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Kazancioglu A, Konuralp I, Sahiner UM, Soyer O, Sekerel BE. Understanding of lipid transfer protein sensitization patterns and its clinical significance in children. Allergy Asthma Proc 2024; 45:120-127. [PMID: 38449011 DOI: 10.2500/aap.2024.45.230075] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/08/2024]
Abstract
Background: Lipid transfer proteins (LTP) are the most common food allergens in the Mediterranean region. Objective: The study aimed to investigate co-sensitization patterns and cluster relationships between LTP allergen molecules across a broad range of allergen-specific sensitization patterns, and clinical outcomes in eastern Mediterranean children. Methods: Among 496 children evaluated for multiple sensitizations with multiplex testing, 105 children (21%) with 16 different LTP sensitizations were analyzed. Clinical reactivity was examined based on clear-cut history of immunoglobulin E mediated symptoms (oral allergy syndrome [OAS], systemic reactions, and anaphylaxis). Results: All children included were sensitive to food LTPs, but 56% were sensitive to pollen LTPs. The number of children with OAS and clinical reactivity was 12 and 59, respectively, and no cofactors were reported. The most common sensitizations were Pru p 3 (74%) and Cor a 8 (66%). Significant correlations were observed in the heatmap between the LTP molecules other than Par j 2 and Tri a 14. Overall, clinical reactivity was associated with increased age and number of LTP molecule positivity. Conclusion: In the eastern Mediterranean region, 21% of children with multiple food and/or pollen sensitizations were found to have LTP sensitization; however, almost half reported clinical reactivity. The hierarchical pathway highlights that distinct LTP allergen molecules can act as primary sensitizers. Clinical reactivity is linked to increasing numbers of LTP molecule positivity and increasing age.
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Affiliation(s)
- Alp Kazancioglu
- From the Department of Pediatric Allergy, Hacettepe University School of Medicine, Ankara, Turkey, and
| | - Ilteber Konuralp
- Department of Statistics, Middle East Technical University, Ankara, Turkey
| | - Umit Murat Sahiner
- From the Department of Pediatric Allergy, Hacettepe University School of Medicine, Ankara, Turkey, and
| | - Ozge Soyer
- From the Department of Pediatric Allergy, Hacettepe University School of Medicine, Ankara, Turkey, and
| | - Bulent Enis Sekerel
- From the Department of Pediatric Allergy, Hacettepe University School of Medicine, Ankara, Turkey, and
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Dinardo G, Dahdah L, Cafarotti A, Arasi S, Fierro V, Pecora V, Mazzuca C, Urbani S, Artesani MC, Riccardi C, Valluzzi RL, Indolfi C, Miraglia Del Giudice M, Fiocchi A. Botanical Impurities in the Supply Chain: A New Allergenic Risk Exacerbated by Geopolitical Challenges. Nutrients 2024; 16:628. [PMID: 38474756 DOI: 10.3390/nu16050628] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2023] [Revised: 02/19/2024] [Accepted: 02/22/2024] [Indexed: 03/14/2024] Open
Abstract
BACKGROUND The supply chains of food raw materials have recently been heavily influenced by geopolitical events. Products that came from, or transited through, areas currently in conflict are now preferentially supplied from alternative areas. These changes may entail risks for food safety. METHODS We review the potential allergenicity of botanical impurities, specifically vegetable contaminants, with particular attention to the contamination of vegetable oils. We delve into the diverse types of botanical impurities, their sources, and the associated allergenic potential. Our analysis encompasses an evaluation of the regulatory framework governing botanical impurities in food labeling. RESULTS Unintended plant-derived contaminants may manifest in raw materials during various stages of food production, processing, or storage, posing a risk of allergic reactions for individuals with established food allergies. Issues may arise from natural occurrence, cross-contamination in the supply chain, and contamination at during production. The food and food service industries are responsible for providing and preparing foods that are safe for people with food allergies: we address the challenges inherent in risk assessment of botanical impurities. CONCLUSIONS The presence of botanical impurities emerges as a significant risk factor for food allergies in the 2020s. We advocate for regulatory authorities to fortify labeling requirements and develop robust risk assessment tools. These measures are necessary to enhance consumer awareness regarding the potential risks posed by these contaminants.
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Affiliation(s)
- Giulio Dinardo
- Department of Woman, Child and of General and Specialized Surgery, University of Campania Luigi Vanvitelli, 80138 Naples, Italy
| | - Lamia Dahdah
- Allergy Diseases Research Area, Pediatric Allergology Unit, Bambino Gesù Children's Hospital IRCCS, 0165 Rome, Italy
| | - Arianna Cafarotti
- Allergy Diseases Research Area, Pediatric Allergology Unit, Bambino Gesù Children's Hospital IRCCS, 0165 Rome, Italy
| | - Stefania Arasi
- Allergy Diseases Research Area, Pediatric Allergology Unit, Bambino Gesù Children's Hospital IRCCS, 0165 Rome, Italy
| | - Vincenzo Fierro
- Allergy Diseases Research Area, Pediatric Allergology Unit, Bambino Gesù Children's Hospital IRCCS, 0165 Rome, Italy
| | - Valentina Pecora
- Allergy Diseases Research Area, Pediatric Allergology Unit, Bambino Gesù Children's Hospital IRCCS, 0165 Rome, Italy
| | - Carmen Mazzuca
- Allergy Diseases Research Area, Pediatric Allergology Unit, Bambino Gesù Children's Hospital IRCCS, 0165 Rome, Italy
| | - Sara Urbani
- Allergy Diseases Research Area, Pediatric Allergology Unit, Bambino Gesù Children's Hospital IRCCS, 0165 Rome, Italy
| | - Maria Cristina Artesani
- Allergy Diseases Research Area, Pediatric Allergology Unit, Bambino Gesù Children's Hospital IRCCS, 0165 Rome, Italy
| | - Carla Riccardi
- Allergy Diseases Research Area, Pediatric Allergology Unit, Bambino Gesù Children's Hospital IRCCS, 0165 Rome, Italy
| | - Rocco Luigi Valluzzi
- Allergy Diseases Research Area, Pediatric Allergology Unit, Bambino Gesù Children's Hospital IRCCS, 0165 Rome, Italy
| | - Cristiana Indolfi
- Department of Woman, Child and of General and Specialized Surgery, University of Campania Luigi Vanvitelli, 80138 Naples, Italy
| | - Michele Miraglia Del Giudice
- Department of Woman, Child and of General and Specialized Surgery, University of Campania Luigi Vanvitelli, 80138 Naples, Italy
| | - Alessandro Fiocchi
- Allergy Diseases Research Area, Pediatric Allergology Unit, Bambino Gesù Children's Hospital IRCCS, 0165 Rome, Italy
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Ridolo E, Barone A, Ottoni M, Peveri S, Montagni M, Nicoletta F. Factors and co-factors influencing clinical manifestations in nsLTPs allergy: between the good and the bad. FRONTIERS IN ALLERGY 2023; 4:1253304. [PMID: 37841053 PMCID: PMC10568476 DOI: 10.3389/falgy.2023.1253304] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Accepted: 09/18/2023] [Indexed: 10/17/2023] Open
Abstract
Non-specific lipid transfer proteins (nsLTPs) are a family of plant pan-allergens that represent the primary cause of food allergies in the Mediterranean area, characterized by a wide range of clinical manifestations, ranging from the total absence of symptoms up to anaphylaxis. This wide variety of symptoms is related to the intrinsic capacity of nsLTPs to cause an allergic reaction in a specific subject, but also to the presence of co-factors exacerbating (i.e., exercise, NSAIDs, PPIs, alcohol, cannabis, prolonged fasting, menstruation, acute infections, sleep deprivation, chronic urticaria) or protecting from (i.e., co-sensitization to PR10, profilin or polcalcin) severe reactions. In this picture, recognizing some nsLTPs-related peculiarities (i.e., route, type and number of sensitizations, concentration of the allergen, cross-reactions) and eventual co-factors may help the allergist to define the risk profile of the single patient, in order to promote the appropriate management of the allergy from dietary advices up to the prescription of life-saving epinephrine autoinjector.
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Affiliation(s)
- Erminia Ridolo
- Department of Medicine and Surgery, University of Parma, Parma, Italy
- Allergology Unit, University Hospital of Parma, Parma, Italy
| | | | - Martina Ottoni
- Allergology Unit, University Hospital of Parma, Parma, Italy
| | - Silvia Peveri
- Departmental Unit of Allergology, Guglielmo da Saliceto Hospital, Piacenza, Italy
| | - Marcello Montagni
- Departmental Unit of Allergology, Guglielmo da Saliceto Hospital, Piacenza, Italy
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Mameri H, Gaudin JC, Lollier V, Tranquet O, Brossard C, Pietri M, Marion D, Codreanu-Morel F, Beaudouin E, Wien F, Gohon Y, Briozzo P, Denery-Papini S. Critical structural elements for the antigenicity of wheat allergen LTP1 (Tri a 14) revealed by site-directed mutagenesis. Sci Rep 2022; 12:12253. [PMID: 35851276 PMCID: PMC9293932 DOI: 10.1038/s41598-022-15811-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Accepted: 06/29/2022] [Indexed: 11/09/2022] Open
Abstract
Lipid transfer proteins (LTPs) were identified as allergens in a large variety of pollens and foods, including cereals. LTPs belong to the prolamin superfamily and display an α-helical fold, with a bundle of four α-helices held together by four disulfide bonds. Wheat LTP1 is involved in allergic reactions to food. To identify critical structural elements of antibody binding to wheat LTP1, we used site-directed mutagenesis on wheat recombinant LTP1 to target: (i) sequence conservation and/or structure flexibility or (ii) each disulfide bond. We evaluated the modifications induced by these mutations on LTP1 secondary structure by synchrotron radiation circular dichroism and on its antigenicity with patient's sera and with mouse monoclonal antibodies. Disruption of the C28-C73 disulfide bond significantly affected IgE-binding and caused protein denaturation, while removing C13-C27 bond decreased LTP1 antigenicity and slightly modified LTP1 overall folding. In addition, we showed Lys72 to be a key residue; the K72A mutation did not affect global folding but modified the local 3D structure of LTP1 and strongly reduced IgE-binding. This work revealed a cluster of residues (C13, C27, C28, C73 and K72), four of which embedded in disulfide bonds, which play a critical role in LTP1 antigenicity.
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Affiliation(s)
- Hamza Mameri
- INRAE, UR 1268 Biopolymères Interactions Assemblages (BIA), 44316, Nantes, France. .,UMR 1208 IATE, Univ Montpellier, INRAE, L'Institut-Agro Montpellier, 34060, Montpellier, France.
| | - Jean-Charles Gaudin
- INRAE, UR 1268 Biopolymères Interactions Assemblages (BIA), 44316, Nantes, France.,INRAE, UMR 0588 Biologie intégrée pour la valorisation de la diversité des arbres et de la forêt (BIOFORA), 45075, Orléans, France
| | - Virginie Lollier
- INRAE, UR 1268 Biopolymères Interactions Assemblages (BIA), 44316, Nantes, France.,INRAE, UR BIA, 44316, Nantes, France.,INRAE, PROBE Research Infrastructure, BIBS Facility, 44316, Nantes, France
| | - Olivier Tranquet
- INRAE, UR 1268 Biopolymères Interactions Assemblages (BIA), 44316, Nantes, France.,INRAE UMR 1163 Biodiversité et Biotechnologie Fongiques (BBF), 13288, Marseille, France
| | - Chantal Brossard
- INRAE, UR 1268 Biopolymères Interactions Assemblages (BIA), 44316, Nantes, France
| | - Manon Pietri
- INRAE, UR 1268 Biopolymères Interactions Assemblages (BIA), 44316, Nantes, France.,Institut de Cancérologie de l'Ouest, Centre René Gauducheau, 44805, Saint Herblain Cedex, France
| | - Didier Marion
- INRAE, UR 1268 Biopolymères Interactions Assemblages (BIA), 44316, Nantes, France
| | - Fanny Codreanu-Morel
- CHU Luxembourg, Centre Hospitalier de Luxembourg, Kanner Klinik, 1210, Luxembourg, Luxembourg
| | - Etienne Beaudouin
- Service d'Allergologie, Hôpital de Mercy, CHR Metz, 57000, Metz, France
| | - Frank Wien
- Synchrotron Soleil, Saint-Aubin, 91192, Gif-sur-Yvette, France
| | - Yann Gohon
- INRAE, UMR 1318 Institut Jean-Pierre Bourgin, 78026, Versailles, France
| | - Pierre Briozzo
- INRAE, UMR 1318 Institut Jean-Pierre Bourgin, 78026, Versailles, France
| | - Sandra Denery-Papini
- INRAE, UR 1268 Biopolymères Interactions Assemblages (BIA), 44316, Nantes, France.
