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Lejeune S, Bouazza N, Nicaise PR, Jolaine V, Roditis L, Marguet C, Amat F, Berger P, Fayon M, Dubus JC, Valois S, Reix P, Pellan M, Brouard J, Chiron R, Giovannini-Chami L, de Blic J, Deschildre A, Lezmi G. COBRAPed cohort: Do sensitization patterns differentiate children with severe asthma from those with a milder disease? Pediatr Allergy Immunol 2024; 35:e14112. [PMID: 38520021 DOI: 10.1111/pai.14112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Revised: 03/05/2024] [Accepted: 03/06/2024] [Indexed: 03/25/2024]
Abstract
BACKGROUND It is unclear whether sensitization patterns differentiate children with severe recurrent wheeze (SRW)/severe asthma (SA) from those with non-severe recurrent wheeze (NSRW)/non-severe asthma (NSA). Our objective was to determine whether sensitization patterns can discriminate between children from the French COBRAPed cohort with NSRW/NSA and those with SRW/SA. METHODS IgE to 112 components (c-sIgE) (ImmunoCAP® ISAC) were analyzed in 125 preschools (3-6 years) and 170 school-age children (7-12 years). Supervised analyses and clustering methods were applied to identify patterns of sensitization among children with positive c-sIgE. RESULTS We observed c-sIgE sensitization in 51% of preschool and 75% of school-age children. Sensitization to house dust mite (HDM) components was more frequent among NSRW than SRW (53% vs. 24%, p < .01). Sensitization to non-specific lipid transfer protein (nsLTP) components was more frequent among SA than NSA (16% vs. 4%, p < .01) and associated with an FEV1/FVC < -1.64 z-score. Among sensitized children, seven clusters with varying patterns were identified. The two broader clusters identified in each age group were characterized by "few sensitizations, mainly to HDM." One cluster (n = 4) with "multiple sensitizations, mainly to grass pollen, HDM, PR-10, and nsLTP" was associated with SA in school-age children. CONCLUSIONS Although children with wheeze/asthma display frequent occurrences and high levels of sensitization, sensitization patterns did not provide strong signals to discriminate children with severe disease from those with milder disease. These results suggest that the severity of wheeze/asthma may depend on both IgE- and non-IgE-mediated mechanisms.
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Affiliation(s)
- Stéphanie Lejeune
- Pediatric Pulmonology and Allergy Department, U1019-UMR 9017-CIIL-Center for Infection and Immunity of Lille, CNRS, Inserm, CHU Lille, Institut Pasteur de Lille, Hôpital Jeanne de Flandre, Univ. Lille, Lille, France
- Clinical Investigation Center, LIRIC UMR 995 Inserm, CIC-1403-Inserm-CHU, Univ. Lille, Lille, France
| | - Naïm Bouazza
- Unité de Recherche Clinique-Centre Investigation Clinique, APHP, Hôpital Necker-Enfants malades, Paris, France
| | - Pascale Roland Nicaise
- Immunology Department, Hôpital Bichat, APHP, Paris, France
- Inserm, PHERE, Université Paris Cité, Paris, France
| | - Valérie Jolaine
- Unité de Recherche Clinique-Centre Investigation Clinique, APHP, Hôpital Necker-Enfants malades, Paris, France
| | - Léa Roditis
- Pediatric Pulmonology and Allergology Unit CHU Toulouse, Children Hospital, Toulouse, France
| | - Christophe Marguet
- Pediatric Respiratory and Allergic Diseases, CF Reference Center, Rouen University Hospital-Charles Nicolle, EA3830-GHRV, Rouen University, Rouen, France
| | - Flore Amat
- Pediatric Pulmonology and Allergology, INSERM UMR 1018, Robert Debré Hospital, University of Paris Cité, Paris, France
| | - Patrick Berger
- Centre de Recherche Cardio-Thoracique de Bordeaux, INSERM, U1045, Centre d'Investigation Clinique (CIC 1401), Univ. Bordeaux, Bordeaux, France
| | - Michael Fayon
- Unité de Pneumologie Pédiatrique, Centre d'Investigation Clinique (CIC 1401), CHU de Bordeaux, Bordeaux, France
| | - Jean-Christophe Dubus
- Unité de Pneumopédiatrie CHU Timone-Enfants, Aix-Marseille Université, IRD MEPHI, IHU Méditerranée-Infection, Marseille, France
| | - Sophie Valois
- Pédiatrie, CHU Grenoble Alpes, INSERM, Institute for Advanced Biosciences, Université Grenoble Alpes, Grenoble, France
| | - Philippe Reix
- Service de Pneumologie, Allergologie et Mucoviscidose Pédiatrique, CHU de Lyon, Lyon, France
- UMR 5558 (EMET), CNRS, LBBE, Université de Lyon, Villeurbanne, France
| | | | - Jacques Brouard
- Service de Pédiatrie Médicale, CHU Caen, Caen, France
- Groupe de Recherche sur l'Adaptation Microbienne (GRAM 2.0), Normandie Université, Caen, France
| | - Raphael Chiron
- Pediatric Department, Montpellier University Hospital, Montpellier, France
| | | | - Jacques de Blic
- Department of Pediatric Pulmonology and Allergy, AP-HP, Hôpital Necker-Enfants Malades, Université Paris Cité, Paris, France
| | - Antoine Deschildre
- Pediatric Pulmonology and Allergy Department, U1019-UMR 9017-CIIL-Center for Infection and Immunity of Lille, CNRS, Inserm, CHU Lille, Institut Pasteur de Lille, Hôpital Jeanne de Flandre, Univ. Lille, Lille, France
- Clinical Investigation Center, LIRIC UMR 995 Inserm, CIC-1403-Inserm-CHU, Univ. Lille, Lille, France
| | - Guillaume Lezmi
- Department of Pediatric Pulmonology and Allergy, AP-HP, Hôpital Necker-Enfants Malades, Université Paris Cité, Paris, France
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Zhang Z, Li XM, Wang H, Lin H, Xiao H, Li Z. Seafood allergy: Allergen, epitope mapping and immunotherapy strategy. Crit Rev Food Sci Nutr 2023; 63:1314-1338. [PMID: 36825451 DOI: 10.1080/10408398.2023.2181755] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/25/2023]
Abstract
Seafoods are fashionable delicacies with high nutritional values and culinary properties, while seafood belongs to worldwide common food allergens. In recent years, many seafood allergens have been identified, while the diversity of various seafood species give a great challenge in identifying and characterizing seafood allergens, mapping IgE-binding epitopes and allergen immunotherapy development, which are critical for allergy diagnostics and immunotherapy treatments. This paper reviewed the recent progress on seafood (fish, crustacean, and mollusk) allergens, IgE-binding epitopes and allergen immunotherapy for seafood allergy. In recent years, many newly identified seafood allergens were reported, this work concluded the current situation of seafood allergen identification and designation by the World Health Organization (WHO)/International Union of Immunological Societies (IUIS) Allergen Nomenclature Sub-Committee. Moreover, this review represented the recent advances in identifying the IgE-binding epitopes of seafood allergens, which were helpful to the diagnosis, prevention and treatment for seafood allergy. Furthermore, the allergen immunotherapy could alleviate seafood allergy and provide promising approaches for seafood allergy treatment. This review represents the recent advances and future outlook on seafood allergen identification, IgE-binding epitope mapping and allergen immunotherapy strategies for seafood allergy prevention and treatment.
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Affiliation(s)
- Ziye Zhang
- Laboratory of Food Safety, College of Food Science and Engineering, Ocean University of China, Qingdao, China
| | - Xiu-Min Li
- Department of Pathology, Microbiology and Immunology and Department of Otolaryngology, School of Medicine, New York Medical College, Valhalla, New York, USA
| | - Hao Wang
- Laboratory of Food Safety, College of Food Science and Engineering, Ocean University of China, Qingdao, China
| | - Hong Lin
- Laboratory of Food Safety, College of Food Science and Engineering, Ocean University of China, Qingdao, China
| | - Hang Xiao
- Department of Food Science, University of Massachusetts, Amherst, Massachusetts, USA
| | - Zhenxing Li
- Laboratory of Food Safety, College of Food Science and Engineering, Ocean University of China, Qingdao, China
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3
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Costanzo G, Matolo A, Saderi L, Messina MR, Firinu D, Barca MP, Serra P, Corso N, Sotgiu G, Del Giacco S. Cofactors, age at onset, allergic comorbidities and gender are different in patients sensitized to omega-5 gliadin and Pru p 3. Sci Rep 2022; 12:20868. [PMID: 36460730 PMCID: PMC9718743 DOI: 10.1038/s41598-022-25368-y] [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: 05/05/2022] [Accepted: 11/29/2022] [Indexed: 12/03/2022] Open
Abstract
Aim of this study is to clarify the impact of cofactors on allergic reactions in patients sensitized to LTP and ω-5-gliadin. We retrospectively examined the charts of our outpatients from January 2015 to July 2019 and identified 157 patients seen for urticaria/angioedema or anaphylaxis after a meal, in presence or absence of cofactors and sensitized to LTPs (Pru p 3 and/or Tri a 14) and/or ω-5-gliadin (Tri a 19). we compared LTPs-positive patients and those sensitized to Tri a 19 in order to assess the difference in cofactors involved and in frequency of clinical presentation. Our data show that exercise is the most frequent cofactor in FDEIAn and the involvement of exercise, alcohol and multiple cofactors was more frequently found in males than in females. We found that exercise, pollen counts peaks and multiple cofactors were more often related to anaphylaxis than mild reactions. Finally, we performed a comparison between patients LTPs+ and Tri a 19+ that showed in the latter group a lower frequency of allergic comorbidities, a higher median age at the onset of symptoms and frequency of alcohol exposure. Our data show that the search for possible cofactors involved in food allergy is essential not only for diagnostic purposes, but also for risk assessment strategies.
