[A case of apple allergy with initial symptoms like food-dependent exercise-induced anaphylaxis]

A 13-year-old boy with two episodes of anaphylaxis after exercise was suspected as food-dependent exercise-induced anaphylaxis (FEIAn). The exercise challenge test after ingestion of an apple was performed, because apple was commonly contained in meals before the both episodes and a prick test for apple was positive. The exercise test was positive accompanied with nasal discharge, sneezing, throat discomfort, swelling of the uvula. The patient was instructed to refrain from exercise for 4 hours after ingestion of apple. In five months, he developed allergic symptoms only by an intake of foods containing heated apple without exercise and showed a slight increase in apple-specific IgE from negative to 0.51 IU/ml. The prognosis of FEIAn has not been well described. Cases with FEIAn to apples like this case require a close follow-up in consideration of development of allergic reactions without exercise.

ACAID induced by allogeneic corneal tissue promotes subsequent survival of orthotopic corneal grafts

PURPOSE

To determine whether immune deviation is induced by allogeneic corneal tissue implanted in the anterior chamber and whether survival of subsequent orthotopic corneal allografts is thereby enhanced.

METHODS

Corneal tissue from C57BL/6 mice was implanted in the anterior chamber of eyes of BALB/c mice. The fate of these implants was assessed histologically, and the donor-specific immune response of recipient mice was tested for donor-specific delayed hypersensitivity and the capacity to accept or reject C57BL/6 corneas grafted orthotopically into the fellow eye.

RESULTS

C57BL/6 cornea implants in the anterior chamber failed to induce donor-specific delayed hypersensitivity but impaired donor-specific delayed hypersensitivity in a proportion of recipients with implants in place for 2 weeks. Mice with donor-specific delayed hypersensitivity rejected the intraocular implants. Mice bearing C57BL/6 cornea implants in the anterior chamber for 2 (but not 4) weeks accepted the C57BL/6 corneas grafted orthotopically into the fellow eye at a high rate and with few rejection reactions.

CONCLUSIONS

Implantation of allogeneic corneal tissue in the anterior chamber of the eye has the transient capacity to alter the recipient alloimmune response in a manner that promotes survival of subsequent orthotopic corneal allografts.