Farmaco; Drug & Food Biotechnology Center, Università del Piemonte Orientale “A. Avogadro”; largo Donegani 2; 28100; Novara; Italy
| | - Marco Arlorio
- Dipartimento di Scienze del Farmaco; Drug & Food Biotechnology Center, Università del Piemonte Orientale “A. Avogadro”; largo Donegani 2; 28100; Novara; Italy
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Ebo D, Swerts S, Sabato V, Hagendorens M, Bridts C, Jorens P, De Clerck L. New Food Allergies in a European Non-Mediterranean Region: IsCannabis sativato Blame? Int Arch Allergy Immunol 2013; 161:220-8. [DOI: 10.1159/000346721] [Citation(s) in RCA: 50] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2012] [Accepted: 12/19/2012] [Indexed: 11/19/2022] Open
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Lange L, Beyer K, Kleine-Tebbe J. Molekulare Diagnostik bei Allergie gegen Schalenfrüchte. ALLERGO JOURNAL 2012. [DOI: 10.1007/s15007-012-0390-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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68
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Paşaoğlu G, Mungan D, Misirligil Z. Allergy to hazelnut in adults: a two-step study. Allergol Immunopathol (Madr) 2012; 40:288-94. [PMID: 21862196 DOI: 10.1016/j.aller.2011.05.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2010] [Revised: 04/19/2011] [Accepted: 05/02/2011] [Indexed: 11/20/2022]
Abstract
BACKGROUND Although hazelnut consumption is very high in Turkey, the prevalence of hazelnut allergy is still unknown. This study's objective was to investigate the prevalence of hazelnut sensitisation and to verify its clinical importance using double-blind, placebo-controlled challenge (DBPCFC) in an adult population. METHODS Prick-to-prick skin tests were performed with fresh hazelnut in 904 patients admitted to the allergy department. Among the 904 subjects, 20 patients with a history of allergic reactions to hazelnut and/or positive skin tests were recalled for further evaluation. Specific IgE was measured in these subjects. Eleven (11/20) patients accepted to undergo DBPCFC with hazelnut. RESULTS Among the 904 individuals, the history of reactions to hazelnut was positive in 16 subjects (1.8%); prick-to-prick skin tests were positive in 13 (1.4%); prick tests with the commercial product were positive in nine (0.9%); and history plus skin tests were positive in 16 (1.8%). Specific IgE to hazelnut was positive in only three patients. DBPCFC was conducted in 11 subjects with a positivity rate of 63.6% (7/11). We observed six mild and one moderate systemic reactions during the DBPCFC. Among seven subjects with a positive DBPCFC, six (85.7%) had a history of hazelnut allergy, and five (71.4%) had both history and skin test positivity. CONCLUSION Skin test sensitisation to hazelnut was found to be 1.76% (16/904) which is similar to the sensitisation rate in previous reports. However, DBPCFC was positive in 63% of cases with a history of hazelnut allergy and/or positive skin tests in this study. These results indicate that the presence of history with a positive skin test can be suggestive of hazelnut allergy; however an oral food challenge is needed to confirm the diagnosis.
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Affiliation(s)
- G Paşaoğlu
- Ankara University, School of Medicine, Department of Allergy, Ankara, Turkey.
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69
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Le TM, van Hoffen E, Lebens AFM, Bruijnzeel-Koomen CAFM, Knulst AC. Anaphylactic versus mild reactions to hazelnut and apple in a birch-endemic area: different sensitization profiles? Int Arch Allergy Immunol 2012; 160:56-62. [PMID: 22948203 DOI: 10.1159/000339244] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2011] [Accepted: 05/02/2012] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Hazelnut and apple are common causes of food allergy in Europe. In northern Europe, symptoms are usually mild and associated with cross-reactivity to the birch pollen allergen, Bet v 1. In the Mediterranean area, symptoms are more frequently severe and associated with sensitization to lipid transfer protein (LTP). This study compared patients with anaphylactic versus mild reactions to hazelnut and apple in The Netherlands, a birch-endemic area, with respect to sensitization to Bet v 1-homologues (i.e. PR10-proteins) and LTP. METHODS Twenty-one patients fulfilling the criteria for anaphylaxis and 21 with only mild symptoms (oral allergy) to hazelnut and/or apple were recruited. Specific immunoglobulin E to birch pollen, apple, hazelnut and PR10-proteins (rBet v 1, rPru p 1, rMal d 1 and rCor a 1) and recombinant LTP (rPru p 3 and rCor a 8) was measured by ImmunoCAP. RESULTS Both mild and anaphylactic apple-allergic patients were sensitized to PR10-proteins, whereas only 1/7 of the mild and none of the anaphylactic apple-allergic patients was sensitized to LTP. In contrast, anaphylactic hazelnut-allergic patients displayed no such clear sensitization pattern: some were sensitized to both PR10-proteins and hazelnut LTP (1/9), and others to only LTP (2/9) or to only PR10-proteins (4/9) or to neither PR10-proteins nor LTP (2/9). CONCLUSION This study shows that in a birch-endemic area, the sensitization profile to PR10-proteins and LTP in anaphylactic patients may differ between different plant foods. In this patient group, anaphylaxis to hazelnut can be LTP-associated, whereas anaphylaxis to apple is not.
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Affiliation(s)
- T M Le
- Department of Dermatology and Allergology, University Medical Center Utrecht, Utrecht, The Netherlands.
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70
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Dölle S, Hompes S, Grünhagen J, Worm M. [Food-associated anaphylaxis. Data from the anaphylaxis registry]. Hautarzt 2012; 63:294-8. [PMID: 22430610 DOI: 10.1007/s00105-011-2265-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Severe allergic reactions are reported to the anaphylaxis registry in German-speaking countries. The data provides knowledge regarding the diagnosis and management of patients suffering from anaphylaxis. The ranking of the most frequent elicitors inducing anaphylaxis is age-dependent and also influenced by the group which is reporting the data. The list of food allergens inducing anaphylaxis also varies with age. In children and adolescents peanuts are common elicitors of food-dependent anaphylaxis: in adults wheat is the most frequent cause. Furthermore, the data from the anaphylaxis registry provides information about rare triggers, as well as alerting us to those causative agents which are increasing in frequency. The relevance of augmentation factors is most likely age-dependent, whereas co-morbidities including atopic diseases like atopic dermatitis and allergic asthma occur frequently in children suffering from food-dependent anaphylaxis. The present manuscript provides data on food allergens such as peas and cauliflower, which have been reported as rare causes of anaphylaxis.