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Affiliation(s)
- Giulia Costanzo
- grid.7763.50000 0004 1755 3242Department of Medical Sciences and Public Health, University of Cagliari, 09042 Monserrato, CA Italy
| | - Annalisa Matolo
- grid.7763.50000 0004 1755 3242Department of Medical Sciences and Public Health, University of Cagliari, 09042 Monserrato, CA Italy
| | - Laura Saderi
- grid.11450.310000 0001 2097 9138Clinical Epidemiology and Medical Statistics Unit, Department of Medical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy
| | - Maria Rita Messina
- grid.7763.50000 0004 1755 3242Department of Medical Sciences and Public Health, University of Cagliari, 09042 Monserrato, CA Italy
| | - Davide Firinu
- grid.7763.50000 0004 1755 3242Department of Medical Sciences and Public Health, University of Cagliari, 09042 Monserrato, CA Italy
| | - Maria Pina Barca
- grid.7763.50000 0004 1755 3242Department of Medical Sciences and Public Health, University of Cagliari, 09042 Monserrato, CA Italy
| | - Paolo Serra
- grid.7763.50000 0004 1755 3242Department of Medical Sciences and Public Health, University of Cagliari, 09042 Monserrato, CA Italy
| | - Nicoletta Corso
- grid.7763.50000 0004 1755 3242Department of Medical Sciences and Public Health, University of Cagliari, 09042 Monserrato, CA Italy
| | - Giovanni Sotgiu
- grid.11450.310000 0001 2097 9138Clinical Epidemiology and Medical Statistics Unit, Department of Medical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy
| | - Stefano Del Giacco
- grid.7763.50000 0004 1755 3242Department of Medical Sciences and Public Health, University of Cagliari, 09042 Monserrato, CA Italy
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Wolters P, Ostermann T, Hofmann SC. Lipid‐Transfer‐Protein‐Allergie: Charakterisierung und Vergleich mit birkenpollenassoziierter Nahrungsmittelallergie. J Dtsch Dermatol Ges 2022; 20:1430-1440. [DOI: 10.1111/ddg.14881_g] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Accepted: 07/25/2022] [Indexed: 11/17/2022]
Affiliation(s)
- Paula Wolters
- Zentrum für Dermatologie Allergologie und Dermatochirurgie Helios Universitätsklinikum Wuppertal Universität Witten/Herdecke Wuppertal
| | - Thomas Ostermann
- Lehrstuhl für Forschungsmethodik und Statistik in der Psychologie Fakultät für Gesundheit Universität Witten/Herdecke Witten
| | - Silke C. Hofmann
- Zentrum für Dermatologie Allergologie und Dermatochirurgie Helios Universitätsklinikum Wuppertal Universität Witten/Herdecke Wuppertal
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5
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Alves PB, Pereira HP, Alves MP, Roseta L, Tavares B, Loureiro G, Carrapatoso I, Todo-Bom A, Regateiro FS. Predictors of anaphylaxis to peanut and tree nuts in a Mediterranean population. Allergy Asthma Proc 2022; 43:533-542. [PMID: 36335421 DOI: 10.2500/aap.2022.43.220060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Background: Peanuts (PN) and tree nuts (TN) are major causes of anaphylaxis worldwide. We aimed to determine the clinical and demographic characteristics associated with anaphylaxis in patients sensitized to PN and/or TN in a Mediterranean population. Methods: We conducted a retrospective study, which included 198 patients allergic to PN and/or TN (allergy symptoms plus specific immunoglobulin E [sIgE] sensitization), evaluated in consultations from January 2015 to December 2020. Univariate analysis and multivariate logistic regression models were developed, including demographic, clinical, and laboratory data as independent variables, and anaphylaxis to each PN and/or TN as a dependent variables. Results: Anaphylaxis was associated with an earlier age of onset of allergy to PN, cashew and/or pistachio, and pine nut allergy but not to other TN allergies. Gender, atopic comorbidities, and cofactors were not associated with PN and/or TN anaphylaxis. Anaphylaxis to PN, cashew and/or pistachio, and pine nut were associated with reactivity to a fewer number of PN and/or TN foods. Although sIgE sensitization to lipid transfer proteins (LTP) was highly prevalent in our population, only seed storage protein (SSP) positivity was associated with anaphylaxis in PN allergy. The absence of pathogenesis-related protein family 10 sensitization correlated with PN and hazelnut anaphylaxis. A higher level of sIgE to almond extract predicted anaphylaxis but the level of sIgE to other PN and/or TN extracts did not predict it. Conclusion: The high prevalence of sensitization to the pan-allergen LTP did not seem to have a significant impact in PN and/or TN allergy severity in our study. Instead, other factors, such as early age of onset and positivity for SSPs, seem to strongly associate with anaphylaxis to specific PN and/or TN. These findings may contribute to individual risk assessment in these populations.
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Affiliation(s)
- Pedro B Alves
- From the Allergy and Clinical Immunology Unit, University Hospital of Coimbra, Coimbra, Portugal
| | - Helena P Pereira
- From the Allergy and Clinical Immunology Unit, University Hospital of Coimbra, Coimbra, Portugal
| | - Marta P Alves
- From the Allergy and Clinical Immunology Unit, University Hospital of Coimbra, Coimbra, Portugal
| | - Luis Roseta
- Clinical Pathology Unit, University Hospital of Coimbra, Coimbra, Portugal
| | - Beatriz Tavares
- From the Allergy and Clinical Immunology Unit, University Hospital of Coimbra, Coimbra, Portugal
| | - Graça Loureiro
- From the Allergy and Clinical Immunology Unit, University Hospital of Coimbra, Coimbra, Portugal
| | - Isabel Carrapatoso
- From the Allergy and Clinical Immunology Unit, University Hospital of Coimbra, Coimbra, Portugal
| | - Ana Todo-Bom
- From the Allergy and Clinical Immunology Unit, University Hospital of Coimbra, Coimbra, Portugal
| | - Frederico S Regateiro
- From the Allergy and Clinical Immunology Unit, University Hospital of Coimbra, Coimbra, Portugal
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6
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Wolters P, Ostermann T, Hofmann SC. Lipid transfer protein allergy: characterization and comparison to birch‐related food allergy. J Dtsch Dermatol Ges 2022; 20:1430-1438. [DOI: 10.1111/ddg.14881] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Revised: 12/12/1912] [Accepted: 07/25/2022] [Indexed: 11/05/2022]
Affiliation(s)
- Paula Wolters
- Department of Dermatology Allergy and Dermatosurgery Helios University Hospital Wuppertal University Witten/Herdecke Wuppertal Germany
| | - Thomas Ostermann
- Department for Psychology and Psychotherapy, Faculty of Health University Witten/Herdecke Witten Germany
| | - Silke C. Hofmann
- Department of Dermatology Allergy and Dermatosurgery Helios University Hospital Wuppertal University Witten/Herdecke Wuppertal Germany
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7
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Cabrera CM. Feasibility of the ALEX multiplex platform in the diagnosis of nut allergy from a Mediterranean population. Clin Chim Acta 2022; 535:112-119. [PMID: 36030884 DOI: 10.1016/j.cca.2022.08.022] [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: 07/07/2022] [Revised: 08/16/2022] [Accepted: 08/22/2022] [Indexed: 11/19/2022]
Abstract
BACKGROUND ALEX multiplex platform has been recently commercialized but its clinical utility as quantitative technique respect to ImmunoCAP-singleplex as the reference method has not yet been confirmed on patients suffering from nut allergy and co-sensitization to different nuts. METHODS 58 serum samples from patients with nut allergy from a Mediterranean population were assayed in parallel by ALEX-multiplex and ImmunoCAP-singleplex techniques. Patients were diagnosed based on clinical symptoms and positive skin prick tests (SPTs). The following whole extracts were compared between both techniques: walnut, hazelnut, peanut, almond, pistachio and sunflower seed; besides the recombinant Pru p 3. A qualitative and quantitative study was carried out. RESULTS Both techniques had similar sensitivities respect to whole extracts from walnut, hazelnut and peanut as well as to Pru p 3 (p > 0.05). However for whole extracts from almond, pistachio and sunflower seed the sensitivity obtained by ALEX was much lower than ImmunoCAP (9.09 % vs 88.63 %; 14.81 vs 70.37 %; and 8.51 % vs 88.88 %; respectively). The concordance between both techniques showed only a substantial agreement for Pru p 3 (k = 0.791); moderate agreement for hazelnut and peanut (k = 0.550 and k = 0.544, respectively); fair agreement for walnut (k = 0.386) and poor agreement for almond, pistachio and sunflower seed (k < 0.2). Quantitative analysis showed that ImmunoCAP for walnut, peanut and sunflower seed had higher mean values than ALEX. Relationships were significant for all specific IgE levels except to for almond, pistachio and sunflower seed. CONCLUSIONS ALEX platform is a suitable technique to patients with nut allergy from the Mediterranean area except to for those suffering from allergy to almond, pistachio and sunflower seed.
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Affiliation(s)
- Carmen Maria Cabrera
- Allergy and Immunology Section, Ciudad Real University General Hospital, Ciudad Real, Spain; Associate Professor of Immunology, University of Castilla-La Mancha, Faculty of Medicine of Ciudad Real, Spain.
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Epinephrine Auto-Injector Prescription and Use: A Retrospective Analysis and Clinical Risk Assessment of Adult Patients Sensitized to Lipid Transfer Protein. Nutrients 2022; 14:nu14132706. [PMID: 35807887 PMCID: PMC9269022 DOI: 10.3390/nu14132706] [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: 04/14/2022] [Revised: 06/25/2022] [Accepted: 06/28/2022] [Indexed: 02/04/2023] Open
Abstract
Lipid transfer proteins (LTPs) are widely widespread plant food allergens which represents the main cause of food allergy in adults living in the Mediterranean basin. The purpose of this study was to investigate in LTP patients the actual use of prescribed epinephrine auto-injector and appropriateness of its prescription. In addition, we investigated in these patients: (1) occurrence of new food reaction in the following three years after to diagnosis; (2) need and number of access to emergency services; (3) presence of possible predictive factors to further food reactions. One-hundred sixty-five adult patients sensitized to LTPs have been included. During follow-up, we recorded 68 further reactions, most of them (77.9%) characterized by local symptoms; rarely the patients required an emergency-department visits (16.1%) and only one patient (1.7%) used the epinephrine auto-injector. The patients with a previous history of anaphylaxis at baseline turned back to access to emergency services also during the follow-up (p = 0.006). The majority of patients with recorded systemic reactions (p = 0.004) and treated in an emergency room (p = 0.028) did not have any co-factor-enhanced at diagnosis. We noted an association between platanus pollen sensitization and severity of further reactions during the follow-up (p = 0.026). Epinephrine auto-injector were prescribed to 108/165 patients (65.5%) with an over-prescription rate of 25%. The unforeseeable clinical presentation of LTP allergic reactions and the eventual role played by the cofactor make necessary schedule a follow-up to monitor the patients over time and to assess the actual use of epinephrine auto injectors prescribed.
