Allergy to fruits and vegetables in pollen‐sensitive patients: Allergen characterization by IgE immunoblotting and peroxidase staining

In vitro determination of the allergenic potential of technologically altered hen's egg

Hen's egg allergy represents one of the most common and severe IgE-mediated reactions to food in infants and young children. It persists, however, in many cases also lifelong. Therefore, the aim of this study was the detailed analysis of a technological process used to reduce the allergenic potential of hen's egg. The investigation focused on the pasteurized egg as starting material, intermediate, and final products of a nine-step manufacturing process performed for use of eggs in convenience products appropriate for allergic individuals. The steps consisted of a combination of various heat treatments and enzymatic hydrolyses. The alterations were controlled by sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE), immunoblotting, enzyme allergosorbent test (EAST) inhibition, and mass spectrometry. Thereby it could be demonstrated that the allergenic potential of the raw material was reduced from step to step, and despite the known stability against heat and proteolysis of certain egg proteins, the total allergenic potential was finally below 1/100 that of the starting material without a significant change in texture and flavor as evaluated in various products.

Influence of maturation on the alteration of allergenicity of green pea (Pisum sativum L.)

The IgE-binding capacity of different maturation levels of green pea seeds (Pisum sativum L.) of the variety Maxigolt is examined to determine the influence of maturation on the alteration of allergenicity. Different protein extraction methods to get total protein extracts and the protein fractions glutelin, globulin, and albumin from different maturation levels of green pea seeds are applied to SDS-PAGE/silver staining as well as SDS-PAGE/immunoblotting and EAST inhibition experiments using sera of 15 green pea allergic individuals. The SDS-PAGE/silver-staining experiments show the continuous change of protein pattern during maturation. SDS-PAGE/immunoblot and EAST inhibition demonstrate that all levels of green pea seeds show relevant IgE-binding capacity, as do immature seeds. Total IgE-binding capacity rises with the progress of maturation. Although the main allergenic activity is dependent upon the albumin fraction, the glutelin and globulin fractions are also important. The implication of these results is an obvious allergenic potency of all maturation levels, even immature seeds, whereas an increase of allergenicity during maturation could be notched up. The highest allergenic potency is caused by the albumin fraction, but globulin and glutelin fractions also contribute to the allergenicity of green pea.

Clinical tolerance of processed foods

OBJECTIVE

To review the effects of technological processing on selected foods of relevance to childhood allergy from the viewpoints of reduced allergenicity, contamination of processed foods by allergens introduced during processing, and ad hoc technologies to produce reduced hypoallergenic products.

DATA SOURCES

We searched the literature (PubMed/MEDLINE) for articles published between January 1994 and April 2004 using the following keywords: food allergy AND process* OR heat* OR cooking OR toleran*.

STUDY SELECTION

We drew on our collective clinical and biological experience to restrict retrieved studies to those of more frequent relevance to a hospital allergy practice.

RESULTS

Comparatively few clinical studies address the modification of allergenicity of food through cooking or processing. Dairy foods are largely unaffected by processing and may be contaminated by, or themselves become, hidden allergens. Hypoallergenic formulas based on milk, soy, or rice and homogenized beef are successful applications of allergenicity reduction via technological processing. Egg, fish, condiments, and vegetables all carry heat-resistant allergens and should also be considered contaminants. Cereals and bakery products are generally well tolerated, but their allergenicity may be enhanced by processing; the case of rice is still open. Peanut allergens are stable, and the evidence is scant that thermal processing affects the allergenicity of soybean and soy hydrolysates. The debate is ongoing about the tolerance of vegetable oils.

CONCLUSIONS

It is too early to systematize clinical studies based on single procedures. Processing affects antigenicity, but this does not always translate into safety recommendations. Industrial processing is liable to contamination, and monitoring and labeling are industry priorities. Clinicians should evaluate foods by as complete a workup as possible before recommending processed foods.