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Affiliation(s)
- S Dölle
- Allergie-Centrum-Charité, Klinik für Dermatologie, Venerologie und Allergologie, Charité - Universitätsmedizin Berlin, Charitéplatz 1, 10117, Berlin, Deutschland
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71
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Wolthers OD. Component-resolved diagnosis in pediatrics. ISRN PEDIATRICS 2012; 2012:806920. [PMID: 22919510 PMCID: PMC3420125 DOI: 10.5402/2012/806920] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/05/2012] [Accepted: 06/28/2012] [Indexed: 11/23/2022]
Abstract
Component resolved diagnosis is a new concept in the investigation of pediatric allergic disease. The aim of the present paper is to review the available data on component resolved diagnosis with respect to implications for investigation of children with allergic disease. In most conditions head-to-head comparisons of component resolved diagnosis with traditional IgE testing have not been performed. Rather than alternatives the molecular methods should be seen as adjuncts to the cheaper traditional specific IgE tests. It may be appropriate to determine IgE antibodies to components as part of the diagnostic work-up in selected cases of peanut and birch pollen allergy and in hymenoptera allergy. However, cost benefit analyses of component resolved diagnosis compared with traditional work-up of allergy are needed. Prospectively planned protocols for assessment of the extent to which component resolved diagnosis may be able to improve the selection of children to immunotherapy and, thus, the efficacy of immunotherapy, are needed. Finally, studies of component resolved diagnosis with microarray technology in screening panels with hundreds of components should be undertaken before it can be determined to which extent such panel screening, if at all, may be helpful in children.
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Affiliation(s)
- Ole D Wolthers
- Asthma and Allergy Clinic, Children's Clinic Randers, Dytmærsken 9, 8900 Randers, Denmark
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72
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Alessandri S, Sancho A, Vieths S, Mills CEN, Wal JM, Shewry PR, Rigby N, Hoffmann-Sommergruber K. High-throughput NMR assessment of the tertiary structure of food allergens. PLoS One 2012; 7:e39785. [PMID: 22768312 PMCID: PMC3388089 DOI: 10.1371/journal.pone.0039785] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2012] [Accepted: 05/30/2012] [Indexed: 11/25/2022] Open
Abstract
Background In vitro component-resolved diagnosis of food allergy requires purified allergens that have to meet high standards of quality. These include the authentication of their conformation, which is relevant for the recognition by specific IgE antibodies from allergic patients. Therefore, highly sensitive and reliable screening methods for the analysis of proteins/allergens are required to assess their structural integrity. In the present study one-dimensional 1H Nuclear Magnetic Resonance (1D 1H-NMR) analysis was adopted for the assessment of overall structural and dynamic properties and authentication of a set of relevant food allergens, including non-specific lipid transfer proteins from apple, peach and hazelnut, 7/8S seed storage globulins from hazelnut and peanut, 11S seed storage globulins from hazelnut and peanut, caseins from cows' and goats' milk and tropomyosin from shrimp. Methodology/Principal Findings Two sets of 1D 1H-NMR experiments, using 700 MHz and 600 MHz instruments at 298 K were carried out to determine the presence and the extent of tertiary structure. Structural similarity among members of the individual allergen families was also assessed and changes under thermal stress investigated. The nuclear magnetic resonance (NMR) results were compared with structural information available either from the literature, Protein Data Bank entries, or derived from molecular models. Conclusions/Significance 1D 1H-NMR analysis of food allergens allowed their classification into molecules with rigid, extended and ordered tertiary structures, molecules without a rigid tertiary structure and molecules which displayed both features. Differences in thermal stability were also detected. In summary, 1D 1H-NMR gives insights into molecular fold of proteins and offers an independent method for assessing structural properties of proteins.
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Affiliation(s)
- Stefano Alessandri
- CERM, Centro di Ricerca di Risonanze Magnetiche and Department of Agricultural Biotechnology, University of Florence, Florence, Italy
| | - Ana Sancho
- Institute of Food Research, Norwich, United Kingdom
| | | | | | - Jean-Michel Wal
- INRA, UR496 Immuno-Allergie Alimentaire, CEA/iBiTeC-S/SPI, CEA de Saclay, Gif sur Yvette, France
| | | | - Neil Rigby
- Institute of Food Research, Norwich, United Kingdom
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Ballmer-Weber BK, Skamstrup Hansen K, Sastre J, Andersson K, Bätscher I, Östling J, Dahl L, Hanschmann KM, Holzhauser T, Poulsen LK, Lidholm J, Vieths S. Component-resolved in vitro diagnosis of carrot allergy in three different regions of Europe. Allergy 2012; 67:758-66. [PMID: 22486768 DOI: 10.1111/j.1398-9995.2012.02827.x] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/13/2012] [Indexed: 10/28/2022]
Abstract
BACKGROUND Carrot is a frequent cause of food allergy in Europe. The objective of this study was to evaluate a panel of carrot allergens for diagnosis of carrot allergy in Spain, Switzerland and Denmark. METHODS Forty-nine carrot allergic patients, 71 pollen allergic but carrot-tolerant patients and 63 nonatopic controls were included. Serum IgE to carrot extract, recombinant carrot allergens (rDau c 1.0104; rDau c 1.0201; rDau c 4; the isoflavone reductase-like proteins rDau c IFR 1, rDau c IFR 2; the carrot cyclophilin rDau c Cyc) were analyzed by ImmunoCAP. RESULTS The sensitivity of the carrot extract-based test was 82%. Use of the recombinant allergens increased the sensitivity to 90%. The Dau c 1 isoforms were major allergens for Swiss and Danish carrot allergic patients, the profilin rDau c 4 for the Spanish patients. The rDau c IFR 1 and rDau c IFR 2 were recognized by 6% and 20% of the carrot allergics, but did not contribute to a further increase of sensitivity. Among pollen allergic controls, 34% had IgE to carrot extract, 18% to each of rDau c 1.0104, rDau c 1.0201 and rDau c 4, 8% to rDau c IFR 1 and 7% to rDau c IFR 2. Sensitization to rDau c Cyc occurred in one carrot allergic patient and one nonatopic control. CONCLUSION Component-resolved in vitro analyses revealed a significant difference in IgE sensitization pattern between geographical regions and in the prevalence of sensitization to carrot components between carrot allergic and carrot-tolerant but pollen sensitized patients.
