1
|
Lee NG, Kim HK, Choi GS. Comparison of inhalant allergen sensitization between children, adolescents, and adults with asthma and allergic rhinitis. ALLERGY ASTHMA & RESPIRATORY DISEASE 2021. [DOI: 10.4168/aard.2021.9.3.148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Affiliation(s)
- Na Gyeom Lee
- Department of Internal Medicine, Kosin University College of Medicine, Busan, Korea
| | - Hee-Kyoo Kim
- Department of Internal Medicine, Kosin University College of Medicine, Busan, Korea
| | - Gil Soon Choi
- Department of Internal Medicine, Kosin University College of Medicine, Busan, Korea
| |
Collapse
|
2
|
Nowakowska-Świrta E, Wiszniewska M, Walusiak-Skorupa J. Allergen-specific IgE to recombinant latex allergens in occupational allergy diagnostics. J Occup Health 2019; 61:378-386. [PMID: 31090202 PMCID: PMC6718933 DOI: 10.1002/1348-9585.12064] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2018] [Revised: 03/12/2019] [Accepted: 04/25/2019] [Indexed: 11/10/2022] Open
Abstract
Objectives Specific challenge tests (SICs) are considered reference tests for allergic occupational diseases diagnosis. However, in numerous cases, SICs cannot be carried out in the diagnosis of allergy to latex due to the risk of generalized reactions. The aim of the study was to evaluate the usefulness of sIgE determination to recombinant latex allergens in diagnostics of occupational respiratory allergy. Materials and Methods The study group comprised 44 healthcare workers (HCW) suspected of suffering from occupational respiratory allergy to latex (they underwent a physical examination, skin‐prick tests (SPTs) to common and latex allergens, spirometry and SIC) and 17 controls not occupationally exposed to latex, with a positive sIgE against latex. Each serum was tested for allergen‐specific IgE to aeroallergens, latex, eight recombinant latex allergens and CCD‐markers. Results Specific IgE against Hev b5, 6.01, and 6.02 were significantly more frequently detected in HCWs and their mean serum levels were higher compared with the control group. In 26 HCWs with occupational asthma (OA), sensitization to Hev b5, Hev b6.01, Hev b6.02 was significantly more frequent than in 18 HCWs with work‐exacerbated asthma (WEA); they had positive results SPT to latex significantly more frequently in comparison with subjects with WEA. Conclusions Test for recombinant latex allergens is much more accurate in recognition of latex allergy than test for latex extract, which seems to produce false‐positive results in patients with pollen allergy. The measurements of sIgE against recombinant latex allergens Hev b 6.01, 6.02, 5, and 8 are useful in differentiating OA from WEA.
Collapse
Affiliation(s)
- Ewa Nowakowska-Świrta
- Department of Occupational Diseases and Environmental Health, Nofer Institute of Occupational Medicine, Lodz, Poland
| | - Marta Wiszniewska
- Department of Occupational Diseases and Environmental Health, Nofer Institute of Occupational Medicine, Lodz, Poland
| | - Jolanta Walusiak-Skorupa
- Department of Occupational Diseases and Environmental Health, Nofer Institute of Occupational Medicine, Lodz, Poland
| |
Collapse
|
3
|
Abstract
PURPOSE OF REVIEW Allergy to natural rubber latex (NRL) reached epidemic proportions during the nineties and led to intense preventive efforts. The aim of this review was to provide a comprehensive compilation of the current status of occupational NRL allergy. RECENT FINDINGS Recent advances led to the characterization of 15 NRL allergens and the development of assays for measuring the allergen content of NRL materials and specific IgE antibodies against NRL allergen components. Preventive measures aimed at reducing workplace exposure to NRL allergens were associated with decreasing incidence rates of NRL allergy. However, a pooled analysis of epidemiological surveys published during the last 10 years provided prevalence estimates of NRL sensitization and allergy similar to those derived from studies conducted before 2003. Substantial progress has been made in the understanding and prevention of NRL allergy, although the disease may still remain a worldwide cause of concern.