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Abstract
This review provides a global overview on Rosaceae allergy and details the particularities of each fruit allergy induced by ten Rosaceae species: almond/peach/cherry/apricot/plum (Amygdaleae), apple/pear (Maleae), and raspberry/blackberry/strawberry (Rosoideae). Data on clinical symptoms, prevalence, diagnosis, and immunotherapies for the treatment of Rosaceae allergy are herein stated. Allergen molecular characterization, cross-reactivity/co-sensitization phenomena, the impact of food processing and digestibility, and the methods currently available for the Rosaceae detection/quantification in foods are also described. Rosaceae allergy has a major impact in context to pollen-food allergy syndrome (PFAS) and lipid transfer protein (LTP) allergies, being greatly influenced by geography, environment, and presence of cofactors. Peach, apple, and almond allergies are probably the ones most affecting the quality of life of the allergic-patients, although allergies to other Rosaceae fruits cannot be overlooked. From patients' perspective, self-allergy management and an efficient avoidance of multiple fruits are often difficult to achieve, which might raise the risk for cross-reactivity and co-sensitization phenomena and increase the severity of the induced allergic responses with time. At this point, the absence of effective allergy diagnosis (lack of specific molecular markers) and studies advancing potential immunotherapies are some gaps that certainly will prompt the progress on novel strategies to manage Rosaceae food allergies.
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Affiliation(s)
- Joana Costa
- REQUIMTE-LAQV, Faculdade de Farmácia, Universidade do Porto, Porto, Portugal
| | - Isabel Mafra
- REQUIMTE-LAQV, Faculdade de Farmácia, Universidade do Porto, Porto, Portugal
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Luo W, Yang S, Huang H, Wu L, Cheng ZJ, Zheng P, Zheng J, Sun B. Analysis of Peanut Allergen Components Sensitization and Cross Reaction with Pollen Allergen in Chinese Southerners with Allergic Rhinitis and/or Asthma. J Asthma Allergy 2021; 14:1285-1293. [PMID: 34737581 PMCID: PMC8560168 DOI: 10.2147/jaa.s335265] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Accepted: 10/13/2021] [Indexed: 11/26/2022] Open
Abstract
Objective Peanut is one of the most frequently reported allergens causing severe allergies in western countries. In China, however, there have been few reports of severe allergies caused by peanuts. We investigated the peanut allergen components sensitization and cross-reaction with pollen allergen in Chinese Southerners with allergic rhinitis and/or asthma. Methods Total IgE (tIgE) and specific IgE (sIgE) antibodies against Ara h 1, Ara h 8, Juglans pollen, Platanus pollen, birch pollen, Bet v 1, Bet v 4, and cross-reactive carbohydrate determinant (CCD) of 58 allergic patients, of whom 33 were peanut-sIgE positive and 25 were negative, were detected by the ImmunoCAP system. The relationships between peanut allergen and pollen allergens were analyzed. Results A 9.1% (3/33) of the patients with peanut sensitization were sensitized to Ara h 8, while 21.2% (7/33) were sensitized to Ara h 1. The peanut-sensitized group had significantly higher positive rates for sIgE antibodies against CCD (69.7% vs 4.0%), Juglans pollen (87.9% vs 12.0%), Platanus pollen (90.9% vs 16.0%), and birch pollen (60.6% vs 4.0%) than the peanut tolerance group (all P < 0.05). Spearman correlation showed that peanut-sIgE were significantly correlated with sIgE to CCD (rs=0.859), Juglans pollen (rs=0.772), Platanus pollen (rs=0.838) and birch pollen (rs=0.816). Conclusion The majority of patients sensitized to peanut allergen in Southern China tested positive for multiple pollen allergens. Peanut sensitization was highly correlated with Platanus, Juglans, and birch pollen sensitization, which suggested there may be cross-reactions between peanut and pollen allergens. Clinicians should pay attention to distinguish diagnosis in clinical peanut allergy diagnosis and treatment.
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Affiliation(s)
- Wenting Luo
- Department of Allergy and Clinical Immunology, State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, First Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, Guangzhou, People's Republic of China
| | - Shuwen Yang
- Department of Allergy and Clinical Immunology, State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, First Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, Guangzhou, People's Republic of China
| | - Huimin Huang
- Department of Allergy and Clinical Immunology, State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, First Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, Guangzhou, People's Republic of China
| | - Liting Wu
- Department of Allergy and Clinical Immunology, State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, First Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, Guangzhou, People's Republic of China
| | - Zhangkai J Cheng
- Department of Allergy and Clinical Immunology, State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, First Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, Guangzhou, People's Republic of China
| | - Peiyan Zheng
- Department of Allergy and Clinical Immunology, State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, First Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, Guangzhou, People's Republic of China
| | - Jinping Zheng
- Department of Allergy and Clinical Immunology, State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, First Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, Guangzhou, People's Republic of China
| | - Baoqing Sun
- Department of Allergy and Clinical Immunology, State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, First Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, Guangzhou, People's Republic of China
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Rossi CM, Lenti MV, Merli S, Santacroce G, Di Sabatino A. Allergic manifestations in autoimmune gastrointestinal disorders. Autoimmun Rev 2021; 21:102958. [PMID: 34560305 DOI: 10.1016/j.autrev.2021.102958] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2021] [Accepted: 09/19/2021] [Indexed: 12/14/2022]
Abstract
Allergic disorders target a young population, are increasing in both incidence and prevalence and are associated with significant disease burden. They result from the complex interplay between (epi)genetic and environmental factors, resulting in a Th2 inflammatory process targeting the epithelium of the respiratory tract (allergic rhinitis and asthma), skin (atopic dermatitis), and gastrointestinal tract (food allergy). Although the exact pathogenic mechanisms remain elusive, an altered immune system response in the gut is increasingly recognized as a relevant step. Allergic and gastrointestinal autoimmune disorders share several epidemiological, pathogenic and risk factors and several treatment modalities. Here we revise the current literature and show that allergic disorders are highly prevalent in gastrointestinal autoimmune diseases, including celiac disease, inflammatory bowel disease, autoimmune pancreatitis, and autoimmune cholangiopathies. No data are available for some autoimmune diseases, such as autoimmune gastritis and autoimmune enteropathy. To ensure the comprehensive care of patients with autoimmune gastrointestinal disorders, along with disease-specific factors, the presence of allergic disorders should be evaluated and treated when present, possibly targeting shared molecular pathways. Future studies are needed to define the exact pathogenic mechanisms underpinning the association between allergic and autoimmune diseases of the gastrointestinal tract.
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Affiliation(s)
- Carlo Maria Rossi
- Department of Internal Medicine, IRCCS San Matteo Hospital Foundation, University of Pavia, Pavia, Italy
| | - Marco Vincenzo Lenti
- Department of Internal Medicine, IRCCS San Matteo Hospital Foundation, University of Pavia, Pavia, Italy
| | - Stefania Merli
- Department of Internal Medicine, IRCCS San Matteo Hospital Foundation, University of Pavia, Pavia, Italy
| | - Giovanni Santacroce
- Department of Internal Medicine, IRCCS San Matteo Hospital Foundation, University of Pavia, Pavia, Italy
| | - Antonio Di Sabatino
- Department of Internal Medicine, IRCCS San Matteo Hospital Foundation, University of Pavia, Pavia, Italy.
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Abstract
INTRODUCTION Allergies affect 20-30% of the population and respiratory allergies are mostly due to pollen grains from anemophilous plants. One to 5% of people suffer from food allergies and clinicians report increasing numbers of pollen-food allergy syndrome (PFAS), such that the symptoms have broadened from respiratory to gastrointestinal, and even to anaphylactic shock in the presence of cofactors. Thirty to 60% of food allergies are associated with pollen allergy while the percentage of pollen allergies associated to food allergy varies according to local environment and dietary habits. AREAS COVERED Articles published in peer-reviewed journals, covered by PubMed databank, clinical data are discussed including symptoms, diagnosis, and management. A chapter emphasizes the role of six well-known allergen families involved in PFAS: PR10 proteins, profilins, lipid transfer proteins, thaumatin-like proteins, isoflavone reductases, and β-1,3 glucanases. The relevance in PFAS of three supplementary allergen families is presented: oleosins, polygalacturonases, and gibberellin-regulated proteins. To support the discussion a few original relevant results were added. EXPERT OPINION Both allergenic sources, pollen and food, are submitted to the same stressful environmental changes resulting in an increase of pathogenesis-related proteins in which numerous allergens are found. This might be responsible for the potential increase of PFAS.
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Affiliation(s)
- Pascal Poncet
- Armand Trousseau Children Hospital, Immunology Department, Allergy & Environment Research Team , Paris, France.,Immunology Department, Institut Pasteur , Paris, France
| | - Hélène Sénéchal
- Armand Trousseau Children Hospital, Immunology Department, Allergy & Environment Research Team , Paris, France
| | - Denis Charpin
- Aix Marseille University and French Clean Air Association (APPA) , Marseille, France
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Skypala IJ, Asero R, Barber D, Cecchi L, Diaz Perales A, Hoffmann-Sommergruber K, Pastorello EA, Swoboda I, Bartra J, Ebo DG, Faber MA, Fernández-Rivas M, Gomez F, Konstantinopoulos AP, Luengo O, van Ree R, Scala E, Till SJ. Non-specific lipid-transfer proteins: Allergen structure and function, cross-reactivity, sensitization, and epidemiology. Clin Transl Allergy 2021; 11:e12010. [PMID: 34025983 PMCID: PMC8129635 DOI: 10.1002/clt2.12010] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Accepted: 01/08/2021] [Indexed: 12/27/2022] Open
Abstract
Background Discovered and described 40 years ago, non‐specific lipid transfer proteins (nsLTP) are present in many plant species and play an important role protecting plants from stressors such as heat or drought. In the last 20 years, sensitization to nsLTP and consequent reactions to plant foods has become an increasing concern. Aim The aim of this paper is to review the evidence for the structure and function of nsLTP allergens, and cross‐reactivity, sensitization, and epidemiology of nsLTP allergy. Materials and Methods A Task Force, supported by the European Academy of Allergy & Clinical Immunology (EAACI), reviewed current evidence and provide a signpost for future research. The search terms for this paper were “Non‐specific Lipid Transfer Proteins”, “LTP syndrome”, “Pru p 3”, “plant food allergy”, “pollen‐food syndrome”. Results Most nsLTP allergens have a highly conserved structure stabilised by 4‐disulphide bridges. Studies on the peach nsLTP, Pru p 3, demonstrate that nsLTPs are very cross‐reactive, with the four major IgE epitopes of Pru p 3 being shared by nsLTP from other botanically related fruits. These nsLTP allergens are to varying degrees resistant to heat and digestion, and sensitization may occur through the oral, inhaled or cutaneous routes. In some populations, Pru p 3 is the primary and sole sensitizing allergen, but many are poly‐sensitised both to botanically un‐related nsLTP in foods, and non‐food sources of nsLTP such as Cannabis sativa, Platanus acerifolia, (plane tree), Ambrosia artemisiifolia (ragweed) and Artemisia vulgaris (mugwort). Initially, nsLTP sensitization appeared to be limited to Mediterranean countries, however more recent studies suggest clinically relevant sensitization occurs in North Atlantic regions and also countries in Northern Europe, with nsLTP sensitisation profiles being broadly similar. Discussion These robust allergens have the potential to sensitize and provoke symptoms to a large number of plant foods, including those which are raw, cooked or processed. It is unknown why some sensitized individuals develop clinical symptoms to foods whereas others do not, or indeed what other allergens besides Pru p 3 may be primary sensitising allergens. It is clear that these allergens are also relevant in non‐Mediterranean populations and there needs to be more recognition of this. Conclusion Non‐specific LTP allergens, present in a wide variety of plant foods and pollens, are structurally robust and so may be present in both raw and cooked foods. More studies are needed to understand routes of sensitization and the world‐wide prevalence of clinical symptoms associated with sensitization to these complex allergens.
