Sensitization profiles in birch pollen-allergic patients with and without oral allergy syndrome to apple: lessons from multiplexed component-resolved allergy diagnosis (original) (raw)
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Allergologia et Immunopathologia, 2012
Background: Component-resolved diagnosis and microarray technology have been recently introduced into clinical allergy practice, and may be particularly useful in poly-sensitized allergic patients. Methods: We compare the clinical usefulness of a microarray-based IgE detection assay (ISAC ® ) with skin tests and specific IgE with standard allergens (sIgE) or their monocomponents in four case reports of patients poly-sensitized to aeroallergens and food. Results: Case 1: a woman with rhinitis, oral allergy syndrome to several fruits and anaphylaxis to cherry. Diagnostic tests supported non-specific lipid transfer proteins (nsLTPs) primary sensitization.
Nutrients, 2020
Background: A proportion of patients allergic to birch pollen are also allergic to pit fruit. The objective of this study was to investigate the effect of immunotherapy with birch pollen on birch-pollen-related apple allergy. Method: Patients with birch pollen immunotherapy underwent a skin-prick test with birch pollen, apple and rMal d 1, global assessments and nasal challenges with birch pollen, open food challenge with apple and a double-blind, placebo-controlled test with rMal d 1 at the start of and during the immunotherapy. Measurements of specific IgE in response to Bet v 1 and rMal d 1 and IgG4 in response to Bet v 1 and rMal d 1 took place. Results: Six of eight patients demonstrated an improvement of nasal challenge test results and all patients improved on global assessment during the immunotherapy. The median oral dose of apple required to elicit a reaction increased but was not statistically significant. The patients showed a decrease in skin-prick test values in respon...
Component-resolved allergy diagnosis by microarray: potential, pitfalls, and prospects
Advances in clinical chemistry, 2010
Diagnosis of IgE-mediated allergies is not always straightforward, as traditional tests can yield equivocal or negative results and provocation tests are hampered by several practical and ethical limitations. During the last decades two new in vitro techniques have entered the field of allergy diagnosis, that is, flow-assisted analysis of allergen-specific activated basophils and component-resolved diagnosis (CRD). This review focuses on component-resolved allergy diagnosis by microarray that has evolved from recent advances in molecular allergology and biochip technology. The technique allows a comprehensive analysis of individual sensitization profiles with multiplexed purified and recombinant allergens within a single run using only a minute amount of serum, providing information that largely exceeds the output from current sIgE capturing tools. Actually, multiplexing allows identification of diagnostic patterns that may facilitate the formulation of diagnostic algorithms. Althou...
Sensitization Profiles of a Case of Pollen-Food Allergy Syndrome
Allergology International, 2011
A 13-year-old girl who had had pollinosis since the age of eight began to experience itching of the ears and vomiting after eating fresh fruits such as peach, apple and watermelon. This occurred at 10 years of age. The girl displayed positive reactions to six kinds of pollens, eleven kinds of fruits, numerous vegetables and to recombinant: rBet v2 present in specific IgE antibodies. She also reacted positively to several pollens, fruits and rBet v2 in the skin prick test. In the component-resolved diagnosis (CRD) using microarray technology, she also tested positive for profilin, a pan-allergen among plants. It is reported that profilin cross-reacts between pollen, fruits, vegetables and latex. From these results, we concluded that the allergic reactions to multiple kinds of foodstuff and pollens observed in this subject were due to cross-reactivity induced by profilin. Our results demonstrate that CRD by microarray is a reliable test in the diagnosis of PFAS.
Assessment of cross-reactivity in patients allergic to birch pollen by immunoblotting
Food and Agricultural Immunology, 2013
Cross-reactivity related to birch pollynosis and ingestion of certain food poses a severe clinical and diagnostic problem. Sera were taken from 21 adult patients allergic to birch pollen with symptoms after ingestion of apples, carrots and celeries, and seven control subjects allergic to birch pollen only. Concentrations of allergen-specific IgE against allergens of birch pollen, apple, carrot and celery were measured with enzyme immunoassay, fluorimetric enzyme-linked immunoassay and immunoblotting. Immunoblotting technique may serve as a valuable diagnostic tool for birch pollen associated cross-reactivity.