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Asero R, Nucera E, Rizzi A, Aruanno A, Uasuf CG, Manzotti G, Villalta D, Conte M, Pastorello EA, Losappio L, Schroeder JV, Pinter E, Miglionico M, Vantaggio L, Macchia D, Radice A, Marra AM, Barzaghi C, Santucci A, Cortellini G, Peveri S, Montagni M, Demonte A, Borrelli P, Errico MA, Rivolta F, Pravettoni V, Sangalli A, Magnani M, Celi G, Yang B, Costantino MT, Deleonardi G, Boni E, Gattoni M, Rizzini FL, Di Paolo C, Montera M, Giordano A, De Carli M, Murzilli F, Fumagalli F, Maffeis L, Ghiglioni DG, Centonze S, Di Lizia M, Calafiore P, Scala E. Peanut allergy in Italy: A unique Italian perspective. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY. GLOBAL 2022; 1:61-66. [PMID: 37780582 PMCID: PMC10509966 DOI: 10.1016/j.jacig.2022.02.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/15/2022] [Revised: 02/12/2022] [Accepted: 02/15/2022] [Indexed: 10/03/2023]
Abstract
Background Peanut allergy has not been well characterized in Italy. Objective Our aim was to better define the clinical features of peanut allergy in Italy and to detect the peanut proteins involved in allergic reactions. Methods A total of 22 centers participated in a prospective survey of peanut allergy over a 6-month period. Clinical histories were confirmed by in vivo and/or in vitro diagnostic means in all cases. Potential risk factors for peanut allergy occurrence were considered. Levels of IgE to Arachis hypogea (Ara h) 1, 2, 3, 6, 8, and 9 and profilin were measured. Results A total of 395 patients (aged 2-80 years) were enrolled. Of the participants, 35% reported local reactions, 38.2% reported systemic reactions, and 26.6% experienced anaphylaxis. The sensitization profile was dominated by Ara h 9 (77% of patients were sensitized to it), whereas 35% were sensitized to pathogenesis-related protein 10 (PR-10) and 26% were sensitized to seed storage proteins (SSPs). Sensitization to 2S albumins (Ara h 2 and Ara h 6) or lipid transfer protein (LTP) was associated with the occurrence of more severe symptoms, whereas profilin and PR-10 sensitization were associated with milder symptoms. Cosensitization to profilin reduced the risk of severe reactions in both Ara h 2- and LTP-sensitized patients. SSP sensitization prevailed in younger patients whereas LTP prevailed in older patients (P < .01). SSP sensitization occurred mainly in northern Italy, whereas LTP sensitization prevailed in Italy's center and south. Atopic dermatitis, frequency of peanut ingestion, peanut consumption by other family members, or use of peanut butter did not seem to be risk factors for peanut allergy onset. Conclusions In Italy, peanut allergy is rare and dominated by LTP in the country's center and south and by SSP in the north. These 2 sensitizations seem mutually exclusive. The picture differs from that in Anglo-Saxon countries.
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Affiliation(s)
- Riccardo Asero
- Ambulatorio di Allergologia, Clinica San Carlo, Paderno Dugnano, Milan, Italy
| | - Eleonora Nucera
- Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore – Roma, Italy
| | - Angela Rizzi
- Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore – Roma, Italy
| | - Arianna Aruanno
- Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore – Roma, Italy
| | - Carina G. Uasuf
- Allergy Center, Institute of Traslational Pharmacology, National Research Council (CNR), Palermo, Italy
| | | | - Danilo Villalta
- SSD di Immunologia e Allergologia, PO S. Maria degli Angeli, Pordenone, Italy
| | | | - Elide A. Pastorello
- Dipartimento di Allergologia, ASST Grande Ospedale Metropolitano Niguarda, Milano, Italy
| | - Laura Losappio
- Dipartimento di Allergologia, ASST Grande Ospedale Metropolitano Niguarda, Milano, Italy
| | - Jan V. Schroeder
- Dipartimento di Allergologia, ASST Grande Ospedale Metropolitano Niguarda, Milano, Italy
| | - Elena Pinter
- UOC Medicina Interna e Immunologia Clinica, Dipartimento Medicina Traslazionale e di Precisione, Sapienza University of Rome, Rome, Italy
| | - Marzia Miglionico
- Allergy and Clinical Immunology Residency Program, Department of Molecular Medicine, Sapienza University of Rome, Italy
| | - Lorenzo Vantaggio
- Allergy and Clinical Immunology Residency Program, Department of Molecular Medicine, Sapienza University of Rome, Italy
| | - Donatella Macchia
- SOS Allergologia e Immunologia Clinica, Ospedale San Giovanni di Dio, Firenze, Italy
| | - Anna Radice
- SOS Allergologia e Immunologia Clinica, Ospedale San Giovanni di Dio, Firenze, Italy
| | - Alessandro M. Marra
- ASST Rhodense - UO Pneumologia - Ospedale di Garbagnate Milanese, Milan, Italy
| | - Claudio Barzaghi
- ASST Rhodense - Ambulatorio di Allergologia - Ospedale di Rho, Italy
| | - Annalisa Santucci
- Ausl Romagna, UOS interdipartimentale di Allergologia, Ospedale degli Infermi di Rimini, Italy
| | - Gabriele Cortellini
- Ausl Romagna, UOS interdipartimentale di Allergologia, Ospedale degli Infermi di Rimini, Italy
| | - Silvia Peveri
- UOsD Allergologia, Ospedale G. Da Saliceto, Piacenza, Italy
| | | | | | - Paolo Borrelli
- SSD Dermatologia - Ambulatorio Allergologia e Immunologia Clinica, Ospedale Beauregard, Aosta, Italy
| | - Micol A. Errico
- SSD Dermatologia - Ambulatorio Allergologia e Immunologia Clinica, Ospedale Beauregard, Aosta, Italy
| | - Federica Rivolta
- General Medicin, Immunology and Allergy Department - IRCCS Foundation Ca' Granda Ospedale Maggiore Policlinico - Milan, Italy
| | - Valerio Pravettoni
- General Medicin, Immunology and Allergy Department - IRCCS Foundation Ca' Granda Ospedale Maggiore Policlinico - Milan, Italy
| | - Andrea Sangalli
- Allergy and Clinical Immunology Residency, University of Milan, Italy
| | | | - Giorgio Celi
- Centro DH Allergologia e Immunologia Clinica, Ospedale Carlo Poma ASST-Mantova, Italy
| | - Baoran Yang
- Centro DH Allergologia e Immunologia Clinica, Ospedale Carlo Poma ASST-Mantova, Italy
| | - Maria T. Costantino
- Centro DH Allergologia e Immunologia Clinica, Ospedale Carlo Poma ASST-Mantova, Italy
| | | | - Elisa Boni
- Allergologia e autoimmunità LUM AUSL Bologna, Italy
| | - Marco Gattoni
- Scuola di Specializzazione in Allergologia e Immunologia Clinica Università degli Studi di Bologna, Italy
| | | | | | - Mariacarmela Montera
- Allergologia e Immunologia Clinica, Ospedale G. Fuscito, Mercato S. Severino; Ospedaliero-Universitaria Ruggi D'Aragona, Salerno, Italy
| | - Annaclaudia Giordano
- Allergologia e Immunologia Clinica, Ospedale G. Fuscito, Mercato S. Severino; Ospedaliero-Universitaria Ruggi D'Aragona, Salerno, Italy
| | - Marco De Carli
- S.O.C Medicina 2, Presidio Ospedaliero Santa Maria della Misericordia, Udine, Italy
| | - Francesco Murzilli
- U.O.S.D. di Allergologia, Ospedale S.S. Filippo e Nicola, Avezzano, Italy
| | | | - Laura Maffeis
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico di Milano, Pediatric Intermediate Care Unit, Milan, Italy
| | - Daniele Giovanni Ghiglioni
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico di Milano, Pediatric Highly Intensive Care Unit, Milan, Italy
| | | | | | | | - Enrico Scala
- Istituto Dermopatico dell’Immacolata, Roma, Italy
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10
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Basophil Activation Test Utility as a Diagnostic Tool in LTP Allergy. Int J Mol Sci 2022; 23:ijms23094979. [PMID: 35563370 PMCID: PMC9105056 DOI: 10.3390/ijms23094979] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Revised: 04/27/2022] [Accepted: 04/28/2022] [Indexed: 12/10/2022] Open
Abstract
Plant-food allergy is an increasing problem, with nonspecific lipid transfer proteins (nsLTPs) triggering mild/severe reactions. Pru p 3 is the major sensitizer in LTP food allergy (FA). However, in vivo and in vitro diagnosis is hampered by the need for differentiating between asymptomatic sensitization and allergy with clinical relevance. The basophil activation test (BAT) is an ex vivo method able to identify specific IgE related to the allergic response. Thus, we aimed to establish the value of BAT in a precise diagnosis of LTP-allergic patients. Ninety-two individuals with peach allergy sensitized to LTP, Pru p 3, were finally included, and 40.2% of them had symptoms to peanut (n = 37). In addition, 16 healthy subjects were recruited. BAT was performed with Pru p 3 and Ara h 9 (peanut LTP) at seven ten-fold concentrations, and was evaluated by flow cytometry, measuring the percentage of CD63 (%CD63+) and CD203c (%CD203chigh) cells, basophil allergen threshold sensitivity (CD-Sens), and area under the dose−response curve (AUC). Significant changes in BAT parameters (%CD63+ and %CD203chigh) were found between the controls and patients. However, comparisons for %CD63+, %CD203chigh, AUC, and CD-Sens showed similar levels among patients with different symptoms. An optimal cut-off was established from ROC curves, showing a significant positive percentage of BAT in patients compared to controls and great values of sensitivity (>87.5%) and specificity (>85%). In addition, BAT showed differences in LTP-allergic patients tolerant to peanut using its corresponding LTP, Ara h 9. BAT can be used as a potential diagnostic tool for identifying LTP allergy and for differentiating peanut tolerance, although neither reactivity nor sensitivity can distinguish the severity of the clinical symptoms.
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11
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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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12
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Does the Food Ingredient Pectin Provide a Risk for Patients Allergic to Non-Specific Lipid-Transfer Proteins? Foods 2021; 11:foods11010013. [PMID: 35010137 PMCID: PMC8750200 DOI: 10.3390/foods11010013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Revised: 12/16/2021] [Accepted: 12/17/2021] [Indexed: 12/27/2022] Open
Abstract
Pectin, a dietary fiber, is a polysaccharide that is widely used in food industry as a gelling agent. In addition, prebiotic and beneficial immunomodulatory effects of pectin have been demonstrated, leading to increased importance as food supplement. However, as cases of anaphylactic reactions after consumption of pectin-supplemented foods have been reported, the present study aims to evaluate the allergy risk of pectin. This is of particular importance since most of the pectin used in the food industry is extracted from citrus or apple pomace. Both contain several allergens such as non-specific lipid transfer proteins (nsLTPs), known to induce severe allergic reactions, which could impair the use of pectins in nsLTP allergic patients. Therefore, the present study for the first time was performed to analyze residual nsLTP content in two commercial pectins using different detection methods. Results showed the analytical sensitivity was diminished by the pectin structure. Finally, spiking of pectin with allergenic peach nsLTP Pru p 3 led to the conclusion that the potential residual allergen content in both pectins is below the threshold to induce anaphylactic reactions in nsLTP-allergic patients. This data suggests that consumption of the investigated commercial pectin products provides no risk for inducing severe reactions in nsLTP-allergic patients.