Comparison of four variants of a major allergen in hazelnut (Corylus avellana) Cor a 1.04 with the major hazel pollen allergen Cor a 1.01

The aim of this study was to produce the Bet v 1-related major hazelnut allergen Cor a 1.0401 and variants thereof as recombinant allergens, and to compare their immuno-reactivity with the major hazel pollen allergen using sera of patients whose hazelnut allergy recently was confirmed by double-blind placebo-controlled food challenges (DBPCFC) in a multicenter study. Total RNA was isolated from immature hazelnuts and transcribed into cDNA. Full length coding DNA obtained by PCR-strategy was subcloned into pTYB11 vector and expressed in E. coli ER2566 cells. Native non-fusion target proteins were purified by DTT-induced self-cleavage of the intein-tagged N-terminal fusion proteins. IgE reactivity of the recombinant allergens was tested by enzyme allergosorbent test (EAST), EAST-inhibition, immunoblot-inhibition and histamine release assays. Four recombinant allergens were produced showing deduced amino acid sequence identities among each other of 97-99%, and were considered as variants Cor a 1.0401 (GenBank Accession no.: AF136945), Cor a 1.0402 (AF323973), Cor a 1.0403 (AF323974) and Cor a 1.0404 (AF323975). Cor a 1.0402 and 03 only differed in a C4S exchange. Cor a 1.0404 had a unique proline residue in position 99. Surprisingly, only 63% identity was revealed with hazel pollen Cor a 1. EAST with 43 sera of patients with positive DBPCFC to hazelnut indicated IgE reactivity to Cor a 1.0401 in 95% of the sera, to Cor a 1.0402 in 93%, to Cor a 1.0403 in 91%, and in only 74% of the sera to the proline variant Cor a 1.0404. The allergenic activity of the four variants was confirmed by histamine release assays in 15 hazelnut-allergic patients stimulated with the four variants and controls. Eleven sera were positive with extract from native hazelnut, 13 with rCor a 1.0401, 12 with rCor a 1.0402, 11 with rCor a 1.0403, and only two with rCor a 1.0404 containing the proline exchange. The high IgE binding variant Cor a 1.0401 showed only partial IgE cross-reactivity with pollen Cor a 1. IgE-binding and histamine release capacity led to a concordant ranking of the allergenic activity of the recombinant variants: Cor a 1.0401>Cor a 1.0402 and 03>Cor a 1.0404 (the proline variant). Similar results for Cor a 1.0402 and 03 suggest a minor influence in IgE binding of cysteine in position 4, whereas proline in position 99 appears to be responsible for the decrease in IgE reactivity in Cor a 1.0404. It appears that the epitopes of hazelnut Cor a 1.04 are less related to pollen Cor a 1 than to Bet v 1 from birch pollen. Low IgE binding variants or mutants of Cor a 1.04 are candidate compounds for developing a novel and safe approach of specific immunotherapy of hazelnut allergy.

Introducing allergists to food chemistry

A report of common analytical methods for the identification and characterization of food allergens is presented. The different electrophoretic and immunologic methods describe the present analytical tools to characterize allergens. With respect to the lack of knowledge on the structure and the properties of food allergens, additional chemical techniques such as chromatography, NMR and MALDI-TOF are of particular importance.

Allergic cross-reactivity made visible: solution structure of the major cherry allergen Pru av 1

Birch pollinosis is often accompanied by hypersensitivity to fruit as a consequence of the cross-reaction of pollen allergen-specific IgE antibodies with homologous food proteins. To provide a basis for examining the cross-reactivity on a structural level, we used heteronuclear multidimensional NMR spectroscopy to determine the high-resolution three-dimensional structure of the major cherry allergen, Pru av 1, in solution. Based on a detailed comparison of the virtually identical structures of Pru av 1 and Bet v 1, the major birch pollen allergen, we propose an explanation for a significant aspect of the observed cross-reactivity pattern among the family of allergens under consideration. The large hydrophobic cavity expected to be important for the still unknown physiological function of Bet v 1 is conserved in Pru av 1. Structural homology to a domain of human MLN64 associated with cholesterol transport suggests phytosteroids as putative ligands for Pru av 1. NMR spectroscopy provides experimental evidence that Pru av 1 interacts with phytosteroids, and molecular modeling shows that the hydrophobic cavity is large enough to accommodate two such molecules.