Collapse
|
4
|
Vandenplas O, Froidure A, Meurer U, Rihs HP, Rifflart C, Soetaert S, Jamart J, Pilette C, Raulf M. The role of allergen components for the diagnosis of latex-induced occupational asthma. Allergy 2016; 71:840-9. [PMID: 26940537 DOI: 10.1111/all.12872] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/01/2016] [Indexed: 11/30/2022]
Abstract
BACKGROUND Recombinant Hevea brasiliensis (rHev b) natural rubber latex (NRL) allergen components have been developed to assess the patients' allergen sensitization profile and to improve the diagnosis of NRL allergy. OBJECTIVE To examine whether the determination of specific IgE (sIgE) reactivity to a panel of recombinant allergen components would be helpful for diagnosing NRL-induced occupational asthma (OA) in predicting the outcome of a specific inhalation test. METHODS sIgE levels to NRL extract and 12 recombinant NRL allergen components were assessed in 82 subjects with OA ascertained by a positive specific inhalation challenge (SIC) with NRL gloves and in 25 symptomatic subjects with a negative challenge. RESULTS The sensitivity, specificity, positive predictive value, and negative predictive value of a NRL-sIgE level ≥0.35 kUA /l as compared to the result of SICs were 94%, 48%, 86%, and 71%, respectively. The positive predictive value increased above 95% when increasing the cutoff value to 5.41 kUA /l. Subjects with a positive SIC showed a significantly higher rate of sIgE reactivity to rHev b 5, 6.01, 6.02, and 11 than those with a negative SIC. A sIgE sum score against rHev b 5 plus 6.01/6.02 ≥ 1.46 kUA /l provided a positive predictive value >95% with a higher sensitivity (79%) and diagnostic efficiency (Youden index: 0.67) as compared with a NRL-sIgE ≥5.41 kUA /l (49% and 0.41, respectively). CONCLUSION In suspected OA, high levels of sIgE against rHev b 5 combined with rHev b 6.01 or 6.02 are the most efficient predictors of a bronchial response to NRL.
Collapse
Affiliation(s)
- O. Vandenplas
- Department of Chest Medicine; Centre Hospitalier Universitaire de Dinant-Godinne; Université catholique de Louvain; Yvoir Belgium
- Institut de Recherche Expérimentale et Clinique; Pôle de Pneumologie; Université catholique de Louvain; Brussels Belgium
- Walloon Institute for Excellence in Lifesciences and Biotechnology (WELBIO); Brussels Belgium
| | - A. Froidure
- Institut de Recherche Expérimentale et Clinique; Pôle de Pneumologie; Université catholique de Louvain; Brussels Belgium
- Walloon Institute for Excellence in Lifesciences and Biotechnology (WELBIO); Brussels Belgium
- Department of Chest Medicine; Cliniques Universitaires Saint-Luc; Université catholique de Louvain; Brussels Belgium
| | - U. Meurer
- IPA Institute for Prevention and Occupational Medicine of the German Social Accident Insurance; Institute of the Ruhr-Universität Bochum; Bochum Germany
| | - H.-P. Rihs
- IPA Institute for Prevention and Occupational Medicine of the German Social Accident Insurance; Institute of the Ruhr-Universität Bochum; Bochum Germany
| | - C. Rifflart
- Department of Chest Medicine; Centre Hospitalier Universitaire de Dinant-Godinne; Université catholique de Louvain; Yvoir Belgium
| | - S. Soetaert
- Prévention et Protection au Travail - Centre de Service Interentreprises (CESI); Brussels Belgium
| | - J. Jamart
- Scientific Support Unit; Centre Hospitalier Universitaire de Dinant-Godinne; Université catholique de Louvain; Yvoir Belgium
| | - C. Pilette
- Institut de Recherche Expérimentale et Clinique; Pôle de Pneumologie; Université catholique de Louvain; Brussels Belgium
- Walloon Institute for Excellence in Lifesciences and Biotechnology (WELBIO); Brussels Belgium
- Department of Chest Medicine; Cliniques Universitaires Saint-Luc; Université catholique de Louvain; Brussels Belgium
| | - M. Raulf
- IPA Institute for Prevention and Occupational Medicine of the German Social Accident Insurance; Institute of the Ruhr-Universität Bochum; Bochum Germany
| |
Collapse
|
5
|