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13
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Asero R, Pravettoni V, Scala E, Villalta D. Lipid transfer protein allergy: A review of current controversies. Clin Exp Allergy 2021; 52:222-230. [PMID: 34773669 DOI: 10.1111/cea.14049] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2021] [Revised: 11/05/2021] [Accepted: 11/08/2021] [Indexed: 01/04/2023]
Abstract
Sensitization to lipid transfer protein (LTP), the most frequent cause of food allergy in southern Europe, still shows several controversial, but also intriguing, aspects. Some of these include the degree of cross-reactivity between LTPs from botanically distant sources, the definition of risk factors, the role of some cofactors, clinical outcomes, geographical differences and the identification of the primary sensitizer in different areas. This review article tries to analyse and comment on these aspects point by point suggesting some explanatory hypotheses with the final scope to stimulate critical thoughts and elicit the scientific discussion about this issue in the readership.
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Affiliation(s)
- Riccardo Asero
- Ambulatorio di Allergologia, Clinica San Carlo, Milan, Italy
| | - Valerio Pravettoni
- Department of General Medicine, Immunology and Allergy, IRCCS Foundation Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Enrico Scala
- Clinical and Laboratory Molecular Allergy Unit, IDI - IRCCS, Rome, Italy
| | - Danilo Villalta
- Immunologia e allergologia, Ospedale S. Maria degli Angeli, Pordenone, Italy
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14
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Zhou X, Yu W, Lyu SC, Macaubas C, Bunning B, He Z, Mellins ED, Nadeau KC. A positive feedback loop reinforces the allergic immune response in human peanut allergy. J Exp Med 2021; 218:e20201793. [PMID: 33944900 PMCID: PMC8103542 DOI: 10.1084/jem.20201793] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2020] [Revised: 12/18/2020] [Accepted: 03/04/2021] [Indexed: 12/13/2022] Open
Abstract
Food allergies are a leading cause of anaphylaxis, and cellular mechanisms involving antigen presentation likely play key roles in their pathogenesis. However, little is known about the response of specific antigen-presenting cell (APC) subsets to food allergens in the setting of food allergies. Here, we show that in peanut-allergic humans, peanut allergen drives the differentiation of CD209+ monocyte-derived dendritic cells (DCs) and CD23+ (FcєRII) myeloid dendritic cells through the action of allergen-specific CD4+ T cells. CD209+ DCs act reciprocally on the same peanut-specific CD4+ T cell population to reinforce Th2 cytokine expression in a positive feedback loop, which may explain the persistence of established food allergy. In support of this novel model, we show clinically that the initiation of oral immunotherapy (OIT) in peanut-allergic patients is associated with a decrease in CD209+ DCs, suggesting that breaking the cycle of positive feedback is associated with therapeutic effect.
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Affiliation(s)
- Xiaoying Zhou
- Sean N. Parker Center for Allergy & Asthma Research at Stanford University and Division of Pulmonary, Allergy, and Critical Care Medicine, Stanford, CA
| | - Wong Yu
- Sean N. Parker Center for Allergy & Asthma Research at Stanford University and Division of Pulmonary, Allergy, and Critical Care Medicine, Stanford, CA
| | - Shu-Chen Lyu
- Sean N. Parker Center for Allergy & Asthma Research at Stanford University and Division of Pulmonary, Allergy, and Critical Care Medicine, Stanford, CA
| | - Claudia Macaubas
- Department of Pediatrics, Program in Immunology, Stanford University, Stanford, CA
| | - Bryan Bunning
- Sean N. Parker Center for Allergy & Asthma Research at Stanford University and Division of Pulmonary, Allergy, and Critical Care Medicine, Stanford, CA
| | - Ziyuan He
- Sean N. Parker Center for Allergy & Asthma Research at Stanford University and Division of Pulmonary, Allergy, and Critical Care Medicine, Stanford, CA
| | - Elizabeth D. Mellins
- Department of Pediatrics, Program in Immunology, Stanford University, Stanford, CA
| | - Kari C. Nadeau
- Sean N. Parker Center for Allergy & Asthma Research at Stanford University and Division of Pulmonary, Allergy, and Critical Care Medicine, Stanford, CA
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15
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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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16
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Asero R, Ariano R, Aruanno A, Barzaghi C, Borrelli P, Busa M, Celi G, Cinquini M, Cortellini G, D’Auria F, De Carli M, Di Paolo C, Garzi G, Lodi Rizzini F, Magnani M, Manzotti G, Marra A, Miceli Sopo S, Murzilli F, Nucera E, Pinter E, Pravettoni V, Rivolta F, Rizzi A, Saporiti N, Scala E, Villalta D, Yacoub M, Zisa G. Systemic allergic reactions induced by labile plant-food allergens: Seeking potential cofactors. A multicenter study. Allergy 2021; 76:1473-1479. [PMID: 33080053 DOI: 10.1111/all.14634] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Revised: 09/13/2020] [Accepted: 10/05/2020] [Indexed: 01/17/2023]
Abstract
BACKGROUND Heat-and-pepsin-sensitive plant food allergens (PR-10 and profilin) sometimes cause systemic reaction. OBJECTIVE To detect the risk factors for systemic reactions induced by labile food allergens. METHODS A retrospective multicenter study was performed on patients with a documented history of systemic allergic reaction to labile plant food allergens and on age-matched controls with a history of oral allergy syndrome (OAS) induced by the same foods. Offending foods, their amount, and state (solid or liquid), and potential cofactors (nonsteroidal anti-inflammatory drugs, protonic pump inhibitors, exercise, alcohol, and fasting) were considered. RESULTS We studied 89 patients and 81 controls. Sensitization to PR-10 or profilin, IgE to Bet v 1 and/or Bet v 2, and foods causing OAS were similar in the two groups. Twenty patients experienced >1 systemic allergic reaction. Tree nuts, Rosaceae, Apiaceae, and soymilk were the main offending foods. Seventeen (19%) patients were taking a PPI when the systemic reaction occurred (vs 5% in controls; P < .025). The ingestion of the offending food in liquid form (soymilk) was frequent among patients (15%) but unusual among controls (2%; P < .025). Soy milk-induced systemic reactions were independent of PPI treatment. Fasting and excess of allergen, but not NSAID and exercise, were other relevant cofactors for systemic reactions. Systemic reactions occurred without any identifiable cofactor in 39 (44%) cases. CONCLUSION PR-10- and profilin-induced systemic reactions are facilitated by PPI, ingestion of large amounts of unprocessed foods, and fasting. Soybean beverages represent a risk for PR-10 hypersensitive patients and should be avoided.
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Affiliation(s)
- Riccardo Asero
- Ambulatorio di Allergologia Clinica san Carlo Paderno Dugnano (MI) Italia
| | | | - Arianna Aruanno
- Fondazione Policlinico Universitario A. Gemelli‐ IRCCS Università Cattolica del Sacro Cuore Roma Italy
| | - Claudio Barzaghi
- Ambulatorio di Allergologia UOC Medicina ASST Rhodenese, P.O Rho Rho Italia
| | - Paolo Borrelli
- SSD Dermatologia e Allergologia ‐ Ospedale Beauregard Aosta Italia
| | - Moira Busa
- Ambulatorio di Allergologia U.O.S. Dermatologia Ospedale di Mirano (VE) Mirano Italia
- Ambulatorio di Allergologia Ospedale di Bassano del Grappa (VI) Bassano del Grappa Italia
| | | | | | | | | | - Marco De Carli
- S.O.C Medicina 2 Presidio Ospedaliero "Santa Maria della Misericordia" Udine Italy
| | | | - Giulia Garzi
- Ambulatorio di Allergologia UOC Medicina Interna ed Immunologia Clinica, Policlinico Umberto I Roma Italia
| | - Fabio Lodi Rizzini
- Dipartimento Scienze Cliniche e Sperimentali Università Studi Brescia / SSVD Allergologia Spedali Civili Brescia Italy
| | | | | | - Alessandro Marra
- Ambulatorio di Allergologia UOC Medicina ASST Rhodenese, P.O Rho Rho Italia
| | - Stefano Miceli Sopo
- Pediatric Allergy Unit Pediatrics Area Department of Life Sciences and Public Health Policlinico Gemelli Fondazione Universitaria IRCCS Università Cattolica del Sacro Cuore Roma Italia
| | - Francesco Murzilli
- U.O.S.D. di Allergologia Ospedale S.S. Filippo e Nicola Avezzano (AQ) Italy
| | - Eleonora Nucera
- Fondazione Policlinico Universitario A. Gemelli‐ IRCCS Università Cattolica del Sacro Cuore Roma Italy
| | - Elena Pinter
- Ambulatorio di Allergologia UOC Medicina Interna ed Immunologia Clinica, Policlinico Umberto I Roma Italia
| | - Valerio Pravettoni
- UOC General Medicine Immunology and Allergology – IRCCS Foudation Ca’ Granda Ospedale Maggiore Policlinico Milan Italy
| | - Federica Rivolta
- UOC General Medicine Immunology and Allergology – IRCCS Foudation Ca’ Granda Ospedale Maggiore Policlinico Milan Italy
| | - Angela Rizzi
- Fondazione Policlinico Universitario A. Gemelli‐ IRCCS Università Cattolica del Sacro Cuore Roma Italy
| | - Nicoletta Saporiti
- Unit of Immunology Rheumatology, Allergy and Rare Diseases IRCCS Ospedale San Raffaele Milano Italy
| | | | - Danilo Villalta
- Immunologia e Allergologia Ospedale S. Maria degli Angeli Pordenone Italia
| | - Mona‐Rita Yacoub
- Unit of Immunology Rheumatology, Allergy and Rare Diseases IRCCS Ospedale San Raffaele Milano Italy
| | - Giuliana Zisa
- S.S. Allergologia e Immunologia Clinica S.C.D.U. Medicina Interna I ‐ A.O.U. Maggiore della Carità di Novara Novara Italy
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17
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Beitia JM, Vega Castro A, Cárdenas R, Peña-Arellano MI. Pru p 3 Sublingual Immunotherapy in Patients with Lipid Transfer Protein Syndrome: Is It Worth? Int Arch Allergy Immunol 2021; 182:447-454. [PMID: 33588417 DOI: 10.1159/000512613] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2020] [Accepted: 10/27/2020] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Lipid transfer proteins (LTPs) syndrome is an important cause of multiple plant food allergy in the Mediterranean area. The effectiveness of sublingual immunotherapy (SLIT) with the LTP Pru p 3 extract has been little investigated in the real-world setting. This study aimed to investigate the outcome of Pru p 3 SLIT in real-life patients with LTP syndrome with/without concurrent reactions to peanut and/or nuts. METHODS This was a prospective real-life study including all patients diagnosed with LTP allergy and treated with Pru p 3 SLIT between 2011 and 2018 in a tertiary hospital in Spain. Patients underwent open oral food challenge (OFC) tests for unpeeled peach and nuts/peanuts 1 year after the treatment started to assess food tolerance. A control group of patients diagnosed with LTP allergy who refused treatment with immunotherapy were included. Severity of symptoms and diet avoidance was recorded in both groups. RESULTS Twenty-nine patients with a median age of 24.7 years (range 5.5-43.1) were included: 100% were allergic to fruit; 72%, to peanut and/or nuts; 19 had a history of severe systemic reactions. Seven patients discontinued therapy; 3 (10%), due to adverse events. One year after SLIT start, 16 (73%) patients had negative OFC to peach; 95%, after 2 years; 69% had negative OFC to nuts/peanuts. The control group included 13 patients: 53.8% experienced reactions with new foods; severity of symptoms increased significantly (p < 0.001), and diet restrictions were maintained in this group. CONCLUSIONS SLIT with Pru p 3 shows a good safety profile, and avoid dietary restrictions in patients with LTP syndrome treated in the real-life setting.