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Affiliation(s)
- Isabel J Skypala
- Department of Allergy & Clinical Immunology Royal Brompton & Harefield NHS Foundation Trust Imperial College London UK
| | - Ricardo Asero
- Ambulatorio di Allergologia Clinica San Carlo Milan Italy
| | - Domingo Barber
- IMMA School of Medicine Universidad San Pablo CEU CEU Universities Madrid Spain.,RETIC ARADYAL RD16/0006/0015 Instituto de Salud Carlos III Madrid Spain
| | - Lorenzo Cecchi
- SOS Allergy and Clinical Immunology USL Toscana Centro Prato Italy
| | - Arazeli Diaz Perales
- Departamento de Biotecnología-Biología Vegetal Centro de Biotecnología y Genómica de Plantas (CBGP, UPM-INIA) Universidad Politécnica de Madrid Madrid Spain
| | | | - Elide A Pastorello
- Unit of Allergology and Immunology ASST Grande Ospedale Metropolitano Niguarda University of Milan Milan Italy
| | - Ines Swoboda
- Biotechnology Section FH Campus Wien University of Applied Sciences Vienna Austria
| | - Joan Bartra
- Hospital Clinic de Barcelona IDIBAPS Universitat de Barcelona ARADyAL Barcelona Spain
| | - Didier G Ebo
- Department of Immunology, Allergology, Rheumatology and Infla-Med Centre of Excellence Faculty of Medicine and Health Sciences University of Antwerp and Antwerp University Hospital Ghent Belgium
| | - Margaretha A Faber
- Department of Immunology, Allergology, Rheumatology and Infla-Med Centre of Excellence Faculty of Medicine and Health Sciences University of Antwerp and Antwerp University Hospital Ghent Belgium
| | - Montserrat Fernández-Rivas
- Department of Allergy Hospital Clínico San Carlos Universidad Complutense de Madrid IdISSC, ARADyAL Madrid Spain
| | - Francesca Gomez
- Allergy Unit IBIMA- Hospital Regional Universitario de Malaga Malaga and Spanish Network for Allergy - RETICS de Asma, Reacciones adversas y Alérgicas (ARADyAL) Madrid Spain
| | | | - Olga Luengo
- Allergy Unit, Internal Medicine Department Vall d'Hebron University Hospital Universitat Autònoma de Barcelona ARADyAL Barcelona Spain
| | - Ronald van Ree
- Department of Experimental Immunology and Department of Otorhinolaryngology Amsterdam University Medical Centers location AMC Amsterdam The Netherlands
| | - Enrico Scala
- Experimental Allergy Unit Istituto Dermopatico Dell'immacolata IRCCS FLMM Rome Italy
| | - Stephen J Till
- Peter Gorer Department of Immunobiology King's College London London UK.,Department of Allergy Guy's & St Thomas' NHS Foundation Trust London UK
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11
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Ruano-Zaragoza M, Somoza ML, Jiménez-Rodriguez TW, Soriano-Gomis V, González-Delgado P, Esteban-Rodriguez A, Palazón-Bru A, Blanca M, Fernández-Sánchez J. Lipid Transfer Protein Sensitization: Risk of Anaphylaxis and Molecular Sensitization Profile in Pru p 3-Sensitized Patients. Int Arch Allergy Immunol 2020; 182:425-432. [PMID: 33341818 DOI: 10.1159/000511977] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2020] [Accepted: 10/02/2020] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Component-resolved diagnosis reveals the IgE response to many inhaled, food, and other allergens, improving the understanding and diagnosis of allergic diseases. OBJECTIVE The aims of the study are to study the recognition of different lipid transfer proteins (LTPs) and other allergen families in a large group of people sensitized to Pru p 3 and to analyze the relationship between the clinical entities and the allergens. METHODS This cross-sectional study included a large cohort of patients with positive skin tests to peach fruit and Pru p 3 specific IgE antibodies. Respiratory and food allergy symptoms were collected, and we performed prick tests with pollen, plant food, and other allergens plus the ImmunoCAP ISAC assay. RESULTS Our sample consisted of 421 people with a mean age of 33.25 years (range 16-68); 54.6% were women. Clinical entities included anaphylaxis (37.1%), urticaria (67.9%), and oral allergy syndrome (59.1%). Rhinitis, rhinoconjunctivitis, and/or asthma were diagnosed in 71.8% of the participants. The most pronounced correlation existed between sensitization to Pru p 3 and to Jug r 3, Pla a 3, Ara h 9, and Cor a 8. We found a higher incidence of anaphylaxis in people with 5 or more recognized LTPs. No association was observed between inhaled and food allergies. CONCLUSION Most Pru p 3-sensitized participants were sensitized to additional allergens from the same family and, to a lesser extent, to other allergens, mainly in the profilin and PR-10 protein families. Anaphylaxis occurred in more than a third of the cases evaluated, and almost three-quarters of them had respiratory symptoms. Respiratory and food allergies involving LTPs do not seem to be associated.
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Affiliation(s)
- Maria Ruano-Zaragoza
- Allergy Section, ARADyAL Spanish Network, Alicante General University Hospital-ISABIAL, Alicante, Spain, .,PhD Program in Public Health, Medical and Surgical Sciences. Miguel Hernandez University, Alicante, Spain,
| | | | | | - Victor Soriano-Gomis
- Allergy Section, ARADyAL Spanish Network, Alicante General University Hospital-ISABIAL, Alicante, Spain.,Clinical Medicine Department, Miguel Hernandez University, Alicante, Spain
| | - Purificación González-Delgado
- Allergy Section, ARADyAL Spanish Network, Alicante General University Hospital-ISABIAL, Alicante, Spain.,Clinical Medicine Department, Miguel Hernandez University, Alicante, Spain
| | | | | | - Miguel Blanca
- Section of Allergy, Infanta Leonor University Hospital, Madrid, Spain
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12
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Bogas G, Muñoz‐Cano R, Mayorga C, Casas R, Bartra J, Pérez N, Pascal M, Palomares F, Torres MJ, Gómez F. Phenotyping peach-allergic patients sensitized to lipid transfer protein and analysing severity biomarkers. Allergy 2020; 75:3228-3236. [PMID: 32535938 DOI: 10.1111/all.14447] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2020] [Revised: 05/10/2020] [Accepted: 05/18/2020] [Indexed: 01/19/2023]
Abstract
BACKGROUND Patients with peach allergy due to nsLTP sensitization constitute a heterogeneous group in terms of sensitization profile and severity. This could be due to the presence of additional allergies to pollens. The aim of this study was to analyse the clinical characteristics, sensitization profile and severity of reactions in peach-allergic patients sensitized to nsLTP from two Mediterranean areas with different pollen exposure. METHODS Patients with diagnosis of LTP allergy from the Allergy Unit of Hospital Regional Universitario de Malaga (HRUM) and Hospital Clinic de Barcelona (HCB) were prospectively included and classified into two groups; (a) LTP-monoallergic: those that presented reaction only with peach and (b) LTP-Allergy: those that presented reaction with peach and at least another plant-food containing LTP. RESULTS A total of 252 patients were included, 235 (93.2%) had LTP-syndrome and 17 (6.8%) were LTP-monoallergic. We found a higher percentage of anaphylaxis and delayed onset of symptoms in the LTP-monoallergic group (P = .02 and P = .04, respectively). Moreover, anaphylaxis was less frequent in patients with profilin sensitization (P = .03). The comparison of patients' data from HRUM with data from HCB showed differences in sensitization to olive tree pollen and profilin (P = .01 and P = .001, respectively). CONCLUSION This study was undertaken to characterize two large group of subjects from to two regions with differing exposures to pollen. We found that more than 90% of peach-allergic patients in both populations evolved to LTP-Allergy and showed an early onset. Profilin sensitization could be more useful as a severity biomarker than the number of nsLTP, aeroallergen sensitizations or sIgE levels. This could provide clues regarding sensitization and severity patterns that might be relevant in other geographical areas.
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Affiliation(s)
- Gador Bogas
- Allergy Unit IBIMA‐ Hospital Regional Universitario de Malaga Malaga Spain
| | - Rosa Muñoz‐Cano
- Allergy Section Pneumology Department IDIBAPS Universitat de Barcelona, Hospital Clínic Barcelona Spain
- Spanish Network for Allergy ‐ RETICS de Asma Reacciones adversas y Alérgicas (ARADyAL) Madrid Spain
| | - Cristobalina Mayorga
- Allergy Unit IBIMA‐ Hospital Regional Universitario de Malaga Malaga Spain
- Spanish Network for Allergy ‐ RETICS de Asma Reacciones adversas y Alérgicas (ARADyAL) Madrid Spain
- Research Laboratory IBIMA‐ Hospital Regional Universitario de Malaga Malaga Spain
| | - Rocio Casas
- Allergy Section Pneumology Department IDIBAPS Universitat de Barcelona, Hospital Clínic Barcelona Spain
| | - Joan Bartra
- Allergy Section Pneumology Department IDIBAPS Universitat de Barcelona, Hospital Clínic Barcelona Spain
- Spanish Network for Allergy ‐ RETICS de Asma Reacciones adversas y Alérgicas (ARADyAL) Madrid Spain
| | - Natalia Pérez
- Allergy Unit IBIMA‐ Hospital Regional Universitario de Malaga Malaga Spain
| | - Mariona Pascal
- Allergy Section Pneumology Department IDIBAPS Universitat de Barcelona, Hospital Clínic Barcelona Spain
- Spanish Network for Allergy ‐ RETICS de Asma Reacciones adversas y Alérgicas (ARADyAL) Madrid Spain
| | - Francisca Palomares
- Research Laboratory IBIMA‐ Hospital Regional Universitario de Malaga Malaga Spain
| | - María José Torres
- Allergy Unit IBIMA‐ Hospital Regional Universitario de Malaga Malaga Spain
- Spanish Network for Allergy ‐ RETICS de Asma Reacciones adversas y Alérgicas (ARADyAL) Madrid Spain
- Research Laboratory IBIMA‐ Hospital Regional Universitario de Malaga Malaga Spain
| | - Francisca Gómez
- Allergy Unit IBIMA‐ Hospital Regional Universitario de Malaga Malaga Spain
- Spanish Network for Allergy ‐ RETICS de Asma Reacciones adversas y Alérgicas (ARADyAL) Madrid Spain
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13
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Aruanno A, Urbani S, Frati F, Nucera E. LTP allergy/sensitization in a pediatric population. Allergol Immunopathol (Madr) 2020; 48:763-770. [PMID: 32402622 DOI: 10.1016/j.aller.2020.03.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2020] [Revised: 03/22/2020] [Accepted: 03/31/2020] [Indexed: 12/30/2022]
Abstract
Plant lipid transfer proteins (LTPs) are widespread plant food allergens, highly resistant to food processing and to the gastrointestinal environment, which have been described as the most common food allergens in the Mediterranean area. LTP allergy is widely described in adults, but it represents an emerging allergen also in the pediatric population. Little is known about the real prevalence and the clinical features of this allergy in children and it still often remains underdiagnosed in these patients. An early identification and a deeper knowledge of this allergy in childhood can avoid severe systemic reactions and improve the child's quality of life. Pediatricians should always consider the possibility of LTP involvement in cases of plant-derived food allergy.