Worm M, Jappe U, Kleine-Tebbe J, Schäfer C, Reese I, Saloga J, Treudler R, Zuberbier T, Waßmann A, Fuchs T, Dölle S, Raithel M, Ballmer-Weber B, Niggemann B, Werfel T. Food allergies resulting from immunological cross-reactivity with inhalant allergens: Guidelines from the German Society for Allergology and Clinical Immunology (DGAKI), the German Dermatology Society (DDG), the Association of German Allergologists (AeDA) and the Society for Pediatric Allergology and Environmental Medicine (GPA). ACTA ACUST UNITED AC 2014; 23:1-16. [PMID: 26120513 PMCID: PMC4479449 DOI: 10.1007/s40629-014-0004-6] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
A large proportion of immunoglobulin E (IgE)-mediated food allergies in older children, adolescents and adults are caused by cross-reactive allergenic structures. Primary sensitization is most commonly to inhalant allergens (e.g. Bet v 1, the major birch pollen allergen). IgE can be activated by various cross-reactive allergens and lead to a variety of clinical manifestations. In general, local and mild — in rare cases also severe and systemic — reactions occur directly after consumption of the food containing the cross-reactive allergen (e. g. plant-derived foods containing proteins of the Bet v 1 family). In clinical practice, sensitization to the primary responsible inhalant and/or food allergen can be detected by skin prick tests and/or in vitro detection of specific IgE. Component-based diagnostic methods can support clinical diagnosis. For individual allergens, these methods may be helpful to estimate the risk of systemic reactions. Confirmation of sensitization by oral provocation testing is important particulary in the case of unclear case history. New, as yet unrecognized allergens can also cause cross-reactions. The therapeutic potential of specific immunotherapy (SIT) with inhalant allergens and their effect on pollen-associated food allergies is currently unclear: results vary and placebo-controlled trials will be necessary in the future. Pollen allergies are very common. Altogether allergic sensitization to pollen and cross-reactive food allergens are very common in our latitudes. The actual relevance has to be assessed on an individual basis using the clinical information. Cite this as Worm M, Jappe U, Kleine-Tebbe J, Schäfer C, Reese I, Saloga J, Treudler R, Zuberbier T, Wassmann A, Fuchs T, Dölle S, Raithel M, Ballmer-Weber B, Niggemann B, Werfel T. Food allergies resulting from immunological cross-reactivity with inhalant allergens. Allergo J Int 2014; 23: 1–16 DOI 10.1007/s40629-014-0004-6
Collapse
Affiliation(s)
- Margitta Worm
- />Allergie-Centrum-Charité Klinik für Dermatologie, Allergologie und Venerologie Charité — Universitätsmedizin Berlin, Charitéplatz 1, 10117 Berlin, Germany
| | - Uta Jappe
- />Klinik für Dermatologie, Allergologie und Venerologie, Universität Lübeck, Germany
- />Forschungsgruppe Klinische und Molekulare Allergologie, Forschungszentrum Borstel, Germany
| | | | - Christiane Schäfer
- />Ernährungstherapie, Allergologische Schwerpunktpraxis, Hamburg, Germany
| | - Imke Reese
- />Ernährungsberatung und -therapie, Schwerpunkt Allergologie, München, Germany
| | - Joachim Saloga
- />Hautklinik, Universitätsmedizin der Johannes Gutenberg-Universität, Mainz, Germany
| | - Regina Treudler
- />Klinik für Dermatologie, Venerologie und Allergologie Universität Leipzig, Germany
| | - Torsten Zuberbier
- />Allergie-Centrum-Charité Klinik für Dermatologie, Allergologie und Venerologie Charité — Universitätsmedizin Berlin, Charitéplatz 1, 10117 Berlin, Germany
| | - Anja Waßmann
- />Dermatologisches Ambulatorium Hamburg-Alstertal, Germany
| | - Thomas Fuchs
- />Hautklinik, Georg-August-Universität, Göttingen, Germany
| | - Sabine Dölle
- />Allergie-Centrum-Charité Klinik für Dermatologie, Allergologie und Venerologie Charité — Universitätsmedizin Berlin, Charitéplatz 1, 10117 Berlin, Germany
| | - Martin Raithel
- />Medizinische Klinik für Gastroenterologie, Pneumologie, Endokrinologie, Universitätsklinikum Erlangen, Germany
| | | | - Bodo Niggemann
- />Klinik für Pädiatrie, Charité — Universitätsmedizin Berlin, Germany
| | - Thomas Werfel
- />Klinik für Dermatologie, Allergologie und Venerologie, Medizinische Hochschule Hannover, Germany
| |
Collapse
|
6
|
Nahrungsmittelallergie infolge immunologischer Kreuzreaktivitäten mit Inhalationsallergenen. ALLERGO JOURNAL 2014. [DOI: 10.1007/s15007-014-0483-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
|
7
|