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Affiliation(s)
- Juan María Beitia
- Allergy Service, Hospital Universitario de Guadalajara, Guadalajara, Spain.,ARADyAL Spanish Thematic Network and Co-operative Research Centre RD16/0006/0023, Spain
| | - Arantza Vega Castro
- Allergy Service, Hospital Universitario de Guadalajara, Guadalajara, Spain, .,ARADyAL Spanish Thematic Network and Co-operative Research Centre RD16/0006/0023, Spain,
| | - Remedios Cárdenas
- Allergy Service, Hospital Universitario de Guadalajara, Guadalajara, Spain.,ARADyAL Spanish Thematic Network and Co-operative Research Centre RD16/0006/0023, Spain
| | - Maria Isabel Peña-Arellano
- Allergy Service, Hospital Universitario de Guadalajara, Guadalajara, Spain.,ARADyAL Spanish Thematic Network and Co-operative Research Centre RD16/0006/0023, Spain
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18
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Midun E, Radulovic S, Brough H, Caubet JC. Recent advances in the management of nut allergy. World Allergy Organ J 2021; 14:100491. [PMID: 33510829 PMCID: PMC7811165 DOI: 10.1016/j.waojou.2020.100491] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2020] [Revised: 11/02/2020] [Accepted: 11/03/2020] [Indexed: 11/25/2022] Open
Abstract
Peanut/tree nut allergy is common and has been associated with particularly severe reactions. Epidemiological data have shown that the prevalence ranges between 0.05% and 4.9% for tree nut and between 0.5% and 3% for peanut. These large variations can be explained by differences in the age of included patients and the geographical region. In addition, the food consumption modality (ie, raw versus roasted) plays a major role, as heat treatment has the capacity to modify the allergenicity of nuts and legumes. Nut allergies tend to persist into adulthood and consequently have a high impact on quality of life. Recently, it has been demonstrated that a significant proportion of nut allergic patients are able to tolerate other nuts. As opposed to the avoidance of all nuts, this approach is currently proposed in several tertiary allergy centers. However, diagnosis of nut allergy is particularly difficult due to co-sensitization leading to high rate of false positive skin prick tests and/or specific IgE to whole allergen extracts. The use of component resolved diagnosis leads to major improvement of diagnosis, particularly to distinguish between primary and secondary nut allergies. The basophil activation test has been suggested to be useful but is still used mainly as a research tool. Thus, diagnosis remains mainly based on the oral food challenge, which is considered as the gold standard. Regarding treatment, avoidance remains the cornerstone of management of nut allergy. Oral immunotherapy is increasingly proposed as an alternative management strategy.
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Key Words
- Component-resolved diagnostic, CRD
- Cross reactivity
- Double-blind, placebo-controlled, food challenge, DBPCFC
- Food allergy
- Lipid transfer protein, LTP
- Oral allergy syndrome, OAS
- Oral food challenge, OFC
- Oral immunotherapy
- Oral induction tolerance, OIT
- Pathogenesis related protein type 10, PR-10
- Peanut
- Platelet-activating factor, PAF
- Pollen-food syndrome, PFS
- Precautionary Allergen Labels, (PAL)
- Skin prick test, SPT
- Tree nut
- Tree nut, TN
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Affiliation(s)
- Elise Midun
- Pediatric Allergy Unit, University Hospitals of Geneva and University of Geneva, Rue Willy Donzé 6, 1205 Geneva, Switzerland, University Lyon 1 Claude Bernard, 43 Boulevard Du 11-Novembre-1918, 69100, Villeurbanne, France
- Corresponding author.
| | - Suzana Radulovic
- Paediatric Allergy Group, Department of Women and Children's Health, King's College London, London, United Kingdom, Paediatric Allergy Group, Peter Gorer Dept of Immunobiology, School of Immunology & Microbial Sciences, King's College London, Guys' Hospital, London, United Kingdom, Children's Allergy Service, Evelina Children's Hospital, Guy's and St. Thomas' Hospital NHS Foundation Trust, London, United Kingdom
| | - Helen Brough
- Paediatric Allergy Group, Department of Women and Children's Health, King's College London, London, United Kingdom, Paediatric Allergy Group, Peter Gorer Dept of Immunobiology, School of Immunology & Microbial Sciences, King's College London, Guys' Hospital, London, United Kingdom, Children's Allergy Service, Evelina Children's Hospital, Guy's and St. Thomas' Hospital NHS Foundation Trust, London, United Kingdom
| | - Jean-Christoph Caubet
- Pediatric Allergy Unit, University Hospitals of Geneva and University of Geneva, Rue Willy Donzé 6, 1205, Geneva, Switzerland
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19
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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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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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21
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Effect of β-lactoglobulin on perception of astringency in red wine as measured by sequential profiling. Lebensm Wiss Technol 2020. [DOI: 10.1016/j.lwt.2020.109611] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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Asero R, Celi G, Scala E. Labile plant food allergens: Really so harmless? Case series and literature review. Allergy 2020; 75:1517-1518. [PMID: 31950505 DOI: 10.1111/all.14184] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2019] [Revised: 07/01/2020] [Accepted: 10/01/2020] [Indexed: 11/28/2022]
Affiliation(s)
- Riccardo Asero
- Ambulatorio di Allergologia Clinica San Carlo Paderno Dugnano Italy
| | - Giorgio Celi
- Ambulatorio di Allergologia Clinica Villa Pia Roma Italy
| | - Enrico Scala
- Ambulatorio di Allergologia Istituto Dermopatico dell'Immacolata Roma Italy
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Abstract
PURPOSE OF REVIEW Focusing on the strict relationship between house dust mites and crustaceans from the allergenic point of view. RECENT FINDINGS The well-known tropomyosin was considered for years as the cross-reacting allergen between shrimp and house dust mites. In the last few years, several allergens not only in shrimps but also in house dust mite have been identified and other molecules other than tropomyosin have been shown to cross-react between crustaceans and mites. The present review investigates the very complex allergen sources in shrimp and mites, giving a satisfactorily complete picture of the interrelationships between common allergens. Several minor HDM allergens are homologous to major and minor shrimp allergens; tropomyosin is not the only cross-reactive allergen between shrimp and mites.
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25
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Rizzi A, Chini R, Inchingolo R, Carusi V, Pandolfi F, Gasbarrini A, Nucera E. Nickel allergy in lipid transfer protein sensitized patients: Prevalence and clinical features. Int J Immunopathol Pharmacol 2020; 34:2058738420974895. [PMID: 33242297 PMCID: PMC7705783 DOI: 10.1177/2058738420974895] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2020] [Accepted: 10/27/2020] [Indexed: 12/12/2022] Open
Abstract
Nickel (Ni), the main responsible for allergic contact dermatitis worldwide, is also involved in systemic condition called "Systemic Nickel Sulfate Allergy Syndrome (SNAS)." Likewise, IgE-mediated reactivity to Lipid Transfer Protein (LTP) represents the main cause of primary food allergy in adults of Mediterranean countries. We evaluated the prevalence of SNAS in LTP allergic patients and investigated patients' clinical features with double sensitization (LTP and Ni). A retrospective, single-center, observational study was conducted performing a complete allergological work-up including: (1) skin prick tests; (2) serum specific IgE for plant food allergens and rPru p3 (LTP); (3) patch test with 5% Ni sulfate in petrolatum. We enrolled 140 LTP allergic patients of which 36 patients (25.7% of sample) showed additional positivity to Ni patch test. Patients with double sensitization were more frequently females and reported fewer cutaneous symptoms. Higher values of sIgE for peach, apple, peanut, walnut, grain, corn, and garlic were found in LTP allergic patients, while higher values for hazelnut in the other subgroup. The prevalence of SNAS in the LTP allergic population is clinically relevant. Moreover, the clinical and immunological profiles of patients with double sensitization were different from patients monosensitized to LTP.