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Affiliation(s)
- A Aruanno
- Allergy Unit, Fondazione Policlinico Universitario A. Gemelli IRCSS, Rome, Italy.
| | - S Urbani
- Allergy Unit, Fondazione Policlinico Universitario A. Gemelli IRCSS, Rome, Italy.
| | | | - E Nucera
- Allergy Unit, Fondazione Policlinico Universitario A. Gemelli IRCSS, Rome, Italy.
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14
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Bruusgaard-Mouritsen MA, Johansen JD, Zachariae C, Kirkeby CS, Garvey LH. Natural ingredients in cosmetic products-A suggestion for a screening series for skin allergy. Contact Dermatitis 2020; 83:251-270. [PMID: 32248558 DOI: 10.1111/cod.13550] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2020] [Revised: 03/31/2020] [Accepted: 04/02/2020] [Indexed: 12/12/2022]
Abstract
BACKGROUND Naturally derived cosmetic product ingredients of both plant and animal origin are being included increasingly in product formulations in order to cater to consumer preferences. They may be an overlooked cause of reactions to cosmetic products in some patients with dermatitis. OBJECTIVES To identify naturally derived cosmetic product ingredients with allergenic potential (type I and type IV) and propose a cosmetic screening test series. METHODS The study was conducted in two steps. The first step was a market survey using a nonprofit application helping consumers avoid problematic substances in cosmetic products. The application contained 10 067 cosmetic products that were label checked for naturally derived cosmetic product ingredients. The second step was a literature search to examine how frequently the naturally derived ingredients were described and related to allergic reactions in cosmetics or other topically administered products. RESULTS We identified 121 different naturally derived cosmetic product ingredients that were included in at least 30 cosmetic products. In total, 22 ingredients were selected for a screening test series. CONCLUSIONS We propose a supplemental patch test and a prick test screening series with naturally derived cosmetic product ingredients for patients with skin reactions to cosmetic products, aiming to identify a cause in more patients than is currently possible.
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Affiliation(s)
- Maria A Bruusgaard-Mouritsen
- National Allergy Research Centre, Department of Dermatology and Allergy, Copenhagen University Hospital Herlev-Gentofte, Hellerup, Denmark
| | - Jeanne D Johansen
- National Allergy Research Centre, Department of Dermatology and Allergy, Copenhagen University Hospital Herlev-Gentofte, Hellerup, Denmark
| | - Claus Zachariae
- Department of Dermatology and Allergy, Copenhagen University Hospital Herlev-Gentofte, Hellerup, Denmark
| | - Christel S Kirkeby
- Danish Consumer Council THINK Chemicals, Danish Consumer Council, Copenhagen K, Denmark
| | - Lene H Garvey
- Allergy Clinic, Department of Dermatology and Allergy, Copenhagen University Hospital Herlev-Gentofte, Hellerup, Denmark.,Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
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15
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Oeo‐Santos C, Navas A, Benedé S, Ruíz‐León B, Díaz‐Perales A, Vogel L, Moreno‐Aguilar C, Jurado A, Villalba M, Barderas R. New insights into the sensitization to nonspecific lipid transfer proteins from pollen and food: New role of allergen Ole e 7. Allergy 2020; 75:798-807. [PMID: 31605380 DOI: 10.1111/all.14086] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2019] [Revised: 09/17/2019] [Accepted: 09/19/2019] [Indexed: 12/13/2022]
Abstract
BACKGROUND Ole e 7 is a nonspecific lipid transfer protein (nsLTP) from olive pollen, one of the main allergenic pollens worldwide. This allergenic nsLTP is responsible for severe symptoms in regions with high olive pollen exposure, where many Ole e 7-sensitized patients exhibit a co-sensitization to the peach nsLTP, Pru p 3. However, there is no evidence of cross-reactivity, which explains this observed co-sensitization. Therefore, the purpose of this study was to explore the relationship between Ole e 7 and Pru p 3. METHODS A total of 48 patients sensitized to Ole e 7 and/or Pru p 3 were included in the study. Specific IgE serum levels were measured by ImmunoCAP 250 and ELISA. Inhibition assays were performed to determine the existence of cross-reactivity between both nsLTPs. Allergic response was analyzed ex vivo (basophil activation test) and in vitro (RBL-2H3 mast cell model). RESULTS Common IgG and IgE epitopes were identified between both allergens. IgE-binding inhibition was detected in Ole e 7-monosensitized patients using rPru p 3 as inhibitor, reaching inhibition values of 25 and 100%. Ex vivo and in vitro assays revealed a response against rPru p 3 in four (31%) Ole e 7-monosensitized patients. CONCLUSIONS Our results suggest that Ole e 7 could play a new role as primary sensitizer in regions with high olive pollen exposure, leading to the peach nsLTP sensitization. This co-sensitization process would occur because of the cross-reactivity between Ole e 7 and Pru p 3 observed in some allergic patients.
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Affiliation(s)
- Carmen Oeo‐Santos
- Departamento de Bioquímica y Biología Molecular Facultad de Ciencias Químicas Universidad Complutense de Madrid Madrid Spain
| | - Ana Navas
- UGC Inmunología y Alergia Hospital Universitario Reina Sofía de Córdoba Córdoba Spain
- Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC)/Hospital Universitario Reina Sofía/Universidad de Córdoba Córdoba Spain
| | - Sara Benedé
- Departamento de Bioquímica y Biología Molecular Facultad de Ciencias Químicas Universidad Complutense de Madrid Madrid Spain
| | - Berta Ruíz‐León
- UGC Inmunología y Alergia Hospital Universitario Reina Sofía de Córdoba Córdoba Spain
- Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC)/Hospital Universitario Reina Sofía/Universidad de Córdoba Córdoba Spain
- Allergy Network ARADyAL Instituto de Salud Carlos III Madrid Spain
| | - Araceli Díaz‐Perales
- Allergy Network ARADyAL Instituto de Salud Carlos III Madrid Spain
- Centro de Biotecnología y Genómica de Plantas (CBGP, UPM‐INIA) Campus de Montegancedo‐UPM Madrid Spain
| | - Lothar Vogel
- Division of Allergology Paul‐Erlich‐Institut Langen Germany
| | - Carmen Moreno‐Aguilar
- UGC Inmunología y Alergia Hospital Universitario Reina Sofía de Córdoba Córdoba Spain
- Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC)/Hospital Universitario Reina Sofía/Universidad de Córdoba Córdoba Spain
- Allergy Network ARADyAL Instituto de Salud Carlos III Madrid Spain
| | - Aurora Jurado
- UGC Inmunología y Alergia Hospital Universitario Reina Sofía de Córdoba Córdoba Spain
- Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC)/Hospital Universitario Reina Sofía/Universidad de Córdoba Córdoba Spain
- Allergy Network ARADyAL Instituto de Salud Carlos III Madrid Spain
| | - Mayte Villalba
- Departamento de Bioquímica y Biología Molecular Facultad de Ciencias Químicas Universidad Complutense de Madrid Madrid Spain
- Allergy Network ARADyAL Instituto de Salud Carlos III Madrid Spain
| | - Rodrigo Barderas
- Allergy Network ARADyAL Instituto de Salud Carlos III Madrid Spain
- UFIEC, Chronic Disease Programme Instituto de Salud Carlos III Madrid Spain
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16
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Decuyper II, Pascal M, Van Gasse AL, Mertens C, Díaz‐Perales A, Araujo G, Torradeflot M, Rius J, Balsells S, Muñoz‐Cano RM, Bartra J, Li L, Sabato V, Hagendorens MM, Bridts CH, De Clerck LS, Ebo DG, Faber MA. Performance of basophil activation test and specific IgG4 as diagnostic tools in nonspecific lipid transfer protein allergy: Antwerp-Barcelona comparison. Allergy 2020; 75:616-624. [PMID: 31512256 DOI: 10.1111/all.14040] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2019] [Revised: 07/23/2019] [Accepted: 08/07/2019] [Indexed: 01/13/2023]
Abstract
BACKGROUND Recent studies show that nsLTP sensitization is not limited to the Mediterranean basin and can present diverse clinical phenotypes. It remains challenging to predict clinical outcome when specific IgE antibodies (sIgE) to nsLTPs are present. This study compares both clinical and in vitro allergy characteristics but also diagnostic performance of a basophil activation test (BAT) and sIgG4 in nsLTP-sensitized patients from Antwerp (ANT, Belgium) and Barcelona (BCN, Spain). METHODS Adult subjects with positive sIgE rPru p 3 and/or rMal d 3 ≥ 0.10 kUA /L (n = 182) and healthy controls (n = 37) were included. NsLTP-sensitized individuals were stratified according to clinical symptoms with peach/apple, respectively. BAT rPru p 3 and rMal d 3 were performed and sIgG4 antibodies to both components quantified. RESULTS In BCN, only ratios of sIgG4/sIgE rMal d 3 and BAT rMal d 3 (0.001 µg/mL) can identify clinically relevant Mal d 3 sensitization (sensitivity of 60%-63% and a specificity of 75%-67%, respectively). In ANT, only the sIgE/total IgE rPru p 3 ratio shows added value (sensitivity 60% and specificity 83%). Finally, it appears that symptomatic patients in BCN are more sensitive to lower allergen concentrations compared to ANT. In addition, it was shown that ANT patients were more often sensitized to pollen and that specific pollen sources differed between regions. CONCLUSIONS NsLTP-related allergy profiles and diagnostic performance differ significantly between regions and are component-specific, which makes extrapolation of data difficult to do. In addition, it seems that basophil sensitivity might show geographical differences. Additional research is needed to confirm these findings.
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Affiliation(s)
- Ine I. Decuyper
- Department of Immunology‐Allergology‐Rheumatology University of Antwerp and Antwerp University Hospital Antwerp Belgium
- Pediatric Department University of Antwerp and Antwerp University Hospital Antwerp Belgium
| | - Mariona Pascal
- Immunology Department Centre de Diagnòstic Biomèdic (CDB)Hospital Clínic de Barcelona Barcelona Spain
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS) Universitat de Barcelona Barcelona Spain
- Spanish Network for Allergy – RETIC de Asma, Reacciones adversas y Alérgicas (ARADYAL) Madrid Spain
| | - Athina L. Van Gasse
- Department of Immunology‐Allergology‐Rheumatology University of Antwerp and Antwerp University Hospital Antwerp Belgium
- Pediatric Department University of Antwerp and Antwerp University Hospital Antwerp Belgium
| | - Christel Mertens
- Department of Immunology‐Allergology‐Rheumatology University of Antwerp and Antwerp University Hospital Antwerp Belgium
| | - Araceli Díaz‐Perales
- Spanish Network for Allergy – RETIC de Asma, Reacciones adversas y Alérgicas (ARADYAL) Madrid Spain
- Plant Biotechnology Institute (UPM‐INIA) Madrid Spain
| | - Giovanna Araujo
- Allergy Section Pneumology Department Institut Clínic Respiratori (ICR)Hospital Clínic de Barcelona Barcelona Spain
| | - Maria Torradeflot
- Immunology Department Centre de Diagnòstic Biomèdic (CDB)Hospital Clínic de Barcelona Barcelona Spain
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS) Universitat de Barcelona Barcelona Spain
| | - Josefina Rius
- Immunology Department Centre de Diagnòstic Biomèdic (CDB)Hospital Clínic de Barcelona Barcelona Spain
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS) Universitat de Barcelona Barcelona Spain
| | - Sara Balsells
- Immunology Department Centre de Diagnòstic Biomèdic (CDB)Hospital Clínic de Barcelona Barcelona Spain
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS) Universitat de Barcelona Barcelona Spain
| | - Rosa M. Muñoz‐Cano
- Spanish Network for Allergy – RETIC de Asma, Reacciones adversas y Alérgicas (ARADYAL) Madrid Spain
- Allergy Section Pneumology Department Institut Clínic Respiratori (ICR)Hospital Clínic de Barcelona Barcelona Spain
| | - Joan Bartra
- Spanish Network for Allergy – RETIC de Asma, Reacciones adversas y Alérgicas (ARADYAL) Madrid Spain
- Allergy Section Pneumology Department Institut Clínic Respiratori (ICR)Hospital Clínic de Barcelona Barcelona Spain
| | - Lynne Li
- Department of Medicine University of British Columbia Vancouver BC Canada
| | - Vito Sabato
- Department of Immunology‐Allergology‐Rheumatology University of Antwerp and Antwerp University Hospital Antwerp Belgium
| | - Margo M. Hagendorens
- Department of Immunology‐Allergology‐Rheumatology University of Antwerp and Antwerp University Hospital Antwerp Belgium
- Pediatric Department University of Antwerp and Antwerp University Hospital Antwerp Belgium
| | - Chris H. Bridts
- Department of Immunology‐Allergology‐Rheumatology University of Antwerp and Antwerp University Hospital Antwerp Belgium
| | - Luc S. De Clerck
- Department of Immunology‐Allergology‐Rheumatology University of Antwerp and Antwerp University Hospital Antwerp Belgium
| | - Didier G. Ebo
- Department of Immunology‐Allergology‐Rheumatology University of Antwerp and Antwerp University Hospital Antwerp Belgium
| | - Margaretha A. Faber
- Department of Immunology‐Allergology‐Rheumatology University of Antwerp and Antwerp University Hospital Antwerp Belgium
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Abstract
Food allergy presents in all ages and has a significant impact on an individual's quality of life. Some of the food allergies that start in childhood remain into adulthood and new-onset allergies can occur at any point of life. Health care providers caring for adult patients should be aware of various food allergy presentations and syndromes. In this article, the authors cover recent literature on food allergies in adults and discuss the epidemiology of adult food allergy as well as common clinical scenarios and presentations of various types of food allergies.