Determination of the IgE-binding activity of soy lecithin and refined and non-refined soybean oils

In the present study refined and non-refined soybean oils as well as soy lecithins were investigated for residual allergenicity and compared with extracts from native soybeans. By means of immunoblotting and EAST inhibition experiments no IgE-binding activity was detectable in refined soybean oils, which is probably due to thermal treatment during the refining. The investigated non-refined oils and soy lecithins showed a residual IgE-binding activity. In addition in the lecithin extracts a new IgE-binding structure with a molecular mass of approximately 16 kDa was detectable.

Determination of the allergenicity of various hazelnut products by immunoblotting and enzyme allergosorbent test inhibition

Although allergic reactions to hazelnuts are common especially in Europe, there are only a few investigations with regard to the influence of processing on the IgE-binding potency of hazelnut proteins. In this study the allergenicity of different hazelnut products, such as chocolate, nougat products, croquant or cookies, was examined by sodium dodecyl sulfatepolyacrylamide gel electrophoresis (SDS-PAGE), immunoblotting and enzyme allergosorbent test (EAST) inhibition experiments using sera of 17 hazelnut-allergic individuals. In only a few cases did the immunoblotting experiments yield positive results as regards the allergenicity of the investigated products. By means of EAST inhibition a residual IgE-binding potency could be detected in almost all of the product extracts. Therefore hazelnuts are a potential hazard to allergic people even as an ingredient of processed foods.

Characterization of cross-reacting allergens in mango fruit

BACKGROUND

Allergic reactions to mango fruit have become increasingly important. A cross-reaction between mango fruit, various other foods, and respiratory allergens has been assumed but not investigated until now.

METHODS

The sera of nine patients were used to characterize cross-reacting allergens in mango fruits by EAST inhibition and immunoblot inhibition.

RESULTS AND CONCLUSIONS

EAST inhibition and immunoblot inhibition demonstrated that cross-reactions between mango fruits, mugwort pollen, birch pollen, celery, and carrot are based on allergens related to Bet v 1 and Art v 1, the major allergens of birch and mugwort pollen, respectively.

Celery allergens in patients with positive double-blind placebo-controlled food challenge

BACKGROUND

Recently, for the first time, allergy to celery was confirmed by double-blind placebo-controlled food challenge (DBPCFC). Api g 1, Api g 4, cross-reactive carbohydrate determinants (CCD), and a 60 kDa allergen have been described as celery allergens.

OBJECTIVE

To get insights in IgE responses of patients with a positive DBPCFC to celery tuber (celeriac) compared with patients with a negative challenge test.

METHODS

Specific IgE to native and heated celery tuber and to recombinant Api g 1, the major celery allergen, were determined by enzyme allergosorbent test and immunoblotting. IgE binding to Api g 1, Api g 4, and CCD was confirmed by inhibition experiments that used recombinant Api g 1, recombinant Api g 4, pure N-glycans, and extracts of celeriac, lychee fruit, and pollens of birch, mugwort, and timothy grass as inhibitors.

RESULTS

Immunoblotting with sera from 22 patients with a positive DBPCFC to celeriac confirmed the presence of known allergenic structures: The major allergen Api g 1 (16 kDa) was recognized by IgE from 13 of 22 patients (59%). Another major allergen was CCD, determined by IgE reactivity in 12 of 22 patients (55%). Celery profilin, Api g 4, was recognized by IgE from 5 of 22 patients (23%).

CONCLUSION

Our DBPCFC-positive patients exclusively presented IgE to known celery allergens, although the prevalences were slightly different than were previously reported. No obvious differences were found in patients with positive IgE antibody but negative challenge test. IgE binding to all 3 structures in celeriac extract was inhibited by birch pollen extract, whereas mugwort pollen extract could only inhibit IgE reactivity to Api g 4 and CCD. Inhibition experiments with a purified carbohydrate moiety clearly showed that the IgE epitope mannose-xylose-fucose-glycan (Manalpha1-6[Xylbeta1-2]Manbeta1-4GlcNAcbeta1-4[ Fucalpha1-3]GlcNAc) or a closely related structure is present in celeriac extract and is important in patients with clinical allergy to celery.