Continuous apple consumption induces oral tolerance in birch-pollen-associated apple allergy
Allergy, 2011
More than 70% of birch-pollen-allergic patients suffer from an oral allergy syndrome (OAS) to fruits and/or nuts, especially to apple (1-3). This pollen fruit syndrome is based on a molecular similarity of their major allergens (all PR-10) leading to clinical cross-reactivity. One of the best studied examples is the cross-reactivity between Bet v 1 in birch pollen and Mal d 1 in apple (4). PR-10 proteins are rapidly released during the chewing process, but rather labile and quickly destroyed by digestive enzymes in the oral cavity. A large proportion of patients with OAS avoid or only eat processed fruits, which contain only negligible amounts of PR-10 proteins. As fresh fruits are considered important for well-balanced diet (5), many of these patients seek help in getting rid of these mostly harmless, but annoying symptoms. There is beneficial effect of birchpollen-specific subcutaneous immunotherapy on OAS to apple, with excellent improvement in some (1, 6-9), but limited effect in other studies (10-15). However, successful birch-pollen-specific sublingual immunotherapy only improved respiratory symptoms but showed no consistent effect on OAS (12, 14-16). In this study, we investigated whether it is possible to induce local oral tolerance in these patients by daily oral intake of increasing amounts of apple allergens. Furthermore, we analyzed the systemic immune response by several in vivo and in vitro markers.
Component-resolved diagnosis with recombinant allergens in patients with cherry allergy
Journal of Allergy and Clinical Immunology, 2002
Background: In pollen-related food allergy, extracts for skin prick tests (SPTs) are often not standardized, and the test reliability is affected by false-negative reactions. Objective: We sought to evaluate a panel of recombinant allergens (RAs) derived from one allergenic food for use in component-resolved in vivo diagnosis, taking cherry as a model food. Methods: Seventy-nine subjects were included in the study: 24 Swiss patients (group 1) with a positive double-blind placebocontrolled food challenge result to cherries, 23 patients with birch pollen allergy but without cherry allergy (group 2), 23 nonatopic subjects (group 3), and 9 Spanish patients with a history of a cherry allergy (group 4). SPTs were performed in duplicate by using recombinant cherry allergens (Bet v 1-related allergen: recombinant (r) Pru av 1; profilin: rPru av 4; and lipid transfer protein: rPru av 3) in concentrations of 10, 50, and 100 µg/mL. Furthermore, IgE reactivity to rPru av 1, rPru av 4, and rPru av 3 was assessed by means of immunoblot analysis. Results: SPT responses with rPru av 1, rPru av 4, and rPru av 3 were positive in 92%, 17%, and 4% of the patients in group 1; in 74%, 30%, and 0% of the patients in group 2; in 0%, 22%, and 89% of the patients in group 4; and negative for all nonatopic subjects (group 3). Thus the sensitivity of a positive SPT response to at least one of the 3 RAs was 96%. The specificities, negative predictive values, and positive predictive values with the 3 RAs were 100%, 96%, and 100% if calculated in relation to the nonatopic control group but 17%, 79%, and 60% when calculated in relation to the control group with birch pollen allergy. The correlation between SPT and immunoblotting results was excellent. Sensitization to rPru av 3 was associated with more severe symptoms than sensitization to rPru av 1. Conclusions: SPTs with RAs proved to be highly sensitive for diagnosis of cherry allergy. Component-resolved in vivo diagnosis with standardized amounts of stable RAs allows us to determine sensitization patterns directly, to correlate them with severity of clinical symptoms, and to analyze geographic differences. (J Allergy Clin Immunol 2002;110:167-73.) is a recipient of a grant for the promotion of academic young people of the University Zürich (Stiefel-Zangger-Stiftung).
Allergen Microarray Indicates Pooideae Sensitization in Brazilian Grass Pollen Allergic Patients
PloS one, 2015
Grass pollen, in particular from Lolium multiflorum is a major allergen source in temperate climate zones of Southern Brazil. The IgE sensitization profile of Brazilian grass pollen allergic patients to individual allergen molecules has not been analyzed yet. To analyze the IgE sensitization profile of a Brazilian grass pollen allergic population using individual allergen molecules. We analyzed sera from 78 grass pollen allergic patients for the presence of IgE antibodies specific for 103 purified micro-arrayed natural and recombinant allergens by chip technology. IgE-ELISA inhibition experiments with Lolium multiflorum, Phleum pratense extracts and a recombinant fusion protein consisting of Phl p 1, Phl p 2, Phl p 5 and Phl p 6 were performed to investigate cross-reactivities. Within the Brazilian grass pollen allergic patients, the most frequently recognized allergens were Phl p 1 (95%), Phl p 5 (82%), Phl p 2 (76%) followed by Phl p 4 (64%), Phl p 6 (45%), Phl p 11 (18%) and Phl ...