Relationship between Bet v 1 and Bet v 2 specific IgE and food allergy in children with grass pollen respiratory allergy

Allergy to apple cultivars among patients with birch pollinosis and oral allergy syndrome

BACKGROUND

Oral allergy syndrome (OAS) is caused by cross-reacting allergens found in pollen, raw fruits, vegetables, and some tree nuts. The major apple allergen, Mal d 1, is a cause of food allergic reactions in birch pollen sensitized patients.

OBJECTIVE

To explore the allergenicity of the most popular and commonly consumed apple cultivars in Poland in patients with birch pollen allergy with or without OAS.

METHODS

Data were obtained from 46 adults with clinical symptoms of birch allergy and allergic rhinitis or rhinoconjunctivitis. Patients were divided into 2 groups according to the occurrence of OAS to apple. Skin prick tests (SPTs) were performed with pulp from the 11 most popular apple cultivars in Poland. Specific IgE (sIgE) to Bet v 1 was measured by radioallergosorbent test.

RESULTS

Patients with OAS had more positive responses to apple SPT vs patients without OAS (odds ratios, 4.8-11.96). Patients with OAS had distinctive responses to apple cultivars. Szara Reneta and Cortland induced positive responses in 50% and 83% of patients, respectively. Patients with OAS vs patients without OAS who were allergic to apples vs nonallergic had 2-fold (P = .008) and 7-fold (P = .03) higher blood concentrations of sIgE Bet v 1, respectively. There were different profiles of correlations of sIgE Bet v 1 with wheal diameter for low and high allergenic cultivars in patients without and with OAS.

CONCLUSION

We noted a substantial role for Bet v 1 sensitization in the allergic response based on evaluation of the allergenicity of 11 apple cultivars. The sIgE Bet v 1 and SPT results of patients with and without OAS allowed differentiation between low and high allergenic cultivars.

Pollen food syndrome amongst children with seasonal allergic rhinitis attending allergy clinic

BACKGROUND

There is limited information regarding the onset and sensitization patterns of pollen food syndrome (PFS) in children. The aim was to explore this within children referred to a specialist allergy clinic at a London Tertiary Hospital.

METHODS

A total of 54 patients with seasonal allergic rhinitis (SAR) were enrolled in equal numbers in three age groups; 0-5, 6-10, 11-15 years. Families completed a questionnaire on rhinitis, food symptoms and quality of life. Children underwent skin prick testing (SPT) to fresh fruits, nuts and a blood test for microarray analysis.

RESULTS

Clinical diagnosis of PFS was made in 26/54 (48%), increasing with age (group 1 = 3 (17%), group 2 = 9 (50%), group 3 = 14 (78%) (p = 0.03)). Microarray demonstrates children aged 2.8 years sensitized to pan-allergens and 4.5 years symptomatic to pan-allergens. Peach, cherry, carrot and strawberry SPT had the highest sensitivity and NPV at 100%. The sensitivity of PR10 molecules on microarray was 92%, PPV 62% and NPV 87%. Microarray confirmed 69% of allergens on clinical history compared to 61% by SPT. Microarray and SPT had a 19% false-negative rate. The quality-of-life data showed moderate impact across all domains, and patients with PFS were significantly more likely to have increased anxiety over time spent preparing food (p = 0.029).

CONCLUSIONS

We demonstrate that SAR occurs in children from 1.4 years and PFS from 4.5 years with a changing pattern of pan-allergen sensitization. Microarray and SPT have moderate concordance in confirming allergens. PFS impacts negatively on quality of life and should be assessed in all paediatric allergy patients.

Tradition of use on medicinal species in Valfurva (Sondrio, Italy)

ETHNOPHARMACOLOGICAL RELEVANCE

In the past Alpine populations were isolated from comforts of industrial and technological development present in large cities and, therefore, they were obliged to find in nature a source of sustenance and care. Traditional use of plant is a wealth of local knowledge that is likely to be lost. This work, carried out during 2012, aims to collect, analyze and process information on the species used for medicinal, veterinary, cosmetic, domestic, ritual and religious purposes by the inhabitants of Valfurva, in the Province of Sondrio (Italy). Furthermore it is a means for the preservation of local traditions regarding such uses and increases the ethnobotanical data from Northern Italy, till now poorly documented.

METHODS

Our survey was conducted by semi-structered interviews. We interviewed 92 people, aged from 23 to 97 y.o., born or resident in Valfurva. All information collected and concerning their use of plants, were analyzed using ethnobotanical indices such as Relative Frequency of Citation (RFC), Relative Importance (RI) and Factor Informant Consensus (FIC).