Quantitative sandwich ELISA for determination of traces of hazelnut (Corylus avellana) protein in complex food matrixes

A hazelnut-specific sandwich-type ELISA based on polyclonal antisera was developed for detection of hidden hazelnut protein residues in complex food matrixes. In the absence of a food matrix, extractable protein from different native and toasted hazelnuts was detected at rates of 94 +/- 13 and 96 +/- 7% applying standards prepared from native and toasted hazelnuts, respectively. From complex food matrixes, 0.001-10% of hazelnut was recovered between 67 and 132%, in average by 106 +/- 17%. Depending on the food matrix, hazelnut protein could be detected down to the ppb (ng/g) level. Intraassay precision was <6% for hazelnut >/= 0.001% and interassay precision was <15% for hazelnut >/= 0.01%. In 12 of 28 commercial food products without labeling or declaration of hazelnut components, between 2 and 421 ppm of hazelnut protein was detected, demonstrating a remarkable presence of potentially allergenic hazelnut protein "hidden" in commercial food products.

Determination of the allergenic activity of birch pollen and apple prick test solutions by measurement of beta-hexosaminidase release from RBL-2H3 cells. Comparison with classical methods in allergen standardization

BACKGROUND

A murine in vitro model of the allergic type I reaction was set up to determine the biologic activity of extracts without involvement of human beings. It is based on beta-hexosaminidase release from passively sensitized RBL cells after allergen challenge. The intended application of this RBL cell assay in the field of quality control of allergenic extracts requires its comparison with established methods.

METHODS

The activity of five standardized birch-pollen prick test solutions was determined in parallel by RBL assay, direct IgE binding, IgE-binding inhibition, major allergen content, histamine-release assay, and skin testing.

RESULTS

The RBL cell-release assay corresponded well to other methods if a reagin raised against natural birch-pollen extract was used for passive sensitization. However, in the case of a reagin against recombinant Bet v 1, only a decreased activity was observed, presumably because a reduced number of epitopes were recognized by the monospecific reagin. In contrast to standardized birch-pollen extracts, nonstandardized apple extracts showed poor activity in all assays.

CONCLUSIONS

This murine model might be a useful tool in the quality control of allergenic extracts. It combines properties of assays based on standardized antisera and of assays that consider IgE cross-linking properties.

Cross-reactivity and epitope analysis of Pru a 1, the major cherry allergen

A high percentage of birch pollen allergic patients experiences food hypersensivity after ingestion of fresh fruits and vegetables. The cross-reactivity of the major allergens of sweet cherry (Pru a 1), apple (Mal d 1), pear (Pyr c 1), celery tuber (Api g 1) and carrot (Dau c 1) is due to structural similarities which are reflected by high amino acid sequence identities with Bet v 1a, the major birch pollen allergen. Apart from a strong cross-reactivity to Bet v 1a, IgE inhibition experiments with Mal d 1, Pru a 1 and Api g 1 demonstrated the presence of common and different epitopes among the tested food allergens. Secondary structure prediction of all investigated allergens indicated the presence of almost identical structural elements. In particular, the 'P-loop' region is a common domain of the pollen related food allergens and of pathogenesis related proteins. To identify the IgE binding epitopes, five overlapping recombinant Pru a 1 fragments representing the entire amino acid sequence with lengths of approximately 60-120 residues were investigated. Weak IgE binding capacity was measured exclusively with Pru a IF4 (1-120) by immunoblotting, whereas none of the fragments showed allergenicity in the rat basophil leukaemia cell mediator release assay. Site-directed mutagenesis experiments with Pru a 1 revealed that amino acid S112 is critical for IgE binding of almost all patients sera tested. This reduced IgE binding was also observed with a single point mutant of Bet v 1a (S112P) and thus indicated serine 112 as an essential residue for preserving the structure of a cross-reactive IgE epitope. Moreover, two Pru a 1 mutants with an altered 'P-loop' region, showed a lowered IgE binding capacity for IgE from a subgroup of allergic patients. The investigation of essential features for preserving cross-reactive IgE-epitopes provides the structural basis for understanding the clinically observed cross-allergenicity between pollen and fruits. Moreover, non-anaphylactic allergen fragments or variants derived from the IgE-inducing pollen allergens may serve as useful tools for a new strategy of specific immunotherapy.