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Affiliation(s)
- Mahboobeh Mahdavinia
- Division of Allergy and Immunology, Department of Internal Medicine, Rush University Medical Center, Professional Building, 1725 West Harrison Street, Suite 117, Chicago, IL 60612, USA.
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Calamelli E, Liotti L, Beghetti I, Piccinno V, Serra L, Bottau P. Component-Resolved Diagnosis in Food Allergies. ACTA ACUST UNITED AC 2019; 55:medicina55080498. [PMID: 31426616 PMCID: PMC6723663 DOI: 10.3390/medicina55080498] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2019] [Revised: 07/31/2019] [Accepted: 08/15/2019] [Indexed: 12/18/2022]
Abstract
Component-resolved diagnostics (CRD) in food allergies is an approach utilized to characterize the molecular components of each allergen involved in a specific IgE (sIgE)-mediated response. In the clinical practice, CRD can improve diagnostic accuracy and assist the physician in many aspects of the allergy work-up. CRD allows for discriminatory co-sensitization versus cross-sensitization phenomena and can be useful to stratify the clinical risk associated with a specific sensitization pattern, in addition to the oral food challenge (OFC). Despite this, there are still some unmet needs, such as the risk of over-prescribing unnecessary elimination diets and adrenaline auto-injectors. Moreover, up until now, none of the identified sIgE cutoff have shown a specificity and sensitivity profile as accurate as the OFC, which is the gold standard in diagnosing food allergies. In light of this, the aim of this review is to summarize the most relevant concepts in the field of CRD in food allergy and to provide a practical approach useful in clinical practice.
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Affiliation(s)
| | - Lucia Liotti
- Pediatric Unit, Civic Hospital, 60019 Senigallia, Italy
| | - Isadora Beghetti
- Pediatric Unit, Department of Medical and Surgical Sciences (DIMEC), S.Orsola-Malpighi Hospital, University of Bologna, 40138 Bologna, Italy
| | | | - Laura Serra
- Pediatric and Neonatology Unit, Imola Hospital, 40026 Imola, Italy
| | - Paolo Bottau
- Pediatric and Neonatology Unit, Imola Hospital, 40026 Imola, Italy
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Carlson G, Coop C. Pollen food allergy syndrome (PFAS): A review of current available literature. Ann Allergy Asthma Immunol 2019; 123:359-365. [PMID: 31376490 DOI: 10.1016/j.anai.2019.07.022] [Citation(s) in RCA: 90] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2019] [Revised: 07/16/2019] [Accepted: 07/24/2019] [Indexed: 12/15/2022]
Abstract
OBJECTIVE Pollen food allergy syndrome (PFAS) is a complex syndrome posing a diagnostic and therapeutic challenge. Our objective was to summarize the available literature regarding its prevalence, pathogenesis, diagnosis, and treatment. DATA SOURCES A PubMed search was performed to include English language articles with the following search terms: pollen food syndrome, pollen food allergy syndrome, PFAS, oral allergy syndrome, OAS, food anaphylaxis, food components. STUDY SELECTIONS Human articles discussing PFAS. RESULTS Varying reports have been made of the prevalence of PFAS, ranging from 4.7% to greater than 20% in children and 13% to 58% in adults. Prevalence varies widely by geographic region. PFAS is typically the results of class II food allergens (e.g. sensitized to anaeroallergen, but reaction occurs due to cross reactivity from a food allergen). Commonly these reactions are limited to the oropharynx due to the lability of the proteins causing the reaction. As multiple families of proteins with varying stability cause PFAS, severe systemic reactions are also possible, as anaphylactic shock has been documented in up to 1.7% of reactions. CONCLUSION Pollen food allergy syndrome therefore cannot be dismissed as a benign food allergy, but it needs to be approached individually based on known risk factors.
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Affiliation(s)
- Geoffrey Carlson
- Wilford Hall Ambulatory Surgical Center, Joint Base San Antonio-Lackland AFB, Texas.
| | - Christopher Coop
- Wilford Hall Ambulatory Surgical Center, Joint Base San Antonio-Lackland AFB, Texas
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20
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Purification and Characterization of a Nonspecific Lipid Transfer Protein 1 (nsLTP1) from Ajwain (Trachyspermum ammi) Seeds. Sci Rep 2019; 9:4148. [PMID: 30858403 PMCID: PMC6411740 DOI: 10.1038/s41598-019-40574-x] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2018] [Accepted: 02/19/2019] [Indexed: 12/19/2022] Open
Abstract
Ajwain (Trachyspermum ammi) belongs to the family Umbelliferae, is commonly used in traditional, and folk medicine due to its carminative, stimulant, antiseptic, diuretic, antihypertensive, and hepatoprotective activities. Non-specific lipid transfer proteins (nsLTPs) reported from various plants are known to be involved in transferring lipids between membranes and in plants defense response. Here, we describe the complete primary structure of a monomeric non-specific lipid transfer protein 1 (nsLTP1), with molecular weight of 9.66 kDa, from ajwain seeds. The nsLTP1 has been purified by combination of chromatographic techniques, and further characterized by mass spectrometry, and Edman degradation. The ajwain nsLTP1 is comprised of 91 amino acids, with eight conserved cysteine residues. The amino acid sequence based predicted three dimensional (3D) structure is composed of four α-helices stabilized by four disulfide bonds, and a long C-terminal tail. The predicted model was verified by using different computational tools; i.e. ERRAT, verify 3D web server, and PROCHECK. The docking of ajwain nsLTP1 with ligands; myristic acid (MYR), and oleic acid (OLE) was performed, and molecular dynamics (MD) simulation was used to validate the docking results. The findings suggested that amino acids; Leu11, Leu12, Ala55, Ala56, Val15, Tyr59, and Leu62 are pivotal for the binding of lipid molecules with ajwain nsLTP1.
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Wheat-dependent exercise-induced anaphylaxis with Tri-a-14-sensitization as part of a lipid transfer protein syndrome. ACTA ACUST UNITED AC 2019. [DOI: 10.1007/s40629-019-0091-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
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Mota I, Gaspar Â, Benito-Garcia F, Correia M, Arêde C, Piedade S, Sampaio G, Pires G, Santa-Marta C, Borrego LM, Morais-Almeida M. Anaphylaxis caused by lipid transfer proteins: an unpredictable clinical syndrome. Allergol Immunopathol (Madr) 2018; 46:565-570. [PMID: 29983237 DOI: 10.1016/j.aller.2018.04.002] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2017] [Revised: 04/03/2018] [Accepted: 04/06/2018] [Indexed: 12/22/2022]
Abstract
INTRODUCTION Lipid transfer proteins (LTPs) are panallergens found in many plant foods. They are a common cause of food-induced anaphylaxis (FIA) in adults living in the Mediterranean area. LTPs have also been proposed as a main cause of food-dependent exercise-induced anaphylaxis (FDEIA). OBJECTIVES Describe clinical characteristics and allergen sensitization profiles in patients with FIA related to LTP. MATERIALS AND METHODS Forty-three patients were included, aged 3-52 years with a clinical history of FIA and proven sensitization to LTP. Patients were tested with a multiple plant food and pollen panel and specific IgE to LTP allergens. LTP sensitization was assessed by in vivo (Pru p 3, LTP extract) and/or by in vitro tests (specific IgE, ImmunoCAP/ISAC®). RESULTS Median age of first anaphylactic episode was 24 years (range 2-51), 44% had asthma, 74% were atopic and 42% had pollinosis (olive, mugwort, plane tree, wall pellitory and cypress). Co-sensitization to profilins was found in 22%. Overall in our center, LTP-induced anaphylaxis represents 17% of all causes of FIA. Foods implicated in anaphylactic reactions were: fresh fruits 51%, tree nuts 42%, vegetables (including peanut) 40% and seeds 14%. Seven patients had FDEIA. CONCLUSIONS LTPs are important allergens of FIA in Portugal. Clinical reactivity to several taxonomically unrelated plant foods may raise suspicion toward LTP sensitization. The association of LTP-induced anaphylaxis with pollinosis is relevant in our country. The unpredictable clinical expression depends on the effect of cofactors such as exercise. The management of avoidance plans can be challenging due to LTP being a widely cross-reacting allergen in plant foods.
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Affiliation(s)
- Inês Mota
- Immunoallergy Department, CUF Descobertas Hospital, Lisbon, Portugal
| | - Ângela Gaspar
- Immunoallergy Department, CUF Descobertas Hospital, Lisbon, Portugal.
| | | | - Magna Correia
- Immunoallergy Department, CUF Descobertas Hospital, Lisbon, Portugal
| | - Cristina Arêde
- Immunoallergy Department, CUF Descobertas Hospital, Lisbon, Portugal
| | - Susana Piedade
- Immunoallergy Department, CUF Descobertas Hospital, Lisbon, Portugal
| | - Graça Sampaio
- Immunoallergy Department, CUF Descobertas Hospital, Lisbon, Portugal
| | - Graça Pires
- Immunoallergy Department, CUF Descobertas Hospital, Lisbon, Portugal
| | | | - Luís-Miguel Borrego
- Immunoallergy Department, CUF Descobertas Hospital, Lisbon, Portugal; CEDOC, NOVA Medical School, Immunology, Lisbon, Portugal
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Immunotherapy with Native Molecule rather than Hypoallergenic Variant of Pru p 3, the Major Peach Allergen, Shows Beneficial Effects in Mice. J Immunol Res 2018; 2018:3479185. [PMID: 30009186 PMCID: PMC6020533 DOI: 10.1155/2018/3479185] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2017] [Revised: 01/03/2018] [Accepted: 03/28/2018] [Indexed: 11/18/2022] Open
Abstract
Background The use of hypoallergenic derivatives is considered beneficial to promote the safety and efficacy of allergen-specific immunotherapy. We aimed to assess the efficacy of reduced and alkylated (R/A) Pru p 3, a hypoallergenic folding variant of the major peach allergen, in subcutaneous immunotherapy (SCIT) using a murine model of peach allergy. Methods and Results After sensitization with Pru p 3, BALB/c mice received SCIT with Pru p 3 or R/A Pru p 3 and were challenged with Pru p 3. SCIT with Pru p 3, but not with R/A Pru p 3, suppressed anaphylaxis upon the challenge significantly. SCIT with Pru p 3 did not suppress Pru p 3-specific IgE and IgG1 production, but enhanced IgG2a production. In contrast, SCIT with R/A Pru p 3 suppressed IgE and IgG1 production, but enhanced IgG2a production only moderately. The therapeutic efficacy of SCIT with Pru p 3 was associated with induction of IL-10 and IFN-γ. Conclusion Hypoallergenic folding variant of Pru p 3 is not likely an efficacious therapeutic component in SCIT of peach allergy. The lower efficacy of R/A Pru p 3 might be attributed to poor antigenicity and/or weak stability due to its unfolded conformation.