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Affiliation(s)
- B. K. Ballmer-Weber
- Allergy Unit; Department of Dermatology; University Hospital; Zürich; Switzerland
| | | | - J. Sastre
- Servicio de Alergologia; Fundación Jiménez Diaz; Madrid; Spain
| | | | - I. Bätscher
- Allergy Unit; Department of Dermatology; University Hospital; Zürich; Switzerland
| | | | - L. Dahl
- Division of Allergology; Paul-Ehrlich-Institut; Langen; Germany
| | | | - T. Holzhauser
- Division of Allergology; Paul-Ehrlich-Institut; Langen; Germany
| | - L. K. Poulsen
- Allergy Unit; Department of Dermatology; University Hospital; Zürich; Switzerland
| | | | - S. Vieths
- Division of Allergology; Paul-Ehrlich-Institut; Langen; Germany
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74
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Masthoff LJ, Pasmans SG, Hoffen E, Knol MJ, Bruijnzeel-Koomen CA, Flinterman AE, Kentie P, Knulst AC, Meijer Y. Diagnostic value of hazelnut allergy tests including rCor a 1 spiking in double-blind challenged children. Allergy 2012; 67:521-7. [PMID: 22175765 DOI: 10.1111/j.1398-9995.2011.02766.x] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/15/2011] [Indexed: 01/27/2023]
Abstract
BACKGROUND The diagnostic value of hazelnut allergy tests in double-blind challenged children is largely unknown. The aim of this study was to analyze the performance of current diagnostic tests for hazelnut allergy in children and the effect of spiking. METHODS Data of 151 children who underwent a double-blind placebo-controlled food challenge for hazelnut were analyzed. The positive predictive value and negative predictive value (PPV/NPV) of level of specific IgE (sIgE) for hazelnut, the influence of rCor a 1 spiking of the ImmunoCAP, and size of the skin prick test (SPT) for hazelnut were determined, also in relation to the severity of the hazelnut allergy. Reported accidental ingestion leading to an allergic reaction to hazelnut was also analyzed in relation to hazelnut allergy. RESULTS Specific IgE ≥0.35 kU(A) /l for hazelnut was a moderate predictor for hazelnut allergy. The spiking decreased the PPV from 41% to 38% and increased the NPV from 91% to 100% for sIgE ≥0.35 kU(A) /l. The maximum reached PPV was 73% for sIgE cutoff of 26 kU(A) /l. Level of sIgE before spiking was significantly different between different grades of severity and was lost after spiking. Skin prick test was a better predictor for hazelnut allergy and severity than the level of sIgE. A history of accidental ingestion leading to an allergic reaction to hazelnut had a predictive value of 59% for hazelnut allergy. CONCLUSIONS This study showed a good NPV of diagnostic tests for hazelnut allergy in children which further improved by rCor a 1 spiking. However, the PPVs are moderate and decreased by spiking.
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Affiliation(s)
- L. J. Masthoff
- Department of Dermatology and Allergology; University Medical Center Utrecht; Utrecht; the Netherlands
| | | | - E. Hoffen
- Department of Dermatology and Allergology; University Medical Center Utrecht; Utrecht; the Netherlands
| | - M. J. Knol
- Julius Center for Health Sciences and Primary Care; University Medical Center Utrecht; Utrecht; the Netherlands
| | - C. A. Bruijnzeel-Koomen
- Department of Dermatology and Allergology; University Medical Center Utrecht; Utrecht; the Netherlands
| | - A. E. Flinterman
- Department of Dermatology and Allergology; University Medical Center Utrecht; Utrecht; the Netherlands
| | | | - A. C. Knulst
- Department of Dermatology and Allergology; University Medical Center Utrecht; Utrecht; the Netherlands
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75
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Cucu T, De Meulenaer B, Bridts C, Devreese B, Ebo D. Impact of thermal processing and the Maillard reaction on the basophil activation of hazelnut allergic patients. Food Chem Toxicol 2012; 50:1722-8. [PMID: 22406579 DOI: 10.1016/j.fct.2012.02.069] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2012] [Revised: 02/21/2012] [Accepted: 02/22/2012] [Indexed: 01/23/2023]
Abstract
Food allergy, an abnormal immunological response due to sensitization to a food component, has become an important health problem, especially in industrialized countries. The aim of this study was to investigate the impact of thermal processing and glycation on the basophil activation by hazelnut proteins using a basophil activation test. Patients with systemic allergic reactions (SR; n=6) to hazelnut as well as patients with an isolated oral allergy syndrome (OAS; n=4) were investigated. Thermal processing of hazelnut proteins either in the presence or absence of wheat proteins did not result in major changes in the stimulatory activity of the basophils for patients with SR or OAS. For the patients with OAS, incubation of hazelnut proteins with glucose led to complete depletion of the stimulatory activity of the basophils. An increase in stimulatory activity of the basophils for two out of six patients with SR was observed. For the other four patients slight or complete abolition of the stimulatory activity was observed. These results indicate that some patients with SR to hazelnut are at risk when exposed to hazelnut proteins, even in processed foods.
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Affiliation(s)
- Tatiana Cucu
- Department of Food Safety and Food Quality, Research Group Food Chemistry and Human Nutrition, Ghent University, Coupure Links 653, B-9000 Gent, Belgium
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76
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Pelkonen AS, Kuitunen M, Dunder T, Reijonen T, Valovirta E, Mäkelä MJ. Allergy in children: practical recommendations of the Finnish Allergy Programme 2008-2018 for prevention, diagnosis, and treatment. Pediatr Allergy Immunol 2012; 23:103-16. [PMID: 22432881 DOI: 10.1111/j.1399-3038.2012.01298.x] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
The Finnish Allergy Programme 2008-2018 is a comprehensive plan intended to reduce the burden of allergies. One basic goal is to increase immunologic tolerance and change attitudes to encourage health instead of medicalizing common and mild allergy symptoms. The main goals can be listed as to: (i) prevent the development of allergic symptoms; (ii) increase tolerance to allergens; (iii) improve diagnostics; (iv) reduce work-related allergies; (v) allocate resources to manage and prevent exacerbations of severe allergies, and (vi) reduce costs caused by allergic diseases. So far, the Allergy Programme has organized 135 educational meetings for healthcare professionals around Finland. These meetings are multidisciplinary meetings gathering together all healthcare professionals working with allergic diseases. Since the start of the program in spring 2008, more than 7000 participants have taken part. Educational material for patient care has been provided on special Web sites/therapeutic portals, which can be accessed by all physicians caring for allergic patients. Local Allergy Working Groups have been created in different parts of Finland. As a part of the Programme, a set of guidelines for child welfare clinics was prepared. Child welfare clinics have a key role in the screening of illnesses and providing advice to families with a symptomatic child. The guidelines aimed to facilitate pattern recognition and clinical decision making for public health nurses and doctors are described in this paper.