Schuler S, Ferrari G, Schmid-Grendelmeier P, Harr T. Microarray-based component-resolved diagnosis of latex allergy: isolated IgE-mediated sensitization to latexprofilin Hev b8 may act as confounder. Clin Transl Allergy 2013; 3:11. [PMID: 23537305 PMCID: PMC3637386 DOI: 10.1186/2045-7022-3-11] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2012] [Accepted: 03/13/2013] [Indexed: 11/10/2022] Open
Abstract
Immediate type allergy to latex is still a widespread problem. Latex-allergic patients undergoing diagnostic and operative medical procedures are at risk of potentially life-threatening reactions. Accurate diagnostic methods are therefore crucial. The aim of this retrospective study was to discriminate between sensitization and relevant allergy to latex based on an easy and suitable diagnostic approach. In 14 patients with clinical symptoms and 27 controls, latex skin prick tests (SPT), IgE against latex (CAP) and serological component resolved specific latex-allergen determination (Hev b1, b3, b5, b6, b7, b8, b9, b10, b11) based on ImmunoCAP ISAC were performed. SPT correlated very well with clinically manifest latex-allergy demonstrating a high specificity (95%) (and a low sensitivity). However, CAP levels to crude latex could not safely discriminate between purely sensitized and latex-allergic patients. The majority of patients mono-sensitized to the latex profilin Hev b8 did not suffer from any relevant symptoms upon contact with latex. However, in two patients with latex-allergy diagnosed by elevated specific IgE only sensitized against Hev b8, additional sensitization to carbohydrate cross-reactive determinants (CCD) was found. In the case of positive serum IgE against latex and negative SPT, component-resolved diagnosis including IgE against specific latex-proteins, specially Hev b8, and carbohydrate cross-reactive determinants (CCD) is a useful tool to discriminate between latex-sensitization and latex-allergy.
Collapse
Affiliation(s)
- Sarah Schuler
- Allergy Unit, Department of Dermatology, University Hospital of Zurich, Zürich, Switzerland.
| | | | | | | |
Collapse
|
8
|
Santos KS, Gadermaier G, Vejvar E, Arcuri HA, Galvão CE, Yang AC, Resende VMF, Martins CDO, Himly M, Mari A, Liso M, Pomponi D, Breiteneder H, Wagner S, Kalil J, Ferreira F, Castro FFM. Novel allergens from ancient foods: Man e 5 from manioc (Manihot esculenta Crantz) cross reacts with Hev b 5 from latex. Mol Nutr Food Res 2013; 57:1100-9. [PMID: 23526605 DOI: 10.1002/mnfr.201200433] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2012] [Revised: 11/10/2012] [Accepted: 01/02/2013] [Indexed: 11/06/2022]
Abstract
SCOPE Manioc (Manihot esculenta) is a tuber mainly consumed in the Southern Hemisphere and used worldwide by food and chemistry industry. We aimed to recombinantly produce and characterize the first manioc allergen and evaluate its IgE reactivity in sera of Brazilian and Italian patients. METHODS AND RESULTS The molecule, termed Man e5, was expressed in E. coli, characterized by amino acid analysis, mass spectrometry, circular dichroism, HPLC, and dynamic light scattering. A tertiary structural model of the protein was produced using bioinformatics and susceptibility to pepsin digestion was analyzed in vitro. Based on its high content of charged residues, heat stability, flexibility and lack of secondary structure elements, the allergen was determined a member of the intrinsically disordered protein family. Brazilian patients were selected based on manioc allergy and Italians based on latex allergy and sensitization to Hev b 5.71% of Brazilians and 40% of Italians were in vitro IgE positive to Man e5. Cross-inhibition assays suggest a possible involvement of this allergen in the latex-fruit syndrome. CONCLUSION Man e5, the first purified allergen from manioc demonstrates IgE cross-reactivity with Hev b 5. Data suggest Hev b 5 might act as primary sensitizer and could therefore lead to allergic manifestations upon manioc consumption without prior exposition.
Collapse
Affiliation(s)
- Keity Souza Santos
- Laboratory of Clinical Immunology and Allergy-LIM60, Division of Clinical Immunology and Allergy, Department of Medicine, University of São Paulo School of Medicine, FMUSP, São Paulo, Brazil.