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24
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Adult-onset food allergies. Ann Allergy Asthma Immunol 2017; 119:111-119. [PMID: 28801016 DOI: 10.1016/j.anai.2017.05.014] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2017] [Revised: 05/11/2017] [Accepted: 05/15/2017] [Indexed: 02/07/2023]
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25
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Asero R, Piantanida M, Pinter E, Pravettoni V. The clinical relevance of lipid transfer protein. Clin Exp Allergy 2017; 48:6-12. [PMID: 29105202 DOI: 10.1111/cea.13053] [Citation(s) in RCA: 65] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Despite a huge number of studies, many aspects of the lipid transfer protein (LTP) syndrome, the most frequent primary food allergy in Mediterranean countries, remain unclear. Its peculiar geographical distribution, along with the extreme variability of its clinical expression, makes this type of food allergy something unique in the panorama of IgE-mediated food-induced allergic reactions. This review article tried to summarize the current knowledge about the most important aspects of LTP sensitization and allergy, along with the importance of positive and negative co-factors in the clinical expression of the syndrome as well as the issues regarding the cross-reactivity between LTPs present in botanically related and unrelated foods. Further, the possible absence of the protein from some plant foods is discussed.
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Affiliation(s)
- R Asero
- Ambulatorio di Allergologia, Clinica San Carlo, Paderno Dugnano, Italy
| | - M Piantanida
- UOC Immunologia e Allergologia, IRCCS Foundation Ca' Granda Ospedale Maggiore Policlinico, Milano, Italy
| | - E Pinter
- UOC Immunologia Clinica A, Policlinico Umberto I, Roma, Italy
| | - V Pravettoni
- UOC Immunologia e Allergologia, IRCCS Foundation Ca' Granda Ospedale Maggiore Policlinico, Milano, Italy
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27
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Scala E, Cecchi L, Abeni D, Guerra EC, Pirrotta L, Locanto M, Giani M, Asero R. Pla a 2 and Pla a 3 reactivities identify plane tree-allergic patients with respiratory symptoms or food allergy. Allergy 2017; 72:671-674. [PMID: 28042669 DOI: 10.1111/all.13121] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/31/2016] [Indexed: 01/16/2023]
Abstract
Nine hundred and thirty-nine rPla a 1, nPla a 2, and rPla a 3 ImmunoCAP ISAC reactors were studied. nPla a 2pos MUXF3pos but Pla a 1/2neg subjects were excluded from the study because they were cross-reactive carbohydrate determinant reactors. Among the 764 remaining participants, 71.9% were Pla a 3pos , 54.1% Pla a 2pos , and 10.9% Pla a 1pos . Among Pla a 3 reactors, 89.6% were Pru p 3pos and 86.8% Jug 3pos , but the strongest IgE recognition relationship was observed between Pla a 3 and Jug r 3. Distinctive clinical subsets could be documented among plane tree-allergic patients. Pla a 3 reactors had both local and systemic food-induced reactions, but lower past respiratory symptoms occurrence. Pla a 2 reactivity was associated with respiratory symptoms but inversely related to systemic reactions to food. Cosensitization to Pla a 2 and Pla a 3 was associated with a lower past incidence of severe food-induced reactions.
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Affiliation(s)
- E. Scala
- Allergy Unit; IDI-IRCCS; Rome Italy
| | - L. Cecchi
- UOSD Allergy and Immunology; Azienda Sanitaria di Prato; Prato Italy
| | - D. Abeni
- Health Services Research Unit; IDI-IRCCS; Rome Italy
| | | | | | | | - M. Giani
- Allergy Unit; IDI-IRCCS; Rome Italy
| | - R. Asero
- Ambulatorio di Allergologia; Clinica San Carlo; Paderno Dugnano Milan Italy
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28
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Abstract
Food allergies can newly arise in adulthood or persist following a food allergy occurring in childhood. The prevalence of primary food allergy is basically higher in children than in adults; however, in the routine practice food allergies in adulthood appear to be increasing and after all a prevalence in Germany of 3.7 % has been published. The clinical spectrum of manifestations of food allergies in adulthood is broad. Allergy symptoms of the immediate type can be observed as well as symptoms occurring after a delay, such as indigestion, triggering of hematogenous contact eczema or flares of atopic dermatitis. The same principles for diagnostics apply in this group as in childhood. In addition to the anamnesis, skin tests and in vitro tests, as a rule elimination diets and in particular provocation tests are employed. Molecular allergy diagnostics represent a major step forward, which allow a better assessment of the risk of systemic reactions to certain foodstuffs (e.g. peanuts) and detection of cross-reactions in cases of apparently multiple sensitivities. Current German and European guidelines from 2015 are available for the practical approach to clarification of food allergies. The most frequent food allergies in adults are nuts, fruit and vegetables, which can cross-react with pollen as well as wheat, shellfish and crustaceans. The therapy of allergies involves a consistent avoidance of the allogen. Detailed dietary plans are available with avoidance strategies and instructions for suitable food substitutes. A detailed counseling of affected patients by specially trained personnel is necessary especially in order to avoid nutritional deficiencies and to enable patients to enjoy a good quality of life.
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Affiliation(s)
- Thomas Werfel
- Klinik für Dermatologie, Allergologie und Venerologie, Medizinische Hochschule Hannover, Carl-Neuberg-Str. 1, 30625, Hannover, Deutschland.
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Decuyper II, Van Gasse AL, Cop N, Sabato V, Faber MA, Mertens C, Bridts CH, Hagendorens MM, De Clerck L, Rihs HP, Ebo DG. Cannabis sativa allergy: looking through the fog. Allergy 2017; 72:201-206. [PMID: 27590896 DOI: 10.1111/all.13043] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/01/2016] [Indexed: 11/28/2022]
Abstract
IgE-mediated Cannabis (C. sativa, marihuana) allergy seems to be on the rise. Both active and passive exposure to cannabis allergens may trigger a C. sativa sensitization and/or allergy. The clinical presentation of a C. sativa allergy varies from mild to life-threatening reactions and often seems to depend on the route of exposure. In addition, sensitization to cannabis allergens can result in various cross-allergies, mostly for plant foods. This clinical entity, designated as the 'cannabis-fruit/vegetable syndrome', might also imply cross-reactivity with tobacco, natural latex and plant-food-derived alcoholic beverages. Hitherto, these cross-allergies are predominantly reported in Europe and appear mainly to rely upon cross-reactivity between nonspecific lipid transfer proteins or thaumatin-like proteins present in C. sativa and their homologues, ubiquitously distributed throughout plant kingdom. At present, diagnosis of cannabis-related allergies predominantly rests upon a thorough history completed with skin testing using native extracts from crushed buds and leaves. However, quantification of specific IgE antibodies and basophil activation tests can also be helpful to establish correct diagnosis. In the absence of a cure, treatment comprises absolute avoidance measures. Whether avoidance of further use will halt the extension of related cross-allergies remains uncertain.
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Affiliation(s)
- I. I. Decuyper
- Department of Immunology, Allergology, and Rheumatology Faculty of Medicine and Health Sciences; University of Antwerp; Antwerp University Hospital; Antwerpen Belgium
- Department of Pediatrics; Faculty of Medicine and Health Sciences; University of Antwerp; Antwerp University Hospital; Antwerpen Belgium
| | - A. L. Van Gasse
- Department of Immunology, Allergology, and Rheumatology Faculty of Medicine and Health Sciences; University of Antwerp; Antwerp University Hospital; Antwerpen Belgium
- Department of Pediatrics; Faculty of Medicine and Health Sciences; University of Antwerp; Antwerp University Hospital; Antwerpen Belgium
| | - N. Cop
- Department of Immunology, Allergology, and Rheumatology Faculty of Medicine and Health Sciences; University of Antwerp; Antwerp University Hospital; Antwerpen Belgium
| | - V. Sabato
- Department of Immunology, Allergology, and Rheumatology Faculty of Medicine and Health Sciences; University of Antwerp; Antwerp University Hospital; Antwerpen Belgium
| | - M. A. Faber
- Department of Immunology, Allergology, and Rheumatology Faculty of Medicine and Health Sciences; University of Antwerp; Antwerp University Hospital; Antwerpen Belgium
| | - C. Mertens
- Department of Immunology, Allergology, and Rheumatology Faculty of Medicine and Health Sciences; University of Antwerp; Antwerp University Hospital; Antwerpen Belgium
| | - C. H. Bridts
- Department of Immunology, Allergology, and Rheumatology Faculty of Medicine and Health Sciences; University of Antwerp; Antwerp University Hospital; Antwerpen Belgium
| | - M. M. Hagendorens
- Department of Immunology, Allergology, and Rheumatology Faculty of Medicine and Health Sciences; University of Antwerp; Antwerp University Hospital; Antwerpen Belgium
- Department of Pediatrics; Faculty of Medicine and Health Sciences; University of Antwerp; Antwerp University Hospital; Antwerpen Belgium
| | - L. De Clerck
- Department of Immunology, Allergology, and Rheumatology Faculty of Medicine and Health Sciences; University of Antwerp; Antwerp University Hospital; Antwerpen Belgium
| | - H. P. Rihs
- Institute for Prevention and Occupational Medicine; German Social Accident Insurance; Ruhr-University Bochum; Bochum Germany
| | - D. G. Ebo
- Department of Immunology, Allergology, and Rheumatology Faculty of Medicine and Health Sciences; University of Antwerp; Antwerp University Hospital; Antwerpen Belgium
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30
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Pascal M, Vazquez-Ortiz M, Folque MM, Jimenez-Feijoo R, Lozano J, Dominguez O, Piquer-Gibert M, Giner MT, Alvaro M, Dias da Costa M, García-Paba B, Machinena A, Alsina L, Yagüe J, Plaza-Martin AM. Asymptomatic LTP sensitisation is common in plant-food allergic children from the Northeast of Spain. Allergol Immunopathol (Madr) 2016; 44:351-8. [PMID: 27040809 DOI: 10.1016/j.aller.2015.10.003] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2015] [Revised: 10/14/2015] [Accepted: 10/29/2015] [Indexed: 11/30/2022]
Abstract
BACKGROUND The sensitisation profile at molecular level in plant-food allergy is complex. Several allergens may be involved, with different potential for severe reactions. lipid transfer proteins (LTP) are considered the most relevant plant-food allergens in adults in Mediterranean countries, but less is known in children. AIM To describe the clinical pattern and sensitisation profile of children with plant-food allergy and LTP sensitisation from Northeast Spain. METHODS Children with history of immediate reaction to plant-food(s), positive skin-prick-test to the culprit plant-food(s) and specific-IgE to plant-food LTPs were analysed. RESULTS 130 children were included. 69.2% (90/130) had reacted to ≥2 taxonomically unrelated plant-foods. Peach, walnut, hazelnut and peanut were most frequently involved. Reactions severity ranged from anaphylaxis (45.4%, 59/130) to oral symptoms only. Sensitisation to a particular plant-food LTP not always caused clinical symptoms with that plant-food; 69% (40/58) and 63% (17/27) of peach- and walnut-tolerant subjects had positive rPru p 3 and nJug r 3 specific IgE, respectively. 65.4% (85/130) of children were also sensitised to storage proteins, which was associated to anaphylaxis and nut allergy. However, 60% of patients without nuts/seeds allergy were sensitised to storage proteins. Specific-IgE levels to LTPs and/or storage proteins were not useful to predict allergy (vs. tolerance) to peach, walnut, peanut or hazelnut. CONCLUSIONS Sensitisation to LTP and/or storage proteins without clear clinical significance is relatively common. Prospective longitudinal studies are required to evaluate the relevance of these silent sensitisations over time. Caution is required when interpreting the results of molecular-based diagnostic tools in clinical practice.