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Affiliation(s)
- Anna S Pelkonen
- Department of Allergy, Helsinki University Central Hospital, Helsinki, Finland
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77
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Martens M, Schnoor HJ, Malling HJ, Poulsen LK. Sensitization to cereals and peanut evidenced by skin prick test and specific IgE in food-tolerant, grass pollen allergic patients. Clin Transl Allergy 2011; 1:15. [PMID: 22409998 PMCID: PMC3339337 DOI: 10.1186/2045-7022-1-15] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2011] [Accepted: 12/09/2011] [Indexed: 01/28/2023] Open
Abstract
BACKGROUND The botanical relation between grass and cereal grains may be relevant when diagnosing food allergy to cereals. The aim was to investigate the diagnostic specificity of skin prick test (SPT) and specific immunoglobulin E (sIgE) tests to cereals and peanut in grass pollen allergic subjects without history of, and clinically reactions to foods botanically related to grass. METHODS 70 subjects (41 females; mean age 32 years) and 20 healthy controls (13 females; mean age 24 years) were tested by open food challenge (OFC) with cereals and peanut. SPT and sIgE both with Immulite® (Siemens) and ImmunoCAP® (Phadia) to grass and birch pollen, cereals, peanut and bromelain were performed. RESULTS Of the 65 OFC-negative subjects 29-46% (SPT, depending on cut-off), 20% (Immulite) and 38% (ImmunoCAP) had positive results to one or more of the foods tested. Controls were negative in all tests. Cross-reactive carbohydrate determinants (CCD) as evidenced by reaction to bromelain could explain only a minority of the measured IgE-sensitizations. CONCLUSION Grass pollen allergic patients with documented food tolerance to cereals and peanut may express significant sensitization. False-positive cereal or peanut allergy diagnoses may be a quantitatively important problem both in routine clinical work and epidemiological studies.
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Affiliation(s)
- Maria Martens
- Allergy Clinic, Copenhagen University Hospital, Gentofte, Denmark.
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Allergenic lipid transfer proteins from plant-derived foods do not immunologically and clinically behave homogeneously: the kiwifruit LTP as a model. PLoS One 2011; 6:e27856. [PMID: 22114713 PMCID: PMC3219694 DOI: 10.1371/journal.pone.0027856] [Citation(s) in RCA: 62] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2011] [Accepted: 10/26/2011] [Indexed: 01/12/2023] Open
Abstract
Background Food allergy is increasingly common worldwide. Tools for allergy diagnosis measuring IgE improved much since allergenic molecules and microarrays started to be used. IgE response toward allergens belonging to the same group of molecules has not been comprehensively explored using such approach yet. Objective Using the model of lipid transfer proteins (LTPs) from plants as allergens, including two new structures, we sought to define how heterogeneous is the behavior of homologous proteins. Methods Two new allergenic LTPs, Act d 10 and Act c 10, have been identified in green (Actinidia deliciosa) and gold (Actinidia chinensis) kiwifruit (KF), respectively, using clinically characterized allergic patients, and their biochemical features comparatively evaluated by means of amino acid sequence alignments. Along with other five LTPs from peach, mulberry, hazelnut, peanut, mugwort, KF LTPs, preliminary tested positive for IgE, have been immobilized on a microarray, used for IgE testing 1,003 allergic subjects. Comparative analysis has been carried out. Results Alignment of Act d 10 primary structure with the other allergenic LTPs shows amino acid identities to be in a narrow range between 40 and 55%, with a number of substitutions making the sequences quite different from each other. Although peach LTP dominates the IgE immune response in terms of prevalence, epitope recognition driven by sequence heterogeneity has been recorded to be distributed in a wide range of behaviors. KF LTPs IgE positive results were obtained in a patient subset IgE positive for the peach LTP. Anyhow, the negative results on homologous molecules allowed us to reintroduce KF in patients' diet. Conclusion The biochemical nature of allergenic molecule belonging to a group of homologous ones should not be taken as proof of immunological recognition as well. The availability of panels of homologous molecules to be tested using microarrays is valuable to address the therapeutic intervention.
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Akkerdaas J, Finkina EI, Balandin SV, Santos Magadán S, Knulst A, Fernandez-Rivas M, Asero R, van Ree R, Ovchinnikova TV. Lentil (Lens culinaris) lipid transfer protein Len c 3: a novel legume allergen. Int Arch Allergy Immunol 2011; 157:51-7. [PMID: 21912173 DOI: 10.1159/000324946] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2010] [Accepted: 02/07/2011] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Lentils are increasingly consumed in many parts of the world.Two allergens, Len c 1 and 2, have been reported previously. Recently, peanut and green bean lipid transfer proteins (LTPs) have been identified as the first two members of an important group of allergens that might be associated with severe food allergies. OBJECTIVE To investigate lentil LTP as a potential new allergen. METHODS Efficacy of LTP extraction was monitored at different acidic pH values, using immunoblotting with cross-reactive anti-peach LTP antiserum. Natural LTP was purified from lentil extract and expressed as recombinant allergen in Escherichia coli. Sera from 10 lentil-allergic and/or -sensitized patients (Spain: 6, Italy: 1 and the Netherlands: 3) were used to further characterize lentil LTP. RESULTS Natural lentil LTP, purified from the homogenized germinated seeds and optimally extracted at pH 3, was identified and designated as allergen Len c 3. By CAP, 9/10 sera showed specific IgE to Len c 3. Recombinant (r) Len c 3 was successfully purified. The natural (n) Len c 3 CAP was completely inhibited by rLen c 3/rPru p 3. IgE binding to lentil pH 3 extract blot was completely inhibited by rLen c 3. CONCLUSION The availability of immunochemically active nLen/rLen c 3 as a novel legume allergen facilitates further development and implementation of a third (next to peanut and green bean) legume LTP in component-resolved diagnosis strategies and contributes to evaluate the clinical importance of legume LTPs. Preferential extraction of Len c 3 (pH 3) will affect the production of sensitive extract-based diagnostic tests.