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
9
|
Profilin cross-reactive panallergen causes latex sensitization in the pediatric population allergic to pollen. Ann Allergy Asthma Immunol 2012; 109:215-9. [PMID: 22920078 DOI: 10.1016/j.anai.2012.07.003] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2012] [Revised: 06/26/2012] [Accepted: 07/02/2012] [Indexed: 11/23/2022]
Abstract
BACKGROUND Component-resolved diagnostics (CRD) has been demonstrated to be an excellent new tool for improving the current diagnosis of allergies, and it allows differentiation between polysensitization and cross-reactivity. OBJECTIVE To demonstrate the role of cross-reactive pollen allergens in pediatric patients living in areas with large amounts of airborne grass pollen grains who are sensitive to grass pollen and latex. METHODS Serum samples were obtained from 106 children between 3 and 14 years of age diagnosed with allergies to pollen based on clinical history, skin prick tests, and specific immunoglobulin E (IgE). None of them had allergy symptoms to latex or fruits. From these 106 children, 56 patients revealed positive results to Phleum-specific major allergens but not to cross-reactive allergens. The other 50 patients who showed positive specific IgE to Phleum-specific major allergens and to cross-reactive pollen allergens also showed positive results to latex allergens. CRD was carried out by specific IgE quantification using a fluoro-enzyme immunoassay (ImmunoCAPT System). RESULTS Results demonstrated a positive significant relationship between the specific IgE to Hev b 8 and Phl p 12 and also between the specific IgE to Hev b 8 and latex extract in the group of patients sensitized to species-specific and cross-reactive Phleum allergens. Positive significant relationships were also found between profilin and avocado or peach sensitizations. No other latex allergens gave positive results. CONCLUSION The apparent sensitization to latex in pediatric patients allergic to grass pollen is caused by the cross-reactive profilin panallergen; however, it is appears not to be clinically relevant.
Collapse
|
10
|
Bernardini R, Catania P, Caffarelli C, Cardinale F, Franceschini F, Pelosi U, Peroni D. Perioperative Latex Allergy. Int J Immunopathol Pharmacol 2011; 24:S55-60. [DOI: 10.1177/03946320110240s308] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
The prevalence of latex allergy varies greatly depending on the population studied and the methods used to detect sensitization. Subjects considered to be at high risk for latex allergy are rubber industry workers, children with spina bifida and urological abnormalities, children undergoing multiple surgical procedures and with urinary catheterization, health care workers and people with food allergy (latex fruit syndrome). In this paper we report a review of latex proteins, the symptoms of latex allergy, diagnosis and management in subjects with latex allergy.
Collapse
Affiliation(s)
- R. Bernardini
- Pediatric Unit, “San Giuseppe” Hospital, Empoli, Florence, Italy
| | - P. Catania
- Pediatric Unit, “San Giuseppe” Hospital, Empoli, Florence, Italy
| | - C. Caffarelli
- Pediatric Clinic, Department of Pediatrics, University of Parma, Parma, Italy
| | - F. Cardinale
- Department of Allergy and Pulmonology, Pediatric Hospital “Giovanni XXIII”, University of Bari, Bari, Italy
| | - F. Franceschini
- Pediatric Unit, “Ospedali Riuniti”, University Hospital, Ancona, Italy
| | - U. Pelosi
- Children and Mother Care Department, Pediatrics Unit, “Santa Barbara” Hospital, Iglesias, Italy
| | - D.G. Peroni
- Department of Pediatrics, University of Verona, Verona, Italy
| |
Collapse
|
11
|
Mertes PM, Karila C, Demoly P, Auroy Y, Ponvert C, Lucas MM, Malinovsky JM. [What is the reality of anaphylactoid reactions during anaesthesia? Classification, prevalence, clinical features, drugs involved and morbidity and mortality]. ACTA ACUST UNITED AC 2011; 30:223-39. [PMID: 21353759 DOI: 10.1016/j.annfar.2011.01.002] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Affiliation(s)
- P-M Mertes
- Service d'anesthésie-réanimation chirurgicale, hôpital Central, CHU de Nancy, 29 avenue de Lattre-de-Tassigny, Nancy cedex, France.