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Affiliation(s)
- M Pascal
- Immunology Department, CDB, Hospital Clinic, IDIBAPS, Universitat de Barcelona, Spain.
| | - M Vazquez-Ortiz
- Pediatric Allergy and Clinical Immunology Section, Hospital Sant Joan de Déu, Universitat de Barcelona, Spain
| | - M M Folque
- Pediatric Allergy and Clinical Immunology Section, Hospital Sant Joan de Déu, Universitat de Barcelona, Spain
| | - R Jimenez-Feijoo
- Pediatric Allergy and Clinical Immunology Section, Hospital Sant Joan de Déu, Universitat de Barcelona, Spain
| | - J Lozano
- Pediatric Allergy and Clinical Immunology Section, Hospital Sant Joan de Déu, Universitat de Barcelona, Spain
| | - O Dominguez
- Pediatric Allergy and Clinical Immunology Section, Hospital Sant Joan de Déu, Universitat de Barcelona, Spain
| | - M Piquer-Gibert
- Pediatric Allergy and Clinical Immunology Section, Hospital Sant Joan de Déu, Universitat de Barcelona, Spain
| | - M T Giner
- Pediatric Allergy and Clinical Immunology Section, Hospital Sant Joan de Déu, Universitat de Barcelona, Spain
| | - M Alvaro
- Pediatric Allergy and Clinical Immunology Section, Hospital Sant Joan de Déu, Universitat de Barcelona, Spain
| | - M Dias da Costa
- Pediatric Allergy and Clinical Immunology Section, Hospital Sant Joan de Déu, Universitat de Barcelona, Spain
| | - B García-Paba
- Pediatric Allergy and Clinical Immunology Section, Hospital Sant Joan de Déu, Universitat de Barcelona, Spain
| | - A Machinena
- Pediatric Allergy and Clinical Immunology Section, Hospital Sant Joan de Déu, Universitat de Barcelona, Spain
| | - L Alsina
- Pediatric Allergy and Clinical Immunology Section, Hospital Sant Joan de Déu, Universitat de Barcelona, Spain
| | - J Yagüe
- Immunology Department, CDB, Hospital Clinic, IDIBAPS, Universitat de Barcelona, Spain
| | - A M Plaza-Martin
- Pediatric Allergy and Clinical Immunology Section, Hospital Sant Joan de Déu, Universitat de Barcelona, Spain
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31
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Azofra J, Berroa F, Gastaminza G, Saiz N, Gamboa PM, Vela C, García BE, Lizarza S, Echenagusia MA, Joral A, Aranzabal MA, Quiñones MD, Jauregui I, Madera JF, Navarro JA, Lizaso MT, Bernad A, Goikoetxea MJ. Lipid Transfer Protein Syndrome in a Non-Mediterranean Area. Int Arch Allergy Immunol 2016; 169:181-8. [PMID: 27144406 DOI: 10.1159/000445893] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2015] [Accepted: 03/30/2016] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Plant food allergies associated with lipid transfer protein (LTP) have been widely described in the Mediterranean Basin. OBJECTIVE The aim of this work was to describe the clinical profile and pollen sensitization of plant food- allergic patients sensitized to LTP in a non-Mediterranean area. METHODS Patients with clear IgE-mediated symptoms associated with plant foods and a positive skin prick test (SPT) to Pru p 3 were included in a prospective study in the north of Spain. Reported symptoms were analyzed together with a battery of food and pollen SPTs and specific IgE components by ISAC microarray. Cross-inhibition studies were performed by ImmunoCAP with plane tree, mugwort and rPru p 3. RESULTS Among the 72 patients included, the most frequent food allergy reported was to peaches (69%) followed by nuts (walnuts 55%, peanuts 54% and hazelnuts 43%). Most patients suffered from symptoms with multiple plant foods (a median of 6 foods per patient). Regarding the patients' pollen sensitization, 36% were sensitized to mugwort pollen (72% showing sIgE to Art v 3), 33% to grass pollen and 24% to plane tree pollen (94% with sIgE to Pla a 3). Inhibition studies showed that specific IgEs against mugwort and plane tree pollen are inhibited by Pru p 3 in a strong manner, whereas Pru p 3 was less inhibited by pollen extracts. CONCLUSIONS LTP syndrome occurs in a non-Mediterranean area and is related to multiple sensitizations to foods and pollens such as plane tree and mugwort. In these pollen sensitizations, Pru p 3 seems to be the primary sensitizer.
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Affiliation(s)
- Julian Azofra
- Allergology Unit, Hospital Central de Asturias, Oviedo, Spain
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32
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Abstract
The prevalence of food allergies has been on the increase over the last 2 decades. Diagnosing food allergies can be complicated, as there are multiple types that have distinct clinical and immunologic features. Food allergies are broadly classified into immunoglobulin E (IgE)-mediated, non-IgE-mediated, or mixed food allergic reactions. This review focuses on the clinical manifestations of the different categories of food allergies and the different tests available to guide the clinician toward an accurate diagnosis.
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Affiliation(s)
- Rebecca Sharon Chinthrajah
- Division of Allergy, Immunology, and Rheumatology, Department of Pediatrics, Sean N Parker Center for Allergy Research, Stanford University, Stanford University School of Medicine, 269 Campus Drive, CCSR 3215, MC 5366, Stanford, CA 94305-5101, USA.
| | - Dana Tupa
- Sean N Parker Center for Allergy Research, Stanford University, Stanford University School of Medicine, 1291 Welch Road, Grant Building S303, Stanford, CA 94305, USA
| | - Benjamin T Prince
- Ann & Robert H. Lurie Children's Hospital of Chicago, Northwestern University, Feinberg School of Medicine, 225 East Chicago Avenue Box 60, Chicago, IL, USA
| | - Whitney Morgan Block
- Sean N Parker Center for Allergy Research, Stanford University, 2500 Grant Road, PEC, 4th Floor Tower C, Mountain View, CA 94040, USA
| | - Jaime Sou Rosa
- Division of Allergy, Immunology, and Rheumatology, Department of Pediatrics, Sean N Parker Center for Allergy Research, Stanford University, Stanford University School of Medicine, 269 Campus Drive, CCSR 3215, MC 5366, Stanford, CA 94305-5101, USA
| | - Anne Marie Singh
- Ann & Robert H. Lurie Children's Hospital of Chicago, Northwestern University Feinberg School of Medicine, 240 East Huron Street, M-317, McGaw Pavilion, Chicago, IL 60611, USA
| | - Kari Nadeau
- Division of Allergy, Immunology, and Rheumatology, Department of Pediatrics, Sean N Parker Center for Allergy Research, Stanford University, Stanford University School of Medicine, 269 Campus Drive, CCSR 3215, MC 5366, Stanford, CA 94305-5101, USA
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33
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[Modern allergy diagnostic procedures and their clinical application]. Hautarzt 2015; 67:27-32. [PMID: 26530489 DOI: 10.1007/s00105-015-3722-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Due to the increasing incidence of allergies, the importance of allergy diagnostic procedures is growing. In addition to a patient's history and prick, intracutaneous and patch testing, serological testing is an important diagnostic procedure. In recent years, tremendous advances have been made in the area of in vitro allergy tests. In particular, it is possible to predict severity and risk management of food allergies with component-based IgE diagnostic procedures. Even new allergy syndromes have been elucidated at the molecular level.
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34
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Quantification of Peach Fruit Allergen Lipid Transfer Protein by a Double Monoclonal Antibody-based Sandwich ELISA. FOOD ANAL METHOD 2015. [DOI: 10.1007/s12161-015-0272-x] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
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35
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Structural features, IgE binding and preliminary clinical findings of the 7kDa Lipid Transfer Protein from tomato seeds. Mol Immunol 2015; 66:154-63. [DOI: 10.1016/j.molimm.2015.02.025] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2015] [Revised: 02/12/2015] [Accepted: 02/19/2015] [Indexed: 01/01/2023]
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36
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Scala E, Till SJ, Asero R, Abeni D, Guerra EC, Pirrotta L, Paganelli R, Pomponi D, Giani M, De Pità O, Cecchi L. Lipid transfer protein sensitization: reactivity profiles and clinical risk assessment in an Italian cohort. Allergy 2015; 70:933-43. [PMID: 25903791 DOI: 10.1111/all.12635] [Citation(s) in RCA: 74] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/19/2015] [Indexed: 01/25/2023]
Abstract
BACKGROUND Nonspecific lipid transfer proteins (nsLTPs) represent a major cause of systemic food allergic reactions in the Mediterranean area. This study investigate hierarchical patterns and cluster relationships of IgE sensitization to different nsLTPs, and the relationship to clinical allergy in a large Italian cohort. METHODS A total of 568 nsLTP-positive subjects after IgE ImmunoCAP-ISAC microarray analysis with Ara h 9, Art v 3, Cor a 8, Jug r 3, Pla a 3, Pru p 3 and Tri a 14 allergens were studied. IgE inhibition experiments were carried out with mugwort and plane tree pollen extracts. RESULTS Eighty-two per cent of nsLTP-positive participants (94% if <6 years old) were Pru p 3(pos) , and 71% were Jug r 3(pos) . Participants who reacted to >5 nsLTPs reported a higher incidence of food-induced systemic reactions. Only Art v 3 and Pla a 3 (mugwort and plane tree nsLTPs, respectively) were associated with respiratory symptoms, and a correlation was observed between sensitization to pollen and plant food nsLTPs, particularly between Pla a 3 and tree nut/peanut nsLTPs. Co-sensitization to Par j 2 and PR-10 or profilin pan-allergens was associated with a lower prior prevalence of severe food-induced reactions. In inhibition assays, plane and mugwort pollen extracts inhibited 50-100% of IgE binding to food nsLTPs in microarrays. CONCLUSIONS Testing IgE reactivity to a panel of nsLTP allergens unveils important associations between nsLTP sensitization profiles and clinical presentation and allows the identification of novel cluster patterns indicating likely cross-reactivities and highlighting potential allergens for nsLTP immunotherapy.
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Affiliation(s)
- E. Scala
- Experimental Allergy Unit; IDI-IRCCS; Rome Italy
| | - S. J. Till
- Asthma, Allergy and Lung Biology; King's College London; School of Medicine; Guy's Hospital; London UK
| | - R. Asero
- Ambulatorio di Allergologia; Clinica San Carlo; Paderno Dugnano Milan Italy
| | - D. Abeni
- Health Services Research Unit; IDI-IRCCS; Rome Italy
| | - E. C. Guerra
- Experimental Allergy Unit; IDI-IRCCS; Rome Italy
| | - L. Pirrotta
- Experimental Allergy Unit; IDI-IRCCS; Rome Italy
| | - R. Paganelli
- Department of Medicine and Ageing Science (DMSI); University G. d'Annunzio of Chieti-Pescara; Chieti Italy
| | - D. Pomponi
- Experimental Allergy Unit; IDI-IRCCS; Rome Italy
| | - M. Giani
- Experimental Allergy Unit; IDI-IRCCS; Rome Italy
| | - O. De Pità
- Laboratory of Allergy and Clinical Immunology; IDI-IRCCS; Rome Italy
| | - L. Cecchi
- UOSD Allergy and Immunology; Azienda Sanitaria di Prato; Prato Italy
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37
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Abstract
This article provides a clinically focused review of food-induced anaphylaxis that includes epidemiology, risk factors, allergens, diagnosis, and management. Currently, there is no treatment for food allergy. Dietary avoidance and emergency preparedness are the cornerstones of management. Effective and safe therapies to reduce the risk of serious food-induced reactions are urgently needed, as are reliable biomarkers to predict severity.