Indirect competitive ELISA for determination of traces of peanut (Arachis hypogaea L.) protein in complex food matrices

An indirect competitive ELISA was developed allowing the detection of hidden peanut protein residues down to 2 ppm (micorgrams per gram) in various foods. The high-titer, peanut-specific polyclonal antiserum used recognized potentially allergenic proteins in both native and roasted peanuts. In the absence of a food matrix, extractable protein from roasted peanuts was detected at 104 +/- 13%. From various food items, peanut protein at > or =13 ppm was recovered between 84 and 126%, and at 2 ppm of peanut protein recovery was 143 +/- 6%. Intra- and interassay precision was <15%. In 5 of 17 commercial food products without declaration of peanut components, between 2 and 18 ppm of peanut protein was detected. This is the first assay based on commercially available reactants that allows the reliable determination of trace amounts of hidden peanut allergens in a variety of complex food matrices.

Factors influencing the quality of food extracts for in vitro and in vivo diagnosis

Food extracts for diagnostic purposes often lack sufficient activity and consistency. Biologically standardized food extracts are not available on the market. Using extracts from plant-derived foods as examples, we investigated factors which may be important for the quality of such extracts. Divergent allergenic activities were found between strains of apples, but not within varieties of celery tuber (celeriac), hazelnut, and peanut, respectively. Heating of the food remarkably reduced the activity of apple, hazelnut, and celeriac, but had little effect on peanut. By contrast, heating of semipurified protein extracts from celery tuber and apple for 30 min at 100 degrees C did not deplete the immunoreactivity of the major allergens, indicating that this is an inappropriate test for identifying labile food allergens. Due to their high endogenous enzyme activities, apples and other fruits require special extraction procedures applying either low temperature or enzyme inhibitors. Variation of extraction conditions had little effect on the composition and activity of extracts from hazelnut. The storage stability of skin test solutions from plant foods can be improved by avoiding phenol as an additive and by including 50% of glycerol. For model studies considering neoallergens, IgE was raised in mice against native and heated celery tuber, respectively. When extracts from nonthermally and thermally processed celeriac were subjected to an RBL-cell mediator release assay with these sera, an inverse ranking was obtained with anti-heated celeriac IgE and anti-native celeriac IgE, respectively. These data indicated that new epitopes had been formed by the heating process. Since all parameters were tested in model experiments with either human or murine IgE, their relevance has to be proven in further clinical investigations.

Determination and characterization of cross-reacting allergens in latex, avocado, banana, and kiwi fruit

Sera of 11 patients were used to characterize allergens in kiwi fruit, latex, avocado, and banana by SDS-PAGE/immunoblotting and to determine cross-reactions between these allergen extracts in EAST inhibition and immunoblot inhibition. By SDS-PAGE/immunoblotting, allergens with apparent molecular weights of 21, 38, 40, and 42 kDa were visualized in latex extract. In avocado extract, IgE-binding components of 27, 43, 52, 58, 65, 75, and 88 kDa were to be seen, whereas, in banana extract, a 40-kDa protein showed strong IgE binding. Furthermore, allergens of 52, 58, 88, and 94 kDa were detected in the extract of banana. Cross-reactions between these allergen extracts were determined by EAST inhibition. Immunoblot inhibition demonstrated that almost all IgE-reactive bands in nitrocellulose-blotted latex, avocado, and banana extracts and two components of 43 and 67 kDa in kiwi fruit shared common IgE epitopes.