| | | | | | | | | | | | | |
Collapse
|
12
|
Microarrayed allergen molecules for the diagnosis of allergic diseases. Curr Allergy Asthma Rep 2010; 10:357-64. [PMID: 20596902 DOI: 10.1007/s11882-010-0132-0] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
IgE-mediated allergic diseases are among the most prevalent diseases worldwide. The use of extracts in the skin test and the additional use of IgE testing still represent the current basis for the diagnostic work-up. During the past 30 years, knowledge of the molecular structure of allergens has increased dramatically, and the characterization and production of allergenic molecules, as natural purified compounds or recombinant products, is allowing us to approach the allergy diagnostic work-up differently. Much of this is based on the adoption of microtechnology since the first release of a biochip for IgE detection. Its use has prompted the development of new concepts linked to the diagnosis of allergic diseases. This review describes the background of allergy diagnosis and the tools currently used for specific IgE detection. It gives insight into the most recent advancement in the field of biotechnology leading to allergenic molecule availability, microtechnology leading to the routine use of protein biochips for IgE detection, and how they should be combined with information technology.
Collapse
|
13
|
Radauer C, Adhami F, Fürtler I, Wagner S, Allwardt D, Scala E, Ebner C, Hafner C, Hemmer W, Mari A, Breiteneder H. Latex-allergic patients sensitized to the major allergen hevein and hevein-like domains of class I chitinases show no increased frequency of latex-associated plant food allergy. Mol Immunol 2010; 48:600-9. [PMID: 21095007 PMCID: PMC3025318 DOI: 10.1016/j.molimm.2010.10.019] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2010] [Revised: 10/21/2010] [Accepted: 10/25/2010] [Indexed: 11/21/2022]
Abstract
Allergies to certain fruits such as banana, avocado, chestnut and kiwi are described in 30–70% of latex-allergic patients. This association is attributed to the cross-reactivity between the major latex allergen hevein and hevein-like domains (HLDs) from fruit class I chitinases. We aimed to assess the extent of cross-reactivity between hevein and HLDs using sera from latex-allergic patients with and without plant food allergy. Hevein and HLDs of latex, banana, and avocado chitinases were expressed in Escherichia coli as fusion proteins with the maltose-binding protein and purified by affinity chromatography. IgE binding to these proteins was studied in sera from 59 latex-allergic patients and 20 banana-allergic patients without latex allergy by ELISA and ELISA inhibition. Additionally, 16,408 allergic patients’ sera were tested for IgE binding to hevein, latex chitinase, and wheat germ agglutinin using an allergen microarray. Hevein-specific IgE was detected in 34/59 (58%) latex-allergic patients’ sera. HLDs of latex, banana, and avocado chitinases were recognized by 21 (36%), 20 (34%), and 9 (15%) sera, respectively. In contrast, only one of 20 banana-allergic patients without latex allergy was sensitized to chitinase HLDs. In most tested latex-allergic patients’ sera, IgE binding to hevein was only partially reduced by preincubation with HLDs. Among hevein-sensitized, latex-allergic patients, the percentage of plant food allergy (15/34 = 44%) was equal to latex-allergic patients without hevein sensitization (11/25 = 44%). In the general allergic population, 230 of 16,408 sera (1.4%) reacted to hevein and/or a hevein-like allergen. Of these, 128 sera showed an isolated sensitization to hevein, whereas only 17 bound to latex chitinase or wheat germ agglutinin without hevein sensitization. In conclusion, the IgE response to HLDs is elicited by hevein as sensitizing allergen in most cases. Despite considerable cross-reactivity between these allergens, no correlation between latex-associated plant food allergy and sensitization to hevein or HLDs was found.