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38
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Choi WB, You JS, Yi YY, Jeong SI, Song JS, Yang S, Hwang IT, Lee HB, Baek HS. Component-resolved diagnosis using microarray for diagnosing hypersensitivity to raw fruits in birch pollen sensitized children. ALLERGY ASTHMA & RESPIRATORY DISEASE 2015. [DOI: 10.4168/aard.2015.3.3.200] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Affiliation(s)
- Won-Bok Choi
- Department of Pediatrics, Hallym University Kangdong Sacred Heart Hospital, Seoul, Korea
| | - Jueng-Sup You
- Department of Pediatrics, Hallym University Kangdong Sacred Heart Hospital, Seoul, Korea
| | - Yoon-Young Yi
- Department of Pediatrics, Hallym University Kangdong Sacred Heart Hospital, Seoul, Korea
| | - Soo-In Jeong
- Department of Pediatrics, Hallym University Kangdong Sacred Heart Hospital, Seoul, Korea
| | - Joon-Sup Song
- Department of Pediatrics, Hallym University Kangdong Sacred Heart Hospital, Seoul, Korea
| | - Seong Yang
- Department of Pediatrics, Hallym University Kangdong Sacred Heart Hospital, Seoul, Korea
| | - Il-Tae Hwang
- Department of Pediatrics, Hallym University Kangdong Sacred Heart Hospital, Seoul, Korea
| | - Ha-Baik Lee
- Department of Pediatrics, Hanyang University Hospital, Seoul, Korea
| | - Hey-Sung Baek
- Department of Pediatrics, Hallym University Kangdong Sacred Heart Hospital, Seoul, Korea
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Abstract
The science of food allergy has been rapidly evolving before our eyes in the past half century. Like other allergic disorders, the prevalence of food allergies has dramatically increased, and coupled with the increased public awareness of anaphylaxis due to food allergy, this has driven an explosion in basic and clinical research in this extremely broad subject. Treatment of food allergies has evolved and practices such as food challenges have become an integral part of an allergy practice. The impact of the increase of food allergy has driven package labeling laws, legislation on emergency treatment availability in schools and other public places, and school policy. But to this day, our knowledge of the pathogenesis of food allergy is still incomplete. There are the most obvious IgE-mediated immediate hypersensitivity reactions, but then multiple previously unidentified conditions such as eosinophilic esophagitis, food protein-induced enterocolitis syndrome, milk protein allergy, food-induced atopic dermatitis, oral allergy syndrome, and others have complicated the diagnosis and management of many of our patients who are unable to tolerate certain foods. Many of these conditions are not IgE-mediated, but may be T cell-driven diseases. The role of T regulatory cells and immune tolerance and the newly discovered immunological role of vitamin D have shed light on the variable clinical presentation of food allergy and the development of new methods of immunotherapy in an example of bench-to-bedside research. Component-resolved diagnostic techniques have already begun to allow us to more precisely define the epitopes that are targeted in food allergic patients. The development of biological modulators, research on genomics and proteomics, and epigenetic techniques all offer promising avenues for new modes of therapy of food allergy in the twenty-first century.
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Affiliation(s)
- Patrick S C Leung
- Division of Rheumatology, Allergy and Clinical Immunology, University of California, 451 Health Sciences Drive, Suite 6510, Davis, CA, 95616, USA,
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Longo V, Costa MA, Cibella F, Cuttitta G, La Grutta S, Colombo P. Multiple IgE recognition on the major allergen of the Parietaria pollen Par j 2. Mol Immunol 2014; 63:412-9. [PMID: 25284812 DOI: 10.1016/j.molimm.2014.09.012] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2014] [Revised: 09/11/2014] [Accepted: 09/18/2014] [Indexed: 12/26/2022]
Abstract
The interaction between IgE antibodies and allergens is a key event in triggering an allergic reaction. The characterization of this region provides information of paramount importance for diagnosis and therapy. Par j 2 Lipid Transfer Protein is one of the most important allergens in southern Europe and a well-established marker of sensitization in Parietaria pollen allergy. The main aim of this study was to map the IgE binding regions of this allergen and to study the pattern of reactivity of individual Parietaria-allergic patients. By means of gene fragmentation, six overlapping peptides were expressed in Escherichia coli, and their IgE binding activity was evaluated by immunoblotting in a cohort of 79 Parietaria-allergic patients. Our results showed that Pj-allergic patients display a heterogeneous pattern of IgE binding to the different recombinant fragments, and that patients reacted simultaneously against several protein domains spread all the over the molecule, even in fragments which do not contain structural features resembling the native allergen. Our results reveal the presence of a large number of linear and conformational epitopes on the Par j 2 sequence, which probably explains the high allergenic activity of this allergen.
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Affiliation(s)
- Valeria Longo
- Istituto di Biomedicina ed Immunologia Molecolare "Alberto Monroy" del Consiglio Nazionale delle Ricerche, Via Ugo La Malfa 153, Palermo, Italy
| | - Maria Assunta Costa
- Istituto di Biofisica del Consiglio Nazionale delle Ricerche (UOS Palermo), Via Ugo La Malfa 153, Palermo, Italy
| | - Fabio Cibella
- Istituto di Biomedicina ed Immunologia Molecolare "Alberto Monroy" del Consiglio Nazionale delle Ricerche, Via Ugo La Malfa 153, Palermo, Italy
| | - Giuseppina Cuttitta
- Istituto di Biomedicina ed Immunologia Molecolare "Alberto Monroy" del Consiglio Nazionale delle Ricerche, Via Ugo La Malfa 153, Palermo, Italy
| | - Stefania La Grutta
- Istituto di Biomedicina ed Immunologia Molecolare "Alberto Monroy" del Consiglio Nazionale delle Ricerche, Via Ugo La Malfa 153, Palermo, Italy
| | - Paolo Colombo
- Istituto di Biomedicina ed Immunologia Molecolare "Alberto Monroy" del Consiglio Nazionale delle Ricerche, Via Ugo La Malfa 153, Palermo, Italy.
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41
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Luengo O, Cardona V. Component resolved diagnosis: when should it be used? Clin Transl Allergy 2014; 4:28. [PMID: 25250172 PMCID: PMC4171720 DOI: 10.1186/2045-7022-4-28] [Citation(s) in RCA: 60] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2014] [Accepted: 08/13/2014] [Indexed: 02/03/2023] Open
Abstract
The knowledge on molecular allergy diagnosis is continuously evolving. It is now time for the clinician to integrate this knowledge and use it when needed to improve the accuracy of diagnosis and thus provide more precise therapeutic and avoidance measures. This review does not intend to comprehensively analyze all the available allergen molecules, but to provide some practical clues on use and interpretation of molecular allergy diagnosis. The potential role of component resolved diagnosis in circumstances such as the indication of allergen immunotherapy, pollen polysensitization, food allergy, latex allergy or anaphylaxis, is assessed. Interpreting the information provided by molecular allergy diagnosis needs a structured approach. It is necessary to evaluate single positivities and negativities, but also to appraise "the big picture" with perspective.
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Affiliation(s)
- Olga Luengo
- Allergy Section, Department of Internal Medicine, Hospital Vall d’Hebron, Barcelona, Spain
- Allergy Research Group, Institut de Recerca Vall d’Hebron, Barcelona, Spain
| | - Victòria Cardona
- Allergy Section, Department of Internal Medicine, Hospital Vall d’Hebron, Barcelona, Spain
- Allergy Research Group, Institut de Recerca Vall d’Hebron, Barcelona, Spain
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42
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Asero R. Looking for sensitization profiles in different populations by recombinant allergens. Int Arch Allergy Immunol 2014; 164:106-8. [PMID: 24943849 DOI: 10.1159/000363448] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Affiliation(s)
- Riccardo Asero
- Ambulatorio di Allergologia, Clinica San Carlo, Paderno Dugnano, Italy
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43
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Ashok Kumar HG, Venkatesh YP. In silico analyses of structural and allergenicity features of sapodilla (Manilkara zapota) acidic thaumatin-like protein in comparison with allergenic plant TLPs. Mol Immunol 2013; 57:119-28. [PMID: 24091295 DOI: 10.1016/j.molimm.2013.08.010] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2013] [Revised: 08/14/2013] [Accepted: 08/18/2013] [Indexed: 10/26/2022]
Abstract
Thaumatin-like proteins (TLPs) belong to the pathogenesis-related family (PR-5) of plant defense proteins. TLPs from only 32 plant genera have been identified as pollen or food allergens. IgE epitopes on allergens play a central role in food allergy by initiating cross-linking of specific IgE on basophils/mast cells. A comparative analysis of pollen- and food-allergenic TLPs is lacking. The main objective of this investigation was to study the structural and allergenicity features of sapodilla (Manilkara zapota) acidic TLP (TLP 1) by in silico methods. The allergenicity prediction of composite sequence of sapodilla TLP 1 (NCBI B3EWX8.1, G5DC91.1) was performed using FARRP, Allermatch and Evaller web tools. A homology model of the protein was generated using banana TLP template (1Z3Q) by HHPRED-MODELLER. B-cell linear epitope prediction was performed using BCpreds and BepiPred. Sapodilla TLP 1 matched significantly with allergenic TLPs from olive, kiwi, bell pepper and banana. IgE epitope prediction as performed using AlgPred indicated the presence of 2 epitopes (epitope 1: residues 36-48; epitope 2: residues 51-63), and a comprehensive analysis of all allergenic TLPs displayed up to 3 additional epitopes on other TLPs. It can be inferred from these analyses that plant allergenic TLPs generally carry 2-3 IgE epitopes. ClustalX alignments of allergenic TLPs indicate that IgE epitopes 1 and 2 are common in food allergenic TLPs, and IgE epitopes 2 and 3 are common in pollen allergenic TLPs; IgE epitope 2 overlaps with a portion of the thaumatin family signature. The secondary structural elements of TLPs vary markedly in regions 1 and 2 which harbor all the predicted IgE epitopes in all food and pollen TLPs in either of the region. Further, based on the number of IgE epitopes, food TLPs are grouped into rosid and non-rosid clades. The number and distribution of the predicted IgE epitopes among the allergenic TLPs may explain the specificity of food or pollen allergy as well as the varied degree of cross-reactivity among plant foods and/or pollens.
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Affiliation(s)
- Hassan G Ashok Kumar
- Department of Biochemistry & Nutrition, CSIR - Central Food Technological Research Institute, Mysore 570020, Karnataka, India.
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44
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Douladiris N, Savvatianos S, Roumpedaki I, Skevaki C, Mitsias D, Papadopoulos NG. A molecular diagnostic algorithm to guide pollen immunotherapy in southern Europe: towards component-resolved management of allergic diseases. Int Arch Allergy Immunol 2013; 162:163-72. [PMID: 23921568 DOI: 10.1159/000353113] [Citation(s) in RCA: 55] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2013] [Accepted: 05/17/2013] [Indexed: 11/19/2022] Open
Abstract
Correct identification of the culprit allergen is an essential part of diagnosis and treatment in immunoglobulin E (IgE)-mediated allergic diseases. In recent years, molecular biology has made important advances facilitating such identification and overcoming some of the drawbacks of natural allergen extracts, which consist of mixtures of various proteins that may be allergenic or not, specific for the allergen source or widely distributed (panallergens). New technologies offer the opportunity for a more accurate component-resolved diagnosis, of benefit especially to polysensitized allergic patients. The basic elements of molecular diagnostics with potential relevance to immunotherapy prescription are reviewed here, with a focus on Southern European sensitization patterns to pollen allergens. We propose a basic algorithm regarding component-resolved diagnostic work-up for pollen allergen-specific immunotherapy candidates in Southern Europe; this and similar algorithms can form the basis of improved patient management, conceptually a 'Component-Resolved Allergy Management'.
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Affiliation(s)
- Nikolaos Douladiris
- Allergy Department, 2nd Pediatric Clinic, University of Athens, Athens, Greece
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