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Affiliation(s)
- Angela Rizzi
- UOSD Allergologia e Immunologia Clinica,
Dip. Scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario A. Gemelli
IRCCS, Roma, Italy
- Università Cattolica del Sacro Cuore,
Roma, Italy
| | - Raffaella Chini
- UOSD Allergologia e Immunologia Clinica,
Dip. Scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario A. Gemelli
IRCCS, Roma, Italy
| | - Riccardo Inchingolo
- Università Cattolica del Sacro Cuore,
Roma, Italy
- UOC Pneumologia, Dip. Scienze Mediche e
Chirurgiche, Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma,
Italy
| | - Valentina Carusi
- UOSD Allergologia e Immunologia Clinica,
Dip. Scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario A. Gemelli
IRCCS, Roma, Italy
| | - Franco Pandolfi
- UOSD Allergologia e Immunologia Clinica,
Dip. Scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario A. Gemelli
IRCCS, Roma, Italy
- Università Cattolica del Sacro Cuore,
Roma, Italy
| | - Antonio Gasbarrini
- Università Cattolica del Sacro Cuore,
Roma, Italy
- UOC Gastroenterologia, Dip. Scienze
Mediche e Chirurgiche, Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma,
Italy
| | - Eleonora Nucera
- UOSD Allergologia e Immunologia Clinica,
Dip. Scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario A. Gemelli
IRCCS, Roma, Italy
- Università Cattolica del Sacro Cuore,
Roma, Italy
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Inomata N. Gibberellin-regulated protein allergy: Clinical features and cross-reactivity. Allergol Int 2020; 69:11-18. [PMID: 31784246 DOI: 10.1016/j.alit.2019.10.007] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2019] [Accepted: 10/26/2019] [Indexed: 12/24/2022] Open
Abstract
Gibberellin-regulated proteins (GRPs)/GASA proteins are members of cysteine-rich antimicrobial peptide families and are conserved in a broad range of plants. Some GRPs in fruits and pollens have been identified as allergens including peach Pru p 7, Japanese apricot Pru m 7, orange Cit s 7, pomegranate Pun g 7, and cypress pollen GRP. The clinical features of fruit-derived GRP allergies frequently include systemic reactions, multiple fruit allergies regardless of plant kingdom classifications and, less frequently, cofactor-dependence. Multiple fruit allergies might be related to cross-reactivity between GRPs. Clinical cross-reactivity, at least between the four fruit-derived GRPs, has been proven. In addition, GRP allergy induces peculiar clinical symptoms, such as laryngeal tightness and facial swelling, especially eyelid edema, which was proposed to be a predictive factor for Pru p 7 allergy. Fruit-derived GRPs have an unusually high content of cysteine, resulting in high stability to heat and resistance to digestive enzymes. Therefore, GRPs are considered "true" food allergens that induce severe allergic reactions. As an alternative mechanism of fruit-derived GRP allergies, cross-reactivity between fruit GRP and cypress pollen GRP, which might play a role as a sensitizer, is suspected. Taken together, these characteristics indicate GRPs are clinically relevant plant allergens. This review article summarizes our current knowledge of the clinical features and important aspects of GRP sensitization and allergy.
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Global Trends in Anaphylaxis Epidemiology and Clinical Implications. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY-IN PRACTICE 2019; 8:1169-1176. [PMID: 31786255 PMCID: PMC7152797 DOI: 10.1016/j.jaip.2019.11.027] [Citation(s) in RCA: 108] [Impact Index Per Article: 21.6] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Subscribe] [Scholar Register] [Received: 10/04/2019] [Revised: 11/18/2019] [Accepted: 11/18/2019] [Indexed: 12/20/2022]
Abstract
The true global scale of anaphylaxis remains elusive, because many episodes occur in the community without presentation to health care facilities, and most regions have not yet developed reliable systems with which to monitor severe allergic events. The most robust data sets currently available are based largely on hospital admissions, which are limited by inherent issues of misdiagnosis, misclassification, and generalizability. Despite this, there is convincing evidence of a global increase in rates of all-cause anaphylaxis, driven largely by medication- and food-related anaphylaxis. There is no evidence of parallel increases in global all-cause anaphylaxis mortality, with surprisingly similar estimates for case-fatality rates at approximately 0.5% to 1% of fatal outcomes for hospitalizations due to anaphylaxis across several regions. Studying regional patterns of anaphylaxis to certain triggers have provided valuable insights into susceptibility and sensitizing events: for example, the link between the mAb cetuximab and allergy to mammalian meat. Likewise, data from published fatality registers can identify potentially modifiable risk factors that can be used to inform clinical practice, such as prevention of delayed epinephrine administration, correct posturing during anaphylaxis, special attention to populations at risk (such as the elderly on multiple medications), and use of venom immunotherapy in individuals at risk of insect-related anaphylaxis.
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Ciprandi G, Del Barba P, Silvestri M, Barberi S, Tosca MA. Pru p 3 sensitization in children with allergy to Parietaria pollens. ACTA BIO-MEDICA : ATENEI PARMENSIS 2019; 90:265-268. [PMID: 31125006 PMCID: PMC6776197 DOI: 10.23750/abm.v90i2.7611] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/08/2018] [Accepted: 02/13/2019] [Indexed: 11/23/2022]
Abstract
Background: Pru p 3 is the major allergen of the peach and belongs to the LTP family. Pru p 3 sensitization has been associated with severe allergic symptoms after eating LTP-containing foods. However, a previous experience partially downsized the potential danger of Pru p 3 sensitization in a group of adult rhinitics. This study aimed to evaluate the real impact of Pru p 3 sensitization in children in a real-world setting. Methods: 82 consecutive paediatric patients (55 males and 27 females, mean age 8.19±4.23 years) with allergic rhinitis due to Parietaria pollen allergy and sensitization to Pru p 3, documented by ISAC test, were evaluated. Serum IgE was measured by ImmunoCap method. Allergic symptoms occurring after ingesting LTP-containing foods were considered and scored as oral allergy syndrome, food allergy, and anaphylaxis. Results: About one-quarter of Pru p 3-sensitized children reported anaphylaxis after ingesting LTP-containing foods, about half reported food allergy or oral allergy syndrome. Only ¼ was merely sensitized. Conclusions: Pru p 3 sensitization deserves careful attention in children contrary to what might occur in adult patients. It could depend on the age and the serum IgE level. Thus, Pru p 3 sensitization should be adequately interepreted and managed in clinical practice. (www.actabiomedica.it)
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Klingebiel C, Chantran Y, Arif‐Lusson R, Ehrenberg AE, Östling J, Poisson A, Liabeuf V, Agabriel C, Birnbaum J, Porri F, Sarrat A, Apoil P, Vivinus M, Garnier L, Chiriac AM, Caimmi D, Bourrain J, Demoly P, Guez S, Boralevi F, Lovato B, Palussière C, Leroy S, Bourrier T, Giovannini‐Chami L, Gouitaa M, Aferiat‐Derome A, Charpin D, Sofalvi T, Cabon‐Boudard I, Massabie‐Bouchat Y, Hofmann B, Bonardel N, Dron‐Gonzalvez M, Sterling B, Carsin A, Vivinus S, Poitevin B, Nicolau L, Liautard G, Soler C, Mezouar S, Annesi‐Maesano I, Mège J, Lidholm J, Vitte J. Pru p 7 sensitization is a predominant cause of severe, cypress pollen‐associated peach allergy. Clin Exp Allergy 2019; 49:526-536. [DOI: 10.1111/cea.13345] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2018] [Revised: 11/11/2018] [Accepted: 12/12/2018] [Indexed: 12/21/2022]
Affiliation(s)
| | - Yannick Chantran
- UPMC Univ Paris 06 INSERM UMRS 938 Centre de Recherche Saint‐Antoine, team “Immune System, Neuroinflammation and Neurodegenerative Diseases” Hôpital Saint‐Antoine Sorbonne Universités Paris France
- Immunology Department AP‐HP Saint‐Antoine Hospital Paris France
| | - Rihane Arif‐Lusson
- Aix‐Marseille Univ IRD APHM MEPHI IHU Méditerranée Infection Marseille France
| | | | | | - Alain Poisson
- Service de Pneumo‐Allergologie Hôpital Saint Joseph Marseille France
| | - Valérie Liabeuf
- Aix‐Marseille Univ APHM, Hôpital Timone Service de Dermatologie‐Vénéréologie Marseille France
| | - Chantal Agabriel
- Aix‐Marseille Univ APHM, Hôpital Timone Service de Pédiatrie Multidisciplinaire Marseille France
| | - Joëlle Birnbaum
- Service de Pneumologie et Allergologie CH du Pays d'Aix Aix‐en‐Provence France
| | - Françoise Porri
- Service de Pneumo‐Allergologie Hôpital Saint Joseph Marseille France
| | - Anne Sarrat
- Laboratoire d'Immunologie et Immunogénétique GH Pellegrin CHU Bordeaux Bordeaux France
| | - Pol‐André Apoil
- Institut Fédératif de Biologie Hôpital Purpan, CHU Toulouse Toulouse France
| | - Mylène Vivinus
- Laboratoire d'Immunologie Hôpital de l'Archet CHU Nice Nice France
| | - Lorna Garnier
- Laboratoire d'Immunologie CH Lyon Sud CHU Lyon Pierre‐Bénite France
| | - Anca Mirela Chiriac
- Département de pneumologie et addictologie CHU Montpellier Hôpital Arnaud‐de‐Villeneuve Univ Montpellier Montpellier France
- Sorbonne Universités INSERM UMRS 1136 IPLESP, team EPAR Paris France
| | - Davide‐Paolo Caimmi
- Département de pneumologie et addictologie CHU Montpellier Hôpital Arnaud‐de‐Villeneuve Univ Montpellier Montpellier France
- Sorbonne Universités INSERM UMRS 1136 IPLESP, team EPAR Paris France
| | - Jean‐Luc Bourrain
- Département de pneumologie et addictologie CHU Montpellier Hôpital Arnaud‐de‐Villeneuve Univ Montpellier Montpellier France
| | - Pascal Demoly
- Département de pneumologie et addictologie CHU Montpellier Hôpital Arnaud‐de‐Villeneuve Univ Montpellier Montpellier France
- Sorbonne Universités INSERM UMRS 1136 IPLESP, team EPAR Paris France
| | - Stéphane Guez
- Unité d'allergologie, GH Pellegrin, CHU Bordeaux Bordeaux France
| | - Franck Boralevi
- Unité de Dermatologie Pédiatrique Hôpital Pellegrin‐Enfants, CHU Bordeaux Bordeaux France
| | | | | | - Sylvie Leroy
- Service de Pneumologie Hôpital Pasteur CHU Nice Nice France
| | | | | | - Marion Gouitaa
- Aix‐Marseille Univ APHM, Hôpital Nord Service de Pneumologie Marseille France
| | | | - Denis Charpin
- Aix‐Marseille Univ APHM, Hôpital Timone Unité de Pneumologie Marseille France
| | - Tünde Sofalvi
- Aix‐Marseille Univ APHM, Hôpital Nord Service de Pneumologie Marseille France
| | - Isabelle Cabon‐Boudard
- Aix‐Marseille Univ APHM, Hôpital Timone Service de Chirurgie Pédiatrique Marseille France
| | | | | | | | | | - Benoît Sterling
- Medical Office Marseille France
- Aix‐Marseille Univ APHM, Hôpital Timone Service de Pneumo‐Pédiatrie Marseille France
| | - Ania Carsin
- Aix‐Marseille Univ APHM, Hôpital Timone Service de Pneumo‐Pédiatrie Marseille France
| | - Serge Vivinus
- Service de Pneumologie Hôpital Pasteur CHU Nice Nice France
| | | | | | | | | | - Soraya Mezouar
- Aix‐Marseille Univ IRD APHM MEPHI IHU Méditerranée Infection Marseille France
| | | | - Jean‐Louis Mège
- Aix‐Marseille Univ IRD APHM MEPHI IHU Méditerranée Infection Marseille France
| | | | - Joana Vitte
- Aix‐Marseille Univ IRD APHM MEPHI IHU Méditerranée Infection Marseille France
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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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Ciprandi G, Ferrero F, Comite P. The pragmatic relevance of Pru p 3 sensitization in patients with pollen allergy. REVUE FRANÇAISE D'ALLERGOLOGIE 2018; 58:473-474. [DOI: 10.1016/j.reval.2018.02.223] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/23/2023]
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Rial MJ, Sastre J. Food Allergies Caused by Allergenic Lipid Transfer Proteins: What Is behind the Geographic Restriction? Curr Allergy Asthma Rep 2018; 18:56. [PMID: 30206718 DOI: 10.1007/s11882-018-0810-x] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
PURPOSE OF REVIEW To critically examine evidence suggesting that food allergy induced by lipid transfer proteins (LTPs) follows a geographic pattern. RECENT FINDINGS LTP syndrome remains most common in the Mediterranean basin, with a clear gradient seen in prevalence of LTP sensitization between northern and southern Europe. We hypothesize that high levels of birch pollen seem to protect against LTP allergy, as these higher levels correlate with a lower prevalence of LTP hypersensitivity. Nevertheless, LTP food allergy cases still appear in areas having a high environmental level of birch pollen. Food allergy caused by LTP may be related to (1) primary sensitization to a food LTP allergen in the absence of pollinosis, (2) primary sensitization to LTP from a pollen source, and (3) co-sensitization to LTP from pollen and food.