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80
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The fascinating world of molecular diagnosis in the management of food allergy: nondum matura est. Curr Opin Allergy Clin Immunol 2011; 11:200-3. [DOI: 10.1097/aci.0b013e32834694ae] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
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81
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Han D, Lai X, Gjesing B, Zhong N, Zhang L, Spangfort MD. The specific IgE reactivity pattern of weed pollen-induced allergic rhinitis patients. Acta Otolaryngol 2011; 131:533-8. [PMID: 21189055 DOI: 10.3109/00016489.2010.539265] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
CONCLUSION Specific immunoglobulin E (IgE) reactivity towards the major mugwort allergen Art v 1 is a good indicator for Art v sensitization. Allergens from the ragweed species Amb t and Amb a possibly share common IgE-binding epitopes. OBJECTIVE The aim of this study was to investigate the reactivity pattern of IgE in Chinese patients with weed pollen-induced allergic rhinitis. METHODS Sera from 50 weed pollen-induced allergic rhinitis patients were tested for specific serum IgE reactivity against allergenic extracts of mugwort (Artemisia vulgaris, Art v), short ragweed (Ambrosia artemisiifolia, Amb a), giant ragweed (Ambrosia trifida, Amb t), and single allergens of Art v 1, Art v 3, Amb a 1, and profilin. RESULTS Sera from 88% of the patients demonstrated positive specific IgE reactivity to Art v, and of these 82% were positive to Art v 1. Sera from 38% of the patients showed positive specific IgE reactivity to both ragweed species Amb t and Amb a. A strong correlation was found between the specific IgE levels of Amb t and Amb a. Of the Amb a IgE-positive patients, 38% were positive for Amb a 1. Of all patient sera tested, 12% were specific IgE-positive to profilin.
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Affiliation(s)
- Demin Han
- Department of Otolaryngology, Head and Neck Surgery, Beijing TongRen Hospital, Beijing Institute of Otolaryngology, Capital Medical University, No. 17 HouGouHuTong, Beijing, China
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Moneret-Vautrin DA, Vitte J, Jacquenet S, Morisset M, Denery-Papini S, Renaudin JM, Codreanu F, Bonardel N, Fardeaux MF, Beaudouin E. Diagnostic de l’IgE-réactivité par analyse des composants moléculaires (test ISAC). REVUE FRANCAISE D ALLERGOLOGIE 2011. [DOI: 10.1016/j.reval.2011.01.007] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
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Birch pollen–related food allergy: Clinical aspects and the role of allergen-specific IgE and IgG4 antibodies. J Allergy Clin Immunol 2011; 127:616-22.e1. [DOI: 10.1016/j.jaci.2010.10.027] [Citation(s) in RCA: 164] [Impact Index Per Article: 12.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2010] [Revised: 09/10/2010] [Accepted: 10/18/2010] [Indexed: 12/24/2022]
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84
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Verweij MM, Hagendorens MM, De Knop KJ, Bridts CH, De Clerck LS, Stevens WJ, Ebo DG. Young infants with atopic dermatitis can display sensitization to Cor a 9, an 11S legumin-like seed-storage protein from hazelnut (Corylus avellana). Pediatr Allergy Immunol 2011; 22:196-201. [PMID: 20579306 DOI: 10.1111/j.1399-3038.2010.01088.x] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Allergy to hazelnut (Corylus avellana) can be severe and occur at young age. Atopic dermatitis (AD) can involve sensitization to various foods. The objective is to investigate the pattern of hazelnut sensitization in infants with AD. Sera of 34 infants all under 1 year of age and suffering from AD were selected according to prior specific IgE results. Twenty-nine infants were sensitized to traditional food allergens, five were not. From the 29 infants with a sensitization to at least one food allergen, 20 demonstrated IgE reactivity to hazelnut. All sera were analyzed with the allergen microarray immunoassay (ImmunoCAP ISAC). Twelve (60%) of the children with IgE reactivity to hazelnut demonstrated sensitization to Cor a 9, the 11S legumin-like seed-storage protein from hazelnut. In these infants, no sensitization to Cor a 1, the homologue of the major birch pollen allergen Bet v 1 (Betula verrucosa), or the lipid transfer protein (Cor a 8) from hazelnut was demonstrable. Half of the children sensitized to Cor a 9 demonstrated IgE reactivity to its homologue in peanut (Arachis hypogaea; Ara h 3) from which five were also sensitized to Gly m 6 from soy (Glycine max). None of the infants with AD without IgE reactivity to hazelnut demonstrated sensitization to Cor a 1, 8, or 9. In conclusion, young infants with atopic dermatitis sensitized to hazelnut can already display IgE reactivity to Cor a 9, a potentially dangerous hazelnut component. The mechanism(s) of this early sensitization and its clinical significance remain elusive.
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Affiliation(s)
- Marjoke M Verweij
- Department of Immunology-Allergology-Rheumatology, Faculty of Medicine, University of Antwerp, Antwerpen, Belgium
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Abstract
Food allergies affect up to 6% of young children and 3%-4% of adults. They encompass a range of disorders that may be IgE and/or non-IgE mediated, including anaphylaxis, pollen food syndrome, food-protein-induced enterocolitis syndrome, food-induced proctocolitis, eosinophilic gastroenteropathies, and atopic dermatitis. Many complex host factors and properties of foods are involved in the development of food allergy. With recent advances in the understanding of how these factors interact, the development of several novel diagnostic and therapeutic strategies is underway and showing promise.
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Affiliation(s)
- Julie Wang
- Division of Allergy and Immunology, Department of Pediatrics, Mount Sinai Hospital, New York, New York, USA.