RESULTS

Our study stated that people living in Valfurva use 126 species belonging to 48 families. Findings revealed that the most cited species is Achillea moschata Wulfen, with values of RFC and RI equal to 1.00 and 1.12 respectively. Furthermore, 95 species were collected in the wild and 31 were cultivated. The most commonly used part plants were leaves, flowers, fruits, roots and complete aerial parts. The most frequent preparation methods were infusion, decoction and poultice. Among the recorded species, 91 of them are used for medicinal purposes, 72 for cooking, 19 for veterinary purposes, 10 for animal feed, 12 for cosmetic practices, 7 for religious or ritual purposes and 45 for domestic and various uses. The validity of the species use emerged in our survey is confirmed by scientific literature and research conducted on the same topics.

CONCLUSIONS

This study increases ethnobotanical data coming from Italian Alps, whose regions have been so far hardly investigated. Our study confirms the interest in species already mentioned in previous surveys and placings. It also provides evidences which could be usefully exploited by new investigations aimed at knowing the active metabolites found responsible for plants use in traditional medicine.

Rhinitis in children: common clinical presentations and differential diagnoses

Rhinitis is a common presentation in childhood. Acute virally induced rhinitis is generally self-limiting and usually does not require medical attention. Whilst allergic rhinitis is the focus of the paediatric allergist, the presentation of other diseases or comorbidities that can complicate or mimic allergic rhinitis needs to be considered. Effects on the child's quality of life also need to be addressed. Rhinitis can be associated with asthma and other significant comorbidities: importantly, non-allergic rhinitis can sometimes be a consequence of systemic immune impairment. The diagnosis of rhinitis is based on clinical findings with directed investigations. Nasal nitric oxide measurement is an emerging diagnostic tool and helpful particularly in relation to evaluating the differential diagnosis in more difficult rhinitis. Successfully identifying the cause of rhinitis in childhood and associated comorbidities can ensure that the patient is successfully treated as described in the recently published EAACI Pediatric Rhinitis Position Paper.

Detection of Walnut Residues in Processed Foods by Polymerase Chain Reaction

A sensitive qualitative detection method for walnut (Juglans regia) using polymerase chain reaction (PCR) was developed. For detection of walnuts with high specificity, the primer pair WAL-F/WAL-R was designed based on walnut matK genes. Trace amounts of walnuts in commercial food products can be qualitatively detected using this method.

Citrus allergy from pollen to clinical symptoms

Allergy to citrus fruits is often associated with pollinosis and sensitization to other plants due to a phenomenon of cross-reactivity. The aims of the present study were to highlight the cross-reactivity among citrus and the major allergenic pollens/fruits, throughout clinical and molecular investigations, and to evaluate the sensitization frequency to citrus fruits in a population of children and adults with pollinosis. We found a relevant percentage of sensitisation (39%) to citrus fruits in the patients recruited and in all of them the IgE-mediated mechanism has been confirmed by the positive response to the prick-to-prick test. RT-PCR experiments showed the expression of Cit s 1, Cit s 3 and a profilin isoform, already described in apple, also in Citrus clementine pollen. Data of multiple sequence alignments demonstrated that Citrus allergens shared high percentage identity values with other clinically relevant species (i.e. Triticum aestivum, Malus domestica), confirming the possible cross-allergenicity citrus/grasses and citrus/apple. Finally, a novelty of the present work has been the expression of two phospholipaseA2 isoforms (PLA2 α and β) in Citrus as well as in Triticum pollens; being PLA2 able to generate pro-inflammatory factors, this enzyme could participate in the activation of the allergenic inflammatory cascade.

Detection of Phl p 1, Phl p 5, Phl p 7 and Phl p 12 specific IgE antibodies in the sera of children and adult patients allergic to Phleum pollen

BACKGROUND

Grasses belong to major sources of inhaled allergens. The knowledge of particular molecules responsible for hypersensitivity is of crucial importance for better understanding of individual differences among single allergic subjects and allergic populations living in various world-areas.

METHODS

Specific-IgE-antibodies against Phl p 1, Phl p 5, Phl p 7, Phl p 12 were detected in a group of 130 Phleum-allergic-subjects (82 children, 48 adults).

RESULTS

Phl p 1 antibodies were detected in most pediatric and adult patients, however, the children were associated with higher RAST classes more often. Anti-Phl p 5-antibodies were found more frequently in adults. An increase was observed in the number of pediatric patients reacting to Phl p 7 and Phl p 12. There were no differences in concentrations of specific-IgE against Phl p 5, Phl p 7 and Phl p 12 depending on age. Almost 10% of allergic children produced antibodies directed exclusively against minor allergens or did not produce specific-IgE-antibodies against tested molecules. Part of the patients reacted to profilin and calcium-binding protein originating from only one source (Phl p 12/Bet v 2 and Phl p 7/Bet v 4).