Collapse
Affiliation(s)
- Christian Radauer
- Department of Pathophysiology and Allergy Research, Center for Pathophysiology, Infectiology and Immunology, Medical University of Vienna, Währinger Gürtel 18-20, 1090 Vienna, Austria
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
14
|
Ebo DG, Hagendorens MM, De Knop KJ, Verweij MM, Bridts CH, De Clerck LS, Stevens WJ. Component-resolved diagnosis from latex allergy by microarray. Clin Exp Allergy 2010; 40:348-58. [PMID: 20210809 DOI: 10.1111/j.1365-2222.2009.03370.x] [Citation(s) in RCA: 77] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND A positive specific IgE (sIgE) result for latex does not always mirror the clinical situation and is frequently found in individuals without overt latex allergy. OBJECTIVE We sought to investigate the potential of component-resolved diagnosis (CRD) of latex allergy by microarray and to assess whether the technique allows discriminating genuine allergy from asymptomatic sensitization. METHODS Twenty-six healthy controls without a history of latex allergy with a negative latex sIgE and skin test, 22 latex-allergic patients with a compelling history of latex allergy with a positive latex sIgE and prick test and 20 latex-sensitized individuals with a frequent asymptomatic exposure to natural rubber latex-containing devices with a negative latex skin test but a positive sIgE were also included. CRD was performed with the ImmunoCAP ISAC microarray and traditional singleplexed ImmunoCAP. RESULTS In all patients, the diagnosis of latex allergy could be established by the combination of recombinant latex components present on the microarray (Hev b 1, Hev b 3, Hev b 5 and Hev b 6.02). Over three-quarters of our patients were sensitized for Hev b 5 and/or Hev b 6.02. Some patients also displayed reactivity for Hev b 1 and/or Hev b 3. In contrast, none of the individuals sensitized to natural rubber latex or control individuals demonstrated IgE reactivity for rHev b 1, rHev b 3, rHev b 5 or rHev b 6.02. Three-quarters of the patients sensitized to latex displayed a positive microarray result for recombinant latex profilin (rHev b 8). In contrast to the results obtained by traditional ImmunoCAP for bromelain, almost no sensitization for cross-reactive carbohydrates was demonstrated by bromelain spotted on the microarray. CRD by traditional singleplexed ImmunoCAP showed highly comparable results. CONCLUSION CRD by microarray is a reliable tool for diagnosing latex allergy. In addition, the technique allows discrimination between genuine allergy and sensitization. CRD by microarray can improve the diagnosis of IgE-mediated latex allergy by discriminating between genuine allergy and sensitization. CRD by microarray is a reliable tool to diagnose latex allergy. In addition, the technique allows discrimination between a genuine allergy and simple sensitization.
Collapse
Affiliation(s)
- D G Ebo
- Department of Immunology - Allergology - Rheumatology, Faculty of Medicine, University of Antwerp, Antwerp, Belgium
| | | | | | | | | | | | | |
Collapse
|
15
|
Harper NJN, Dixon T, Dugué P, Edgar DM, Fay A, Gooi HC, Herriot R, Hopkins P, Hunter JM, Mirakian R, Pumphrey RSH, Seneviratne SL, Walls AF, Williams P, Wildsmith JA, Wood P, Nasser AS, Powell RK, Mirakhur R, Soar J. Suspected anaphylactic reactions associated with anaesthesia. Anaesthesia 2009; 64:199-211. [PMID: 19143700 PMCID: PMC3082210 DOI: 10.1111/j.1365-2044.2008.05733.x] [Citation(s) in RCA: 212] [Impact Index Per Article: 14.1] [Reference Citation Analysis] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022]
Affiliation(s)
- N J N Harper
- British Society for Allergy and Clinical Immunology
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
16
|
Coutinho V, Vidal C, Garrido M, Gude F, Lojo S, Linneberg A, Gonzalez-Quintela A. Interference of cross-reactive carbohydrates in the determination of specific IgE in alcohol drinkers and strategies to minimize it: the example of latex. Ann Allergy Asthma Immunol 2008; 101:394-401. [PMID: 18939728 DOI: 10.1016/s1081-1206(10)60316-x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
BACKGROUND Cross-reactive carbohydrate determinants (CCDs) are N-glycans in plant and invertebrate proteins that interfere with specific IgE determinations. The prevalence of IgE to Man2XylFucGlcNAc2 (MUXF), the CCD from bromelain, may be increased in heavy drinkers. OBJECTIVE To further investigate the relationship of alcohol consumption to CCD specific IgE. Latex was used as an example for investigating CCD interference with in vitro allergy testing and how to minimize the interference by using nonglycosylated recombinant allergens and inhibition assays. METHODS We determined the levels of IgE to CCD markers (MUXF and ascorbate oxidase) and natural rubber latex in 270 adults without a history of latex allergy (73 abstainers or occasional drinkers, 76 light drinkers, 47 moderate drinkers, and 74 heavy drinkers). In cases with latex reactivity, we performed inhibition assays with MUXF and screened for IgE to a panel of recombinant latex allergens. Fourteen-day serologic follow-up was available for a subset of individuals. RESULTS Moderate to heavy drinkers displayed an increased prevalence of IgE to CCD markers. The presence of CCD specific IgE was closely associated with latex IgE reactivity. Inhibition studies and the absence of reactivity to nonglycosylated recombinant latex allergens indicated CCD interference in latex IgE determinations. Serum levels of specific IgE decreased with alcohol abstention. CONCLUSIONS In this population, alcohol consumption is associated with an increased prevalence of IgE reactivity to natural rubber latex due to CCD interference. The use of nonglycosylated recombinant allergens and inhibition assays may help to minimize CCD interference in populations in which IgE to CCDs is common.