Characterization of a new IgE-binding 35-kDa protein from birch pollen with cross-reacting homologues in various plant foods

The present investigation was undertaken to obtain molecular data of a new immunoglobulin (Ig)E-binding birch pollen protein with a mass of 35 kDa. In a previous study, this protein showed IgE cross-reactivity with 34- and 35-kDa proteins in apples, pears, carrots, bananas and other exotic fruits. Since the protein was N-terminally blocked, it was purified by preparative SDS-PAGE, and multiple proteolytic fragments were subsequently generated by in-gel digestion with the endoproteinases Glu C, Lys C and Clostripain. After electrophoretic separation and blotting onto polyvinylidene difluoride (PVDF), the resulting polypeptides were subjected to N-terminal amino acid microsequencing. The internal sequences obtained showed a high degree of sequence identity to isoflavone reductases (IFR) and isoflavone reductase-like proteins (IRL) from several plants which also had a similar size. For a stretch of 25 consecutive residues this identity ranged from 56% for IFR from peas and chick peas and an IRL from maize, to 80% for a tobacco IRL. A 453 bp fragment was amplified from total birch pollen RNA by polymerase chain reaction (PCR) using primers derived from the nucleotide sequence of the tobacco IRL. The deduced 151 amino acid sequence represented approximately 50% of the protein and confirmed the sequence identities obtained by Edman degradation. Moreover, the 25 amino acid sequence was included in the cloned fragment. Deduced and determined amino acids showed only one mismatch, which was due to a single nucleotide exchange. At the antibody level, the immunological relationship of the birch pollen protein to IRL and IFR was demonstrated by immunoblotting with a rabbit antiserum against a pea IFR which recognized the same birch protein as patients' IgE. The rabbit antiserum also reproduced the cross-reactivity pattern previously observed with patients' IgE by recognizing related proteins in specific plant foods, including some exotic fruits. We therefore suggest that the 35-kDa birch pollen protein belongs to the IFR/IRL family and represents a minor allergen, possibly being responsible for less common pollen-related food allergies in patients allergic to birch pollen.

Molecular cloning, expression and characterization of Pru a 1, the major cherry allergen

A high percentage of birch pollen allergic patients experiences food hypersensitivity reactions after ingestion of several fruits and vegetables. Previous work demonstrated common epitopes on an allergen of Mr 18,000 from sweet cherry (Prunus avium) and Bet v 1, the major allergen from birch pollen. N-terminal amino acid sequencing showed a sequence identity of 67% with Bet v 1. Here we report the cloning and cDNA sequencing of this cherry allergen. The entire deduced amino acid sequence described a protein of Mr 17,700 with 59.1% identity to Bet v 1. High degrees of identity in the range of 40 to 60% were also found with related allergens from other kinds of tree pollen and plant foods as well as with stress-induced proteins from food plants such as parsley, potato and soya. The coding DNA of the cherry protein was cloned into vector pET-16b and expressed in E. coli strain BL21(DE3) as a His-tag fusion protein. As shown by SDS-PAGE, the apparent molecular masses of the nonfusion protein and the natural allergen were identical. The fusion protein showed high IgE binding potency when sera from patients allergic to cherry were tested by immunoblotting and enzyme allergosorbent tests. Moreover, it cross-reacted strongly with IgE specific for the natural counterpart and for Bet v 1. The high biological activity of the recombinant fusion protein was further confirmed by the induction of a strong histamine release in basophils from cherry-allergic patients. Since sera from 17/19 of such patients contained IgE against this allergen it was classified as a major allergen and named Pru a 1. Recombinant Pru a 1 mimics most of the allergenic potency of cherry extract and hence could be a useful tool for studying the molecular and immunological properties of pollen related food allergens.

Oral allergy syndrome to a jackfruit (Artocarpus integrifolia)

A 30-year-old man from the Philippines with pollen allergy noted the appearance of oral allergy syndrome (OAS) after eating raw apple, raw peach, raw celery, and recently, jackfruit (Artocarpus integrifolia), a tropical fruit which belongs to the Moraceae family (mulberry) and to the genus Artocarpus (breadfruit tree). Despite the patient's multiple sensitization in skin prick tests and in the Pharmacia CAP System to birch, grass, mugwort pollen, related fruits and vegetables, and jackfruit, in RAST-inhibition studies neither rBet v 1 nor rBet v 2 (profilin), the well-known cross-reacting allergenic components in OAS, could inhibit the specific IgE response to jackfruit. Whether the reaction to jackfruit is specific or whether other pollen-related, cross-reacting allergenic components exist should be investigated further.