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Affiliation(s)
- M J Rial
- Allergy Department, Hospital Universitario Fundación Jiménez Díaz, Universidad Autónoma de Madrid, Av. de los Reyes Católicos, 2, 28040, Madrid, Spain
- CIBERES, Instituto Salud Carlos III, Madrid, Spain
| | - J Sastre
- Allergy Department, Hospital Universitario Fundación Jiménez Díaz, Universidad Autónoma de Madrid, Av. de los Reyes Católicos, 2, 28040, Madrid, Spain.
- CIBERES, Instituto Salud Carlos III, Madrid, Spain.
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Einhorn L, Hofstetter G, Brandt S, Hainisch EK, Fukuda I, Kusano K, Scheynius A, Mittermann I, Resch-Marat Y, Vrtala S, Valenta R, Marti E, Rhyner C, Crameri R, Satoh R, Teshima R, Tanaka A, Sato H, Matsuda H, Pali-Schöll I, Jensen-Jarolim E. Molecular allergen profiling in horses by microarray reveals Fag e 2 from buckwheat as a frequent sensitizer. Allergy 2018; 73:1436-1446. [PMID: 29350763 PMCID: PMC6032949 DOI: 10.1111/all.13417] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/09/2018] [Indexed: 12/13/2022]
Abstract
Background Companion animals are also affected by IgE‐mediated allergies, but the eliciting molecules are largely unknown. We aimed at refining an allergen microarray to explore sensitization in horses and compare it to the human IgE reactivity profiles. Methods Custom‐designed allergen microarray was produced on the basis of the ImmunoCAP ISAC technology containing 131 allergens. Sera from 51 horses derived from Europe or Japan were tested for specific IgE reactivity. The included horse patients were diagnosed for eczema due to insect bite hypersensitivity, chronic coughing, recurrent airway obstruction and urticaria or were clinically asymptomatic. Results Horses showed individual IgE‐binding patterns irrespective of their health status, indicating sensitization. In contrast to European and Japanese human sensitization patterns, frequently recognized allergens were Aln g 1 from alder and Cyn d 1 from Bermuda grass, likely due to specific respiratory exposure around paddocks and near the ground. The most prevalent allergen for 72.5% of the tested horses (37/51) was the 2S‐albumin Fag e 2 from buckwheat, which recently gained importance not only in human but also in horse diet. Conclusion In line with the One Health concept, covering human health, animal health and environmental health, allergen microarrays provide novel information on the allergen sensitization patterns of the companion animals around us, which may form a basis for allergen‐specific preventive and therapeutic concepts.
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Affiliation(s)
- L. Einhorn
- The interuniversity Messerli Research Institute; University of Veterinary Medicine Vienna; Medical University Vienna and University Vienna; Vienna Austria
- Institute of Pathophysiology and Allergy Research; Center for Pathophysiology, Infectiology and Immunology; Medical University of Vienna; Vienna Austria
| | - G. Hofstetter
- The interuniversity Messerli Research Institute; University of Veterinary Medicine Vienna; Medical University Vienna and University Vienna; Vienna Austria
| | - S. Brandt
- Research Group Oncology; Equine Clinic; University of Veterinary Medicine Vienna; Vienna Austria
| | - E. K. Hainisch
- Research Group Oncology; Equine Clinic; University of Veterinary Medicine Vienna; Vienna Austria
| | - I. Fukuda
- Racehorse Hospital; Miho Training Center; Japan Racing Association; Mikoma Japan
| | - K. Kusano
- Racehorse Hospital; Miho Training Center; Japan Racing Association; Mikoma Japan
| | - A. Scheynius
- Science for Life Laboratory; Department of Clinical Science and Education; Karolinska Institutet, and Sachs’ Children and Youth Hospital; Södersjukhuset; Stockholm Sweden
| | - I. Mittermann
- Institute of Pathophysiology and Allergy Research; Center for Pathophysiology, Infectiology and Immunology; Medical University of Vienna; Vienna Austria
| | - Y. Resch-Marat
- Institute of Pathophysiology and Allergy Research; Center for Pathophysiology, Infectiology and Immunology; Medical University of Vienna; Vienna Austria
| | - S. Vrtala
- Institute of Pathophysiology and Allergy Research; Center for Pathophysiology, Infectiology and Immunology; Medical University of Vienna; Vienna Austria
| | - R. Valenta
- Institute of Pathophysiology and Allergy Research; Center for Pathophysiology, Infectiology and Immunology; Medical University of Vienna; Vienna Austria
| | - E. Marti
- Department of Clinical Research and Veterinary Public Health; Vetsuisse Faculty; University of Bern; Bern Switzerland
| | - C. Rhyner
- Swiss Institute for Allergy and Asthma Research (SIAF); Davos Switzerland
| | - R. Crameri
- Swiss Institute for Allergy and Asthma Research (SIAF); Davos Switzerland
| | - R. Satoh
- Division of Food Function Research; Food Research Institute; National Agriculture and Food Research Organization; Tsukuba Japan
| | - R. Teshima
- National Institute of Health Sciences; Tokyo Japan
| | - A. Tanaka
- Laboratory of Comparative Animal Medicine; Division of Animal Life Science; Tokyo University of Agriculture and Technology; Fuchu Japan
| | - H. Sato
- Laboratory of Veterinary Molecular Pathology and Therapeutics; Division of Animal Life Science; Tokyo University of Agriculture and Technology; Fuchu Japan
| | - H. Matsuda
- Laboratory of Veterinary Molecular Pathology and Therapeutics; Division of Animal Life Science; Tokyo University of Agriculture and Technology; Fuchu Japan
| | - I. Pali-Schöll
- The interuniversity Messerli Research Institute; University of Veterinary Medicine Vienna; Medical University Vienna and University Vienna; Vienna Austria
- Institute of Pathophysiology and Allergy Research; Center for Pathophysiology, Infectiology and Immunology; Medical University of Vienna; Vienna Austria
| | - E. Jensen-Jarolim
- The interuniversity Messerli Research Institute; University of Veterinary Medicine Vienna; Medical University Vienna and University Vienna; Vienna Austria
- Institute of Pathophysiology and Allergy Research; Center for Pathophysiology, Infectiology and Immunology; Medical University of Vienna; Vienna Austria
- AllergyCare; Allergy Diagnosis and Study Center; Vienna Austria
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Graziano S, Gullì M, Marmiroli N. Detection of allergen coding sequences of kiwi, peach, and apple in processed food by qPCR. JOURNAL OF THE SCIENCE OF FOOD AND AGRICULTURE 2018; 98:3129-3139. [PMID: 29210450 DOI: 10.1002/jsfa.8814] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/05/2017] [Revised: 11/13/2017] [Accepted: 11/30/2017] [Indexed: 06/07/2023]
Abstract
BACKGROUND Food traceability becomes lifesaving for persons suffering severe allergy or intolerance, and therefore need a complete avoidance of the immune-trigger food. This paper describes how to fingerprint the presence of some allergenic species (kiwi, peach, and apple) in foods by quantitative real-time PCR (qPCR). RESULTS Five DNA extraction procedures were tested on fruits and foods. The results were statistically evaluated, and discussed. Analysis by qPCR with SYBR Green was developed to detect traces of these allergenic species in foods. Plasmids containing the target sequences of kiwi, peach and apple were employed as internal reference standard. Analysis of spiked food samples showed a limit of detection of 25 mg kg-1 for kiwi, 20 mg kg-1 for peach and 50 mg kg-1 for apple. CONCLUSION The qPCR method here developed, combined with the use of internal plasmid reference standard, represents a specific system for the quick detection of allergenic species in complex food matrices, with a limit of detection comparable with those reported using more time-consuming methods. © 2017 Society of Chemical Industry.
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Affiliation(s)
- Sara Graziano
- Department of Chemistry, Life Sciences and Environmental Sustainability, University of Parma, Parma, Italy
| | - Mariolina Gullì
- Department of Chemistry, Life Sciences and Environmental Sustainability, University of Parma, Parma, Italy
- Interdepartmental Center SITEIA.PARMA, University of Parma, Parma, Italy
| | - Nelson Marmiroli
- Department of Chemistry, Life Sciences and Environmental Sustainability, University of Parma, Parma, Italy
- Interdepartmental Center SITEIA.PARMA, University of Parma, Parma, Italy
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Abstract
Food allergies manifest in a variety of clinical conditions within the gastrointestinal tract, skin and lungs, with the most dramatic and sometimes fatal manifestation being anaphylactic shock. Major progress has been made in basic, translational and clinical research, leading to a better understanding of the underlying immunological mechanisms that lead to the breakdown of clinical and immunological tolerance against food antigens, which can result in either immunoglobulin E (IgE)-mediated reactions or non-IgE-mediated reactions. Lifestyle factors, dietary habits and maternal-neonatal interactions play a pivotal part in triggering the onset of food allergies, including qualitative and quantitative composition of the microbiota. These factors seem to have the greatest influence early in life, an observation that has led to the generation of hypotheses to explain the food allergy epidemic, including the dual-allergen exposure hypothesis. These hypotheses have fuelled research in preventive strategies that seek to establish desensitization to allergens and/or tolerance to allergens in affected individuals. Allergen-nonspecific therapeutic strategies have also been investigated in a number of clinical trials, which will eventually improve the treatment options for patients with food allergy.