Collapse
Affiliation(s)
- Vitor Coutinho
- Instituto Superior de Saúde do Alto Ave (ISAVE), Povoa de Lanhoso, Portugal
| | | | | | | | | | | | | |
Collapse
|
17
|
Antonicelli L, Micucci C, Mistrello G, Roncarolo D, Zanotta S, Cinti B, Garritani MS, Bonifazi F. Improving latex-allergy diagnosis: the clinical role of Hev b8-specific IgE. Allergy 2008; 63:620-1. [PMID: 18394137 DOI: 10.1111/j.1398-9995.2008.01651.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- L Antonicelli
- Allergy Unit, Department of Internal Medicine, Immuno-Allergic and Respiratory Diseases, Ospedali Riuniti di Ancona, Ancona, Italy.
| | | | | | | | | | | | | | | |
Collapse
|
18
|
Bhalla PL, Singh MB. Biotechnology-based allergy diagnosis and vaccination. Trends Biotechnol 2008; 26:153-61. [PMID: 18222557 DOI: 10.1016/j.tibtech.2007.11.010] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2007] [Revised: 11/21/2007] [Accepted: 11/21/2007] [Indexed: 10/22/2022]
Abstract
The diagnosis and immunotherapy currently applied to allergic diseases involve the use of crude extracts of the allergen source without defining the allergy-eliciting molecule(s). Advances in recombinant DNA technology have made identification, cloning, expression and epitope mapping of clinically significant allergens possible. Recombinant allergens that retain the immunological features of natural allergens form the basis of accurate protein-chip-based methods for diagnosing allergic conditions. The ability to produce rationally designed hypoallergenic forms of allergens is leading to the development of novel and safe forms of allergy vaccines with improved efficacy. The initial clinical tests on recombinant-allergen-based vaccine preparations have provided positive results, and ongoing developments in areas such as alternative routes of vaccine delivery will enhance patient compliance.
Collapse
Affiliation(s)
- Prem L Bhalla
- Plant Molecular Biology and Biotechnology Laboratory, Australian Research Council Centre of Excellence for Integrative Legume Research, Faculty of Land and Food Resources, The University of Melbourne, Parkville, Victoria, Australia.
| | | |
Collapse
|
19
|
Untersmayr E, Lukschal A, Hemmer W, Harwanegg C, Breiteneder H, Jarisch R, Scheiner O, Jensen-Jarolim E. Exercise with latex sport bands represents a risk for latex allergic patients. Immunol Lett 2007; 115:98-104. [PMID: 18035426 DOI: 10.1016/j.imlet.2007.10.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2007] [Accepted: 10/07/2007] [Indexed: 10/22/2022]
Abstract
Based on two clinical observations of adverse reactions during exercise with latex sport bands, we aimed to assess the possible risk for allergic patients posed by this equipment by investigating allergen content and IgE binding potential. Protein extracts of three different latex sport bands were characterized with sera of latex allergic patients. The IgE recognition profile of the allergic patients was identified by component resolved diagnosis and the allergen composition of the extracts was characterized by inhibition assays with the recombinant latex allergens Hev b 1, 3, 5, 6.02, and 8. The sera showed pronounced IgE binding to all three blotted extracts, however with diverse patterns. Inhibition assays revealed the presence of Hev b 1, 3, 5, and 8 in latex sport band extracts. The clinical relevance of contained allergens was demonstrated by strong skin reactions when testing with latex sport bands. From our results we conclude that latex sport bands contain clinically relevant allergens and may cause latex allergic individuals to experience allergic symptoms, potentially amplified by exercise-induced mechanisms. Even though latex is labeled on products, it is important that patients as well as athletic trainers and physical therapists recognize the risk of adverse reactions with these bands.
Collapse
Affiliation(s)
- Eva Untersmayr
- Department of Pathophysiology, Center of Physiology, Pathophysiology and Immunology, Medical University of Vienna, Vienna, Austria
| | | | | | | | | | | | | | | |
Collapse
|