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86
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De Knop KJ, Verweij MM, Grimmelikhuijsen M, Philipse E, Hagendorens MM, Bridts CH, De Clerck LS, Stevens WJ, Ebo DG. Age-related sensitization profiles for hazelnut (Corylus avellana) in a birch-endemic region. Pediatr Allergy Immunol 2011; 22:e139-49. [PMID: 21342279 DOI: 10.1111/j.1399-3038.2011.01112.x] [Citation(s) in RCA: 74] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND Symptoms of hazelnut allergy seem related to geographic and possibly age variations in allergen recognition. OBJECTIVE To investigate sensitization profiles of hazelnut allergy in different age groups in a birch-endemic region using component resolved diagnosis (CRD) by microarray. METHODS Sixty-five patients with hazelnut allergy, 27 healthy control individuals tolerant to hazelnut, and 34 birch pollen allergic but hazelnut tolerant individuals were included. All blood samples were analyzed using ISAC microarray. RESULTS Twenty-nine patients with hazelnut allergy suffered from a systemic reaction (17 preschool children with a median age of 2 years, six school children, and six adults), whereas 36 patients reported an oral allergy syndrome (OAS; three preschool and nine school children and 24 adults). In the hazelnut allergic preschool children with systemic reactions, 65% were sensitized to Cor a 9, 12% to Cor a 8, 18% to Cor a 1.04, 6% to Cor a 1.0101, and 29% to Bet v 1. Of the school-aged systemic reactors, 50% were sensitized to Cor a 9, 17% to Cor a 8, 50% to Cor a 1.04 and Cor a 1.0101, and 67% to Bet v 1. In adults with hazelnut allergy, 3.3% were sensitized to Cor a 9, 6.7% to Cor a 8, 90% to Cor a 1.04 and Bet v 1, and 87% to Cor a 1.0101. In regard to systemic reactors in this group, 17% were sensitized to Cor a 9, 33% to Cor a 8 and Cor a 1.0101, and 50% to Cor a 1.04 and Bet v 1. In the patients with OAS, irrespective the age group, all were sensitized to Bet v 1 and over 97% to Cor a 1.04 and Cor a 1.0101. No sensitization to Cor a 9 or Cor a 8 was found in patients with only an OAS. Of the patients with birch pollen allergy, tolerant to hazelnut, none were sensitized to Cor a 9 or Cor a 8, 56% to Cor a 1.0101, 82% to Cor a 1.04, and 92% to Bet v 1. In healthy controls, no sensitization to components of hazelnut, hazel pollen or birch pollen was demonstrable. CONCLUSION Hazelnut allergy in a birch-endemic region exhibits age-related sensitization profiles with distinct clinical outcomes that can be identified using CRD. The majority of hazelnut allergic preschool and school children in a birch-endemic region show systemic reactions on consumption of processed hazelnut, mostly being sensitized to the hazelnut legumin-like allergen Cor a 9 but unrelated to birch pollen allergy. In contrast, adults generally suffer from an OAS apparently as a result of cross-reactivity between Cor a 1.04 from hazelnut and Bet v 1 from birch pollen.
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Affiliation(s)
- K J De Knop
- Faculty of Medicine, Department of Immunology-Allergology-Rheumatology, University of Antwerp, Universiteitsplein 1, Antwerp, Belgium
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87
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D’Andrea M, Coïsson JD, Locatelli M, Garino C, Cereti E, Arlorio M. Validating allergen coding genes (Cor a 1, Cor a 8, Cor a 14) as target sequences for hazelnut detection via Real-Time PCR. Food Chem 2011. [DOI: 10.1016/j.foodchem.2010.07.029] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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88
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Garino C, Zuidmeer L, Marsh J, Lovegrove A, Morati M, Versteeg S, Schilte P, Shewry P, Arlorio M, van Ree R. Isolation, cloning, and characterization of the 2S albumin: a new allergen from hazelnut. Mol Nutr Food Res 2011; 54:1257-65. [PMID: 20373288 DOI: 10.1002/mnfr.200900456] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
SCOPE 2S albumins are the major allergens involved in severe food allergy to nuts, seeds, and legumes. We aimed to isolate, clone, and express 2S albumin from hazelnut and determine its allergenicity. METHODS 2S albumin from hazelnut extract was purified using size exclusion chromatography and RP-HPLC. After N-terminal sequencing, degenerated and poly-d(T) primers were used to clone the 2S albumin sequence from hazelnut cDNA. After expression in Escherichia coli and affinity purification, IgE reactivity was evaluated by Immunoblot/ImmunoCAP (inhibition) analyses using sera of nut-allergic patients. RESULTS N-terminal sequencing of a approximately 10 kDa peak from size exclusion chromatography/RP-HPLC gave two sequences highly homologous to pecan 2S albumin, an 11 amino acid (aa) N-terminal and a 10 aa internal peptide. The obtained clone (441 bp) encoded a 147 aa hazelnut 2S albumin consisting of a putative signal peptide (22 aa), a linker peptide (20 aa), and the mature protein sequence (105 aa). The latter was successfully expressed in E. coli. Both recombinant and natural 2S albumin demonstrated similar IgE reactivity in Immunoblot/ImmunoCAP (inhibition) analyses. CONCLUSION We confirmed the postulated role of hazelnut 2S albumin as an allergen. The availability of recombinant molecules will allow establishing the importance of hazelnut 2S albumin for hazelnut allergy.
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Affiliation(s)
- Cristiano Garino
- Università del Piemonte Orientale "A. Avogadro", DiSCAFF & Drug and Food Biotechnological Center, Novara, Italy
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89
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Abstract
Component resolved diagnostics introduces new possibilities regarding diagnosis of allergic diseases and individualized, allergen-specific treatment. Furthermore, refinement of IgE-based testing may help elucidate the correlation or lack of correlation between allergenic sensitization and allergic disease. Novel tools to predict severe outcomes and to plan for allergen-specific treatment are necessary, and because only a small amount of blood is needed to test for a multitude of allergens and allergenic components, component resolved diagnostics is promising. A drawback is the risk of overdiagnosis and misinterpretation of the complex results of such tests. Also, the practical use and selection of allergenic components need to be evaluated in large studies including well-characterized patients and healthy, sensitized controls and with representation of different geographical regions.
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90
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Bublin M, Dennstedt S, Buchegger M, Antonietta Ciardiello M, Bernardi ML, Tuppo L, Harwanegg C, Hafner C, Ebner C, Ballmer-Weber BK, Knulst A, Hoffmann-Sommergruber K, Radauer C, Mari A, Breiteneder H. The performance of a component-based allergen microarray for the diagnosis of kiwifruit allergy. Clin Exp Allergy 2010; 41:129-36. [DOI: 10.1111/j.1365-2222.2010.03619.x] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
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91
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Abstract
Development and progress made in the field of recombinant allergens have allowed for the development of a new concept in allergy diagnosis, molecular diagnosis (MD), which makes it possible to identify potential disease-eliciting molecules. Microarray-based testing performed with a small amount of serum sample enables clinicians to determine specific-IgE antibodies against multiple recombinants or purified natural allergen components. Performance characteristics of allergens so far tested are comparable with current diagnostic tests, but have to be confirmed in larger studies. The use of allergen components and the successful interpretation of test results in the clinic require some degree of knowledge about the basis of allergen components and their clinical implications. Allergen components can be classified by protein families based on their function and structure. This review provides a brief overview of basic information on allergen components, recombinants or purified, currently available or soon to become commercially available in ImmunoCAP or ISAC systems, including names, protein family and function. Special consideration is given to primary or species-specific sensitization and possible cross-reactivity, because one of the most important clinical utility of MD is its ability to reveal whether the sensitization is genuine in nature (primary, species-specific) or if it is due to cross-reactivity to proteins with similar protein structures, which may help to evaluate the risk of reaction on exposure to different allergen sources. MD can be a support tool for choosing the right treatment for the right patient with the right timing. Such information will eventually give clinicians the possibility to individualize the actions taken, including an advice on targeted allergen exposure reduction, selection of suitable allergens for specific immunotherapy, or the need to perform food challenges. Nevertheless, all in vitro tests should be evaluated together with the clinical history, because allergen sensitization does not necessarily imply clinical responsiveness.