IgE binding to a new cross-reactive structure: a 35 kDa protein in birch pollen, exotic fruit and other plant foods

Food allergies in birch pollen allergic patients have been shown to be due to cross-reactivities of specific IgE antibodies which are directed against birch pollen allergens with related proteins in fruit, nuts and vegetables. We identified a new cross-reactive structure of 35 kDa in birch pollen and some plant food extracts by Enzyme Allergosorbent Test (EAST) and immunoblot inhibition studies. The 35 kDa birch pollen protein is a minor allergen to which approximately 10-15% of birch pollen allergic individuals have specific IgE. Our data demonstrate that there is cross-reactivity of this protein with proteins of comparable size from lychee, mango, banana, orange, apple, pear and carrot. While the 35 kDa protein is immunologically independent of the major birch pollen allergen Bet v 1, we also observed IgE binding to a 34 kDa structure which appears to be a Bet v 1 dimer.

Honeybee venom allergy: immunoblot studies in allergic patients after immunotherapy and before sting challenge

By immunoblot techniques, detailed antibody studies were performed with sera of 20 honeybee-venom-allergic patients during or at the end of specific immunotherapy (median duration: 3 years) and before honeybee sting challenge. Before immunotherapy, all patients had experienced systemic allergic reactions to a honeybee sting, with a mean severity of 3.5 +/- 0.5 according to the Müller classification. After the sting challenge, 10 patients (reactors) reacted again with a systemic allergic reaction, whereas 10 patients (nonreactors) did not. No differences were observed between reactors and nonreactors in total serum IgE and specific IgE to honeybee venom at the time of challenge. For immunoblot, honeybee venom (RELESS) was separated on 7.5-20% SDS-PAGE. For detection of specific IgE, IgG, IgG1, IgG4, and IgM, an alkaline phosphatase-linked second antibody was used. Both groups showed 11 antibody-binding bands: at 52, 46, 40, 31, 18.7, 16.9, 13, 11, 10, 9, and 8 kDa; however, the antibody-binding pattern was individual. The reactors differed from nonreactors in showing intense IgE and less IgG4 binding to at least one single component of the venom extract. For nonreactors, the inverse relationship was observed. The hypothesis, "intensity of IgE > or = IgG4 leads to allergic symptoms", was highly significant (P = 0.00026; chi-square). These immunoblot findings could offer predictive value in distinguishing reactors from nonreactors.

Anaphylactic reaction to lychee fruit: evidence for sensitization to profilin

BACKGROUND AND OBJECTIVE

Due to the increasing popularity of exotic fruits in the Western diet, allergologists are confronted with allergic reactions to substances in these plants. The present report describes an anaphylactic reaction after the consumption of lychee fruit (Litchi sinensis). The atopic patient also suffers from rhinoconjunctivitis due to a sensitization against pollen of the Compositae family, as well as from dyspnoea after eating sunflower seeds. Our goals were to determine crossreactivity between antibodies against lychee fruit and other plants and to characterize the allergen.

METHODS AND RESULTS

Specific IgE against lychee fruits were detected by an EAST assay. The allergen was characterized by immunoblot, immunoblot inhibition and EAST inhibition assays. Broad crossreactivity between lychee fruit and other plants was found and profilin identified as the protein responsible for the patient's complex allergy syndrome.

CONCLUSION

Lychee fruit contains a significant amount of profilin. Consumption of this exotic fruit can cause severe anaphylactic reactions in patients being sensitized against the plant pan-allergen profilin.

Investigation of the stability of apple allergen extracts

To determine optimal conditions for allergen preservation, we investigated the influence of different stabilizing additives and of storage temperature on the allergen activity of apple protein preparations, obtained by extraction in phosphate buffer or by precipitation in diacetone alcohol and resolubilization in phosphate buffer in the presence or absence of enzyme inhibitors. For this purpose, the extracts were stored for 6 months either in frozen state at -20 degrees C or in lyophilized state at -20 degrees C, 4 degrees C, or room temperature and were characterized by SDS-PAGE, immunoblot, ELISA inhibition, and prick test. The highest stability revealed the extracts that were prepared by precipitation in the organic solvent in the presence of enzyme inhibitors, lyophilized, and stored at -20 degrees C. For storage of extract solutions at 4 degrees C, PBS/glycerol and cysteine/sodium citrate/glycerol were found to be the most effective stabilizing additives.