CONCLUSIONS

Antibodies against Phl p 1 and Phl p 5 can be used as a marker of allergy to grasses in adult patients. Children reacted exclusively to minor allergens more frequently than adults. Prolonged allergen exposure is evidently necessary to induce sensitization to Phl p 5. A high level of homology between profilins and calcium-binding proteins enables only one allergen to be used for diagnostic purposes but a possibility of a reaction to species-bound epitopes should be taken into account.

Microarrays: molecular allergology and nanotechnology for personalised medicine (I)

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.

Detection of allergen walnut component in food by an improved real-time PCR method

A real-time PCR method aimed at the gene sequence of the walnut vicilin-like seed storage protein was established for the detection of the allergen walnut in food. The primers and probe were designed based on published methods. The method provided positive results for walnut and negative results for other tested agricultural plant materials including pecan. The intrinsic detection limit of the method was 0.00125 ng of walnut DNA, and the practical detection limit was 0.001% (wt/wt) walnut content in wheat; both of these values are lower than that of previously published methods. Therefore, this real-time PCR method is sufficiently specific and sensitive for the detection of walnut component in food.

Prevalence of legume sensitization in patients with naso-bronchial allergy

Prevalence of legume allergy and concomitant sensitization to different allergens was evaluated in patients of asthma and/ or rhinitis. Skin prick test with 27 common food allergens and 61 aeroallergens in 76 subjects was performed. Out of 76 subjects, 41 perceived allergenic problems with different food items as contributing factor. Only six patients showed prick test positivity compatible with their anamnesis. However, 35 subjects showed sensitization to different food items, out of which thirty were sensitive to legumes. The common foods in decreasing order of allergenicity were chickpea, followed by green gram, egg white, and bean fresh/red gram. Concomitant sensitization to different legume crops was found in patients.

Hazelnut allergy: from pollen-associated mild allergy to severe anaphylactic reactions

PURPOSE OF REVIEW

Hazelnut allergy can vary between mild oral symptoms and potentially dangerous anaphylaxis. There is a need to predict which subjects are at risk for severe reactions. In this study, possibilities for 'component-resolved diagnosis', based on sensitization to different allergens in hazelnut, are discussed.

RECENT FINDINGS

One type of hazelnut allergy can be associated with sensitization to homologues of pollen allergens, predominantly birch, in hazelnut: Cor a 1 (Bet v 1) and Cor a 2 (profilin). These allergens account for relatively mild symptoms. However, subjects can also be sensitized to several other allergens in hazelnut that are related to more severe symptoms. These allergens are homologues of allergens in other nuts and peanut: Cor a 8 (lipid transfer protein) and Cor a 9 (11S globulin) and perhaps Cor a 11 (7S globulin). The clinical relevance of these and other potential hazelnut allergens has to be further defined. The diagnosis of hazelnut has to be confirmed by oral double-blind placebo-controlled food challenge.

SUMMARY

Sensitization to hazelnut can either be associated with mild oral symptoms, depending on sensitization to pollen, or with more serious allergic symptoms, related to sensitization to homologues of nut and peanut allergens.

Today's allergic rhinitis patients are different: new factors that may play a role

Most of today's patients suffering from allergic rhinitis (AR) are sensitized to more than one trigger and suffer from persistent and moderate/severe symptoms, which severely impair their quality of life (QOL). The objective of this article was to review the data on the effect of increased air pollution, changes in indoor environment/lifestyle/affluence, exposure to new allergens and psychologically stressful lifestyles, as also to explore their potential in the development of this more 'aggressive' form of disease. Increased fossil fuel-generated air pollution may increase the risk of allergic sensitization, airway responsiveness to allergens, and allergenicity and the bioavailability of airborne allergens. Changes in indoor environment/lifestyle/affluence appear to have led to more time being spent indoors and resulted in perennial exposure to indoor allergens, changes in sensitization patterns, and polysensitization to a variety of novel cross-reacting exotic food and pet allergens. Although evidence suggests an association between psychological stress and increased risk for atopy and allergic disease, further studies are required to demonstrate this unequivocally. The more persistent and moderate/severe nature of the disease suggests a need for modification of current treatment strategies and advocacy of the use from the outset of agents, which are both efficacious and safe in managing severe and persistent AR symptoms and in improving the QOL of affected individuals.