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Affiliation(s)
- J Sastre
- Allergy Department, Fundación Jiménez Díaz, Madrid, Spain.
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92
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De Knop KJ, Bridts CH, Verweij MM, Hagendorens MM, De Clerck LS, Stevens WJ, Ebo DG. Component-resolved allergy diagnosis by microarray: potential, pitfalls, and prospects. Adv Clin Chem 2010; 50:87-101. [PMID: 20521442 DOI: 10.1016/s0065-2423(10)50005-2] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Diagnosis of IgE-mediated allergies is not always straightforward, as traditional tests can yield equivocal or negative results and provocation tests are hampered by several practical and ethical limitations. During the last decades two new in vitro techniques have entered the field of allergy diagnosis, that is, flow-assisted analysis of allergen-specific activated basophils and component-resolved diagnosis (CRD). This review focuses on component-resolved allergy diagnosis by microarray that has evolved from recent advances in molecular allergology and biochip technology. The technique allows a comprehensive analysis of individual sensitization profiles with multiplexed purified and recombinant allergens within a single run using only a minute amount of serum, providing information that largely exceeds the output from current sIgE capturing tools. Actually, multiplexing allows identification of diagnostic patterns that may facilitate the formulation of diagnostic algorithms. Although CRD by microarray sounds promising, the diagnostic performance requires further intensive assessment before it can enter mainstream application. In our opinion, the technique should currently be considered a complementary diagnostic tool rather than a first-line choice.
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Affiliation(s)
- K J De Knop
- Department of Immunology-Allergology-Rheumatology, Faculty of Medicine, University of Antwerp, Antwerpen, Belgium
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93
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Current World Literature. Curr Opin Otolaryngol Head Neck Surg 2010; 18:191-4. [DOI: 10.1097/moo.0b013e32833ad4c9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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94
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Lucas J. Microarrays: molecular allergology and nanotechnology for personalised medicine (I). Allergol Immunopathol (Madr) 2010; 38:153-61. [PMID: 20398997 DOI: 10.1016/j.aller.2010.03.001] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2010] [Accepted: 03/02/2010] [Indexed: 02/07/2023]
Abstract
The diagnosis of antibody-mediated allergic disorders is based on the clinical findings and the detection of allergen-specific IgE based on in vitro and in vivo techniques, together with allergen provocation tests. In vitro diagnostic techniques have progressed enormously following the introduction of the advances made in proteomics and nanotechnology--offering tools for the diagnosis and investigation of allergy at molecular level. The most advanced developments are the microarray techniques, which in genomics allowed rapid description of the human genetic code, and which now have been applied to proteomics, broadening the field for research and clinical use. Together with these technological advances, the characterisation of most of the different proteins generating specific IgE and which conform each natural allergen, as well as their purification or genetic engineering-based synthesis, have been crucial elements--offering the possibility of identifying disease-causing allergens at molecular level, establishing a component-resolved diagnosis (CRD), using them to study the natural course of the disease, and applying them to improvements in specific immunotherapy. Microarrays of allergic components offer results relating to hundreds of these allergenic components in a single test, and use a small amount of serum that can be obtained from capillary blood. The availability of new molecules will allow the development of panels including new allergenic components and sources, which will require evaluation for clinical use. The present study reviews these new developments, component-resolved diagnosis, and the development of microarray techniques as a critical element for furthering our knowledge of allergic disease.
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95
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Yang AC, Arruda LK, Santos ABR, Barbosa MCR, Chapman MD, Galvão CES, Kalil J, Morato-Castro FF. Measurement of IgE antibodies to shrimp tropomyosin is superior to skin prick testing with commercial extract and measurement of IgE to shrimp for predicting clinically relevant allergic reactions after shrimp ingestion. J Allergy Clin Immunol 2010; 125:872-8. [PMID: 20226506 DOI: 10.1016/j.jaci.2009.11.043] [Citation(s) in RCA: 65] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2009] [Revised: 11/06/2009] [Accepted: 11/06/2009] [Indexed: 10/19/2022]
Abstract
BACKGROUND Shrimp is a frequent cause of food allergy. Tropomyosin is the major allergen in shrimp, and it shares homology to tropomyosins from other crustaceans, dust mites, cockroach, and parasites. OBJECTIVE The aim of this study was to determine the value of detection of IgE to shrimp tropomyosin in the diagnosis of shrimp allergy. METHODS We have studied 35 patients with asthma, rhinitis, or both who were sensitized to Dermatophagoides pteronyssinus. All subjects underwent skin prick testing in addition to double-blind, placebo-controlled food challenges (DBPCFC); oral open challenges; or both with shrimp. Measurements of IgE to shrimp and shrimp tropomyosin were carried out by means of CAP and chimeric ELISA, respectively. RESULTS Oral challenges confirmed the diagnosis of shrimp allergy in 7 patients. IgE measurement to shrimp tropomyosin was positive in 71.4% of the patients with shrimp allergy. Of the 28 patients without shrimp allergy, only 7.1% (2/28) had IgE to shrimp tropomyosin compared with 25% (7/28) who had IgE to shrimp and 35.7% (10/28) who had positive skin prick test responses to shrimp. Sensitivity was similar for all 3 methods (71.4%); in contrast, specificity of IgE to shrimp tropomyosin (92.8%) was greater than that of IgE to shrimp (75%) and skin prick testing (64.2%). With regard to diagnostic efficiency, measurement of IgE to shrimp tropomyosin was superior to measurement of IgE to shrimp and skin prick testing (88.5%, 74.2%, and 65.7%, respectively). CONCLUSION Use of measurements of IgE to shrimp tropomyosin provided added value to the diagnosis of shrimp allergy.