Isolation and characterization of the 18-kDa major apple allergen and comparison with the major birch pollen allergen (Bet v I)

The major allergen from birch pollen, Bet v I, and the cross-reacting 18-kDa major allergen from Golden Delicious and Granny Smith applies were isolated by micropreparative SDS-PAGE followed by electroelution. In the case of apples, highly active, low-temperature extracts were used. The purity of the allergens was checked by analytic SDS-PAGE and immunoblotting with allergic patients' sera, as well as by N-terminal amino acid microsequencing, and the allergens were found to be very pure. The strong immunologic activity of the isolates was determined by the enzyme allergosorbent test (EAST) and EAST inhibition assays; this activity was, in the case of Bet v I, similar to that of a preparation obtained by monoclonal antibody affinity chromatography. The allergenic potency of Bet v I and of the cross-reactive apple allergen was determined by EAST inhibition and dose-related histamine release. With both assay systems, the allergenic reactivity of Bet v I was considerably higher than that of the major apple allergen. Furthermore, skin prick tests with the purified allergens and with whole allergenic extracts were performed on a group of 33 patients suffering from birch-pollen and apple hypersensitivity, and on a control group of 10 patients. The frequency of positive prick test results in the allergic patient group ranged from 73% for the major allergen from Golden Delicious apples to 97% with Bet v I and whole birch pollen extract, respectively. In contrast to our low-temperature extracts, commercial prick test solutions of four different manufacturers were found to be unreliable for the diagnosis of apple allergy. The skin test results again indicated the strong immunologic activity of the allergen isolates and the predominance of the major allergens in context with birch-pollen and apple hypersensitivity. Taken together, the results support the view that the 18-kDa major allergen represents most of the allergenicity of the the apple fruit, and that all allergenic epitopes of the apple proteins are present on Bet v I.

Optimization of apple allergen preparation for in vivo and in vitro diagnostics

The aim of our investigation was to obtain a well-characterized active apple extract suitable for both in vivo and in vitro diagnostics by a technically simple method. For this purpose, apple extracts were prepared by homogenization in potassium phosphate buffer or by precipitation in organic solvents and resolubilization in potassium phosphate buffer in the presence or in the absence of enzyme inhibitors. These extracts were comparatively investigated by means of SDS-PAGE, two-dimensional electrophoresis, immunoblotting, RAST inhibition, and prick test. The in vitro investigations indicated that extracts prepared by precipitation in organic solvents (diacetone alcohol) at -20 degrees C have a higher allergen activity than those prepared by extraction in aqueous solutions. From the in vivo tests (prick test), it was concluded that application of inhibitors of cytoplasmic enzymes (phenol oxidases, peroxidases, proteases) already during extraction is an essential precondition for active prick test solutions. Correspondingly, the extract obtained by solvent precipitation in the presence of enzyme inhibitors appeared to be most suitable for clinical application.

Apple allergy: the IgE-binding potency of apple strains is related to the occurrence of the 18-kDa allergen

Low-temperature, acetone powder extracts were prepared from mature fruit of 16 apple strains. SDS-PAGE and immunoblot analysis revealed great variation in the relative amounts of the 18-kDa apple allergen in these extracts. EAST (RAST) scores, measured with individual and pool sera from patients allergic to birch pollen and apples, ranged from 0.2 to 4.0 and were related to the relative amount of the 18-kDa protein. These findings were confirmed by ELISA-inhibition assays, dose-related histamine release, semiquantitative evaluation of immunoblots by absorption/reflection densitometry, and skin prick tests with extracts of Golden Delicious, Boskoop, and Jamba apples (corresponding to a high, low, and very low 18-kDa allergen content). Additional open oral challenge tests were performed with two apple-allergic patients and 15 and 16 apple strains. With all methods, the deduced allergenic potency decreased in the following order: Golden Delicious > Boskoop > Jamba. Therefore, we concluded that the IgE-binding potency of apple strains depends on the occurrence of the 18-kDa allergen.