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Affiliation(s)
- Ariana C Yang
- Division of Clinical Immunology and Allergy, University of São Paulo School of Medicine, São Paulo, Brazil
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96
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Sicherer SH, Leung DYM. Advances in allergic skin disease, anaphylaxis, and hypersensitivity reactions to foods, drugs, and insects in 2009. J Allergy Clin Immunol 2010; 125:85-97. [PMID: 20109740 DOI: 10.1016/j.jaci.2009.11.031] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2009] [Accepted: 11/23/2009] [Indexed: 11/15/2022]
Abstract
This review highlights some of the research advances in anaphylaxis and hypersensitivity reactions to foods, drugs, and insects, as well as advances in allergic skin disease that were reported in the Journal in 2009. Among key epidemiologic observations, several westernized countries report that more than 1% of children have peanut allergy, and there is some evidence that environmental exposure to peanut is a risk factor. The role of regulatory T cells, complement, platelet-activating factor, and effector cells in the development and expression of food allergy were explored in several murine models and human studies. Delayed anaphylaxis to mammalian meats appears to be related to IgE binding to the carbohydrate moiety galactose-alpha-1,3-galactose, which also has implications for hypersensitivity to murine mAb therapeutics containing this oligosaccharide. Oral immunotherapy studies continue to show promise for the treatment of food allergy, but determining whether the treatment causes tolerance (cure) or temporary desensitization remains to be explored. Increased baseline serum tryptase levels might inform the risk of venom anaphylaxis and might indicate a risk for mast cell disorders in persons who have experienced such episodes. Reduced structural and immune barrier function contribute to local and systemic allergen sensitization in patients with atopic dermatitis, as well as increased propensity of skin infections in these patients. The use of increased doses of nonsedating antihistamines and potential usefulness of omalizumab for chronic urticaria was highlighted. These exciting advances reported in the Journal can improve patient care today and provide insights on how we can improve the diagnosis and treatment of these allergic diseases in the future.
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Affiliation(s)
- Scott H Sicherer
- Elliot and Roslyn Jaffe Food Allergy Institute, Division of Allergy and Immunology, Department of Pediatrics, Mount Sinai School of Medicine, New York, NY, USA.
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97
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Knol EF, Knulst AC. Application of multiplexed immunoglobulin E determination on a chip in component-resolved diagnostics in allergy. Clin Exp Allergy 2010; 40:190-2. [DOI: 10.1111/j.1365-2222.2009.03402.x] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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98
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Detection of hazelnuts and almonds using commercial ELISA test kits. Anal Bioanal Chem 2010; 396:1939-45. [DOI: 10.1007/s00216-009-3424-2] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2009] [Revised: 12/11/2009] [Accepted: 12/16/2009] [Indexed: 10/19/2022]
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99
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Bublin M, Pfister M, Radauer C, Oberhuber C, Bulley S, Dewitt AM, Lidholm J, Reese G, Vieths S, Breiteneder H, Hoffmann-Sommergruber K, Ballmer-Weber BK. Component-resolved diagnosis of kiwifruit allergy with purified natural and recombinant kiwifruit allergens. J Allergy Clin Immunol 2010; 125:687-94, 694.e1. [PMID: 20061012 DOI: 10.1016/j.jaci.2009.10.017] [Citation(s) in RCA: 69] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2009] [Revised: 10/14/2009] [Accepted: 10/15/2009] [Indexed: 10/20/2022]
Abstract
BACKGROUND Kiwifruit is one of the most common causes of food allergic reactions. Component-resolved diagnostics may enable significantly improved detection of sensitization to kiwifruit. OBJECTIVE To evaluate the use of individual allergens for component-resolved in vitro diagnosis of kiwifruit allergy. METHODS Thirty patients with a positive double-blind placebo-controlled food challenge to kiwifruit, 10 atopic subjects with negative open provocation to kiwifruit, and 5 nonatopic subjects were enrolled in the study. Specific IgE to 7 individual allergens (nAct d 1-5 and rAct d 8-9) and allergen extracts was measured by ImmunoCAP. RESULTS The diagnostic sensitivities of the commercial extract and of the sum of single allergens were 17% and 77%, respectively, whereas diagnostic specificities were 100% and 30%. A combination of the kiwi allergens Act d 1, Act d 2, Act d 4, and Act d 5 gave a diagnostic sensitivity of 40%, whereas diagnostic specificity remained high (90%). Exclusion of the Bet v 1 homolog recombinant (r) Act d 8 and profilin rAct d 9 from this allergen panel reduced sensitivity to 50% but increased specificity to 40%. Kiwifruit-monosensitized patients reacted more frequently (P < .001) with Act d 1 than polysensitized patients, whereas the latter group reacted more frequently with rAct d 8 (P = .004). CONCLUSION Use of single kiwifruit allergen ImmunoCAP increases the quantitative test performance and diagnostic sensitivity compared with the commercial extract. Bet v 1 homolog and profilin are important allergens in pollen-related kiwifruit allergy, whereas actinidin is important in monoallergy to kiwifruit, in which symptoms are often more severe.
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Affiliation(s)
- Merima Bublin
- Department of Pathophysiology, Medical University of Vienna, Vienna, Austria
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100
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Alessandri C, Zennaro D, Zaffiro A, Mari A. Molecular allergology approach to allergic diseases in the paediatric age. Ital J Pediatr 2009; 35:29. [PMID: 19804642 PMCID: PMC2761924 DOI: 10.1186/1824-7288-35-29] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2009] [Accepted: 10/05/2009] [Indexed: 02/08/2023] Open
Abstract
Identification, characterization, and purification of allergens are essential for the structural and immunologic studies needed to understand how these molecules induce specific IgE antibody production by the human immune system. Advances in molecular biology techniques have led to the production of recombinant allergens having constant properties, allowing detection of specific IgE directed against different molecular components of an allergenic source. Presence of homologous allergens in different sources is the reason for cross-reaction. Molecule-based diagnostic tools can lead to better interpretation of poly-sensitizations, observed by ST and in vitro tests using allergenic extracts as they were made before. Some examples IgE sensitization to major genuine allergens and panallergens will be presented.
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Affiliation(s)
- Claudia Alessandri
- Center for Clinical and Experimental Allergology, IDI-IRCCS, Rome, Italy
| | - Danila Zennaro
- Center for Clinical and Experimental Allergology, IDI-IRCCS, Rome, Italy
| | - Alessandra Zaffiro
- Center for Clinical and Experimental Allergology, IDI-IRCCS, Rome, Italy
| | - Adriano Mari
- Center for Clinical and Experimental Allergology, IDI-IRCCS, Rome, Italy
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