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36
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Park YA, Jeong KU, Kim YH, Sol IS, Kim KW, Sohn MH, Lee SY, Kim KE. Etiology and clinical feature of oral allergy syndrome in children. ALLERGY ASTHMA & RESPIRATORY DISEASE 2018. [DOI: 10.4168/aard.2018.6.4.219] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Affiliation(s)
- Young A Park
- Department of Pediatrics and Institute of Allergy, Yonsei University College of Medicine, Seoul, Korea
| | - Kyung-Uk Jeong
- Department of Pediatrics, Ajou University College of Medicine, Suwon, Korea
| | - Yoon Hee Kim
- Department of Pediatrics and Institute of Allergy, Yonsei University College of Medicine, Seoul, Korea
| | - In Suk Sol
- Department of Pediatrics and Institute of Allergy, Yonsei University College of Medicine, Seoul, Korea
| | - Kyung Won Kim
- Department of Pediatrics and Institute of Allergy, Yonsei University College of Medicine, Seoul, Korea
| | - Myung Hyun Sohn
- Department of Pediatrics and Institute of Allergy, Yonsei University College of Medicine, Seoul, Korea
| | - Soo Young Lee
- Department of Pediatrics, Ajou University College of Medicine, Suwon, Korea
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Geiselhart S, Nagl C, Dubiela P, Pedersen AC, Bublin M, Radauer C, Bindslev-Jensen C, Hoffmann-Sommergruber K, Mortz CG. Concomitant sensitization to legumin, Fag e 2 and Fag e 5 predicts buckwheat allergy. Clin Exp Allergy 2017; 48:217-224. [PMID: 29171912 PMCID: PMC5814722 DOI: 10.1111/cea.13068] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2017] [Revised: 10/11/2017] [Accepted: 11/10/2017] [Indexed: 12/03/2022]
Abstract
Background Buckwheat (Fagopyrum esculentum) has become increasingly popular as a healthy food in Europe. However, for sensitized individuals, consumption can cause anaphylactic reactions. The aim of this study was to identify individual well‐characterized buckwheat allergens for component‐resolved diagnosis. Methods Patients were selected by positive skin prick test to buckwheat and divided into two groups: (1) sensitized to buckwheat without clinical symptoms and (2) buckwheat allergy. Buckwheat proteins were extracted from raw buckwheat seeds, purified applying a combination of protein precipitation and chromatographic methods, and analyzed by IgE immunoblotting and ELISA. Results Buckwheat‐allergic patients had a significantly larger median skin prick test weal diameter for buckwheat than the sensitized group and the positive control. Also, IgE immunoblotting clearly showed a distinct pattern in sera from allergic patients when compared to sensitized individuals. Several IgE‐reactive proteins were purified from crude buckwheat extract, namely legumin (Fag e 1 plus its large subunit), Fag e 2 (2S albumin), and newly identified Fag e 5 (vicilin‐like) as well as hevein‐like antimicrobial peptides, designated Fag e 4. All four allergens showed superior diagnostic precision compared to extract‐based ImmunoCAP with high sensitivity as well as high specificity. Conclusions Patients with clinical symptoms clearly show a distinct allergen recognition pattern. We characterized a buckwheat vicilin‐like protein as a new relevant marker allergen, designated Fag e 5. Additionally, another new allergen, Fag e 4, potentially important for cross‐reactivity to latex was added to the allergen panel of buckwheat. Further, our data show that the full‐length legumin comprising both, large and small subunit should be applied for component‐resolved diagnosis. Our data indicate that concomitant sensitization to legumin, Fag e 2 and Fag e 5, predicts buckwheat allergy.
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Affiliation(s)
- S Geiselhart
- Department of Pathophysiology and Allergy Research, Medical University of Vienna, Vienna, Austria
| | - C Nagl
- Department of Pathophysiology and Allergy Research, Medical University of Vienna, Vienna, Austria
| | - P Dubiela
- Department of Pathophysiology and Allergy Research, Medical University of Vienna, Vienna, Austria
| | - A C Pedersen
- Department of Dermatology and Allergy Center, Odense Research Center for Anaphylaxis (ORCA), Odense University Hospital, Odense, Denmark
| | - M Bublin
- Department of Pathophysiology and Allergy Research, Medical University of Vienna, Vienna, Austria
| | - C Radauer
- Department of Pathophysiology and Allergy Research, Medical University of Vienna, Vienna, Austria
| | - C Bindslev-Jensen
- Department of Dermatology and Allergy Center, Odense Research Center for Anaphylaxis (ORCA), Odense University Hospital, Odense, Denmark
| | - K Hoffmann-Sommergruber
- Department of Pathophysiology and Allergy Research, Medical University of Vienna, Vienna, Austria
| | - C G Mortz
- Department of Dermatology and Allergy Center, Odense Research Center for Anaphylaxis (ORCA), Odense University Hospital, Odense, Denmark
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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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Affiliation(s)
- Shikun Ma
- Department of Allergy, Peking Union Medical College Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences, Beijing, People’s Republic of China
| | - Ruiqi Wang
- Department of Allergy, Peking Union Medical College Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences, Beijing, People’s Republic of China
| | - Li Nie
- Beijing Center for Disease Control and Prevention, Beijing, People’s Republic of China
| | - Jia Yin
- Department of Allergy, Peking Union Medical College Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences, Beijing, People’s Republic of China
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40
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Wangorsch A, Jamin A, Lidholm J, Gräni N, Lang C, Ballmer-Weber B, Vieths S, Scheurer S. Identification and implication of an allergenic PR-10 protein from walnut in birch pollen associated walnut allergy. Mol Nutr Food Res 2017; 61. [PMID: 28070926 DOI: 10.1002/mnfr.201600902] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2016] [Revised: 12/21/2016] [Accepted: 12/23/2016] [Indexed: 02/04/2023]
Abstract
SCOPE English walnut (Juglans regia) belongs to the most important allergenic tree nuts. Co-sensitization with birch (Betula verrucosa) pollen has been reported. We aimed to identify a walnut allergen homologous to the major birch pollen allergen Bet v 1. METHODS AND RESULTS A cDNA encoding a Bet v 1-homologous allergen (Jug r 5) in walnut kernels was cloned by RT-PCR. Jug r 5 was expressed in Escherichia coli, purified by column chromatography and characterized by circular dichroism spectroscopy. Specific IgE levels to walnut, Bet v 1, and Jug r 5 in birch pollen allergics (n = 16) with concomitant walnut allergy were measured by ImmunoCAP: 44% of the patients were tested positive to walnut while 94% were reactive to Jug r 5, and 100% to Bet v 1. Jug r 5 and Bet v 1 allergens showed bidirectional IgE cross-reactivity by competitive ELISA and were capable of inducing histamine release from effector cells. Immunoblot competition experiments demonstrated the presence of IgE-reactive Jug r 5 in walnut extract, but at low levels. CONCLUSION A Bet v 1-like allergen was identified in walnut. Diagnostic use of Jug r 5 will compensate for the low sensitivity of walnut extract for patients with birch pollen associated walnut allergy.
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Affiliation(s)
- Andrea Wangorsch
- VPr1 Research Group Molecular Allergology, Paul-Ehrlich-Institut, Langen, Germany
| | - Annette Jamin
- VPr1 Research Group Molecular Allergology, Paul-Ehrlich-Institut, Langen, Germany
| | | | - Nora Gräni
- Department of Dermatology, University Hospital Zürich, Zürich, Switzerland
| | - Claudia Lang
- Department of Dermatology, University Hospital Zürich, Zürich, Switzerland
| | - Barbara Ballmer-Weber
- Department of Dermatology, University Hospital Zürich, Zürich, Switzerland.,Center of Dermatology and Allergology, Luzerner Kantonsspital, Luzern, Switzerland
| | - Stefan Vieths
- VPr1 Research Group Molecular Allergology, Paul-Ehrlich-Institut, Langen, Germany
| | - Stephan Scheurer
- VPr1 Research Group Molecular Allergology, Paul-Ehrlich-Institut, Langen, Germany
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Ciprandi G, De Amici M, Di Martino ML, Barocci F, Comite P. The impact of age on Pru p 3 IgE production in Italy. Asia Pac Allergy 2017; 7:42-47. [PMID: 28154805 PMCID: PMC5287070 DOI: 10.5415/apallergy.2017.7.1.42] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2017] [Accepted: 01/04/2017] [Indexed: 11/22/2022] Open
Abstract
Background Pollen allergy may be frequently associated with fruit-vegetables: the so-called pollen food syndrome. Pru p 3 is the most relevant peach allergen. Previously, it has been reported that serum specific IgE level to Pru p 3 depends on age in a limited geographic area. Objective This study aimed to to test the hypothesis about the differences of Pru p 3 sensitization across Italy, mainly concerning the impact of age. Methods The current study was retrospective and multicentre, involving 2 labs in Northern Italy (709 subjects), 1 in Genoa (1,040 subjects), and 1 in Southern Italy (2,188 subjects). All of them referred to labs for IgE testing because of suspected food allergy. Serum IgE to Pru p 3 was assessed in all subjects. Results Sixteen point seven percent (16.7%) of subjects were sensitized to Pru p 3. Sensitization percentage sigificantly decreased over time. The serum IgE levels increased up to young adulthood and then decreased until aging. Conclusion Our experience demonstrates that Pru p 3 sensitization and production are closely age-dependent phenomena.
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Affiliation(s)
- Giorgio Ciprandi
- Allergy and Laboratory Medicine Department, IRCCS-AOU San Martino-IST, 16132 Genoa, Italy
| | - Mara De Amici
- Department of Pediatrics, Foundation IRCCS Policlinico San Matteo, 27100 Pavia, Italy
| | | | - Fiorella Barocci
- Immunohematology and Transfusion Medicine, AO G. Salvini, 20024, Garbagnate Milanese (MI), Italy
| | - Paola Comite
- Allergy and Laboratory Medicine Department, IRCCS-AOU San Martino-IST, 16132 Genoa, Italy
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42
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Vanga SK, Jain M, Raghavan V. Significance of fruit and vegetable allergens: Possibilities of its reduction through processing. FOOD REVIEWS INTERNATIONAL 2016. [DOI: 10.1080/87559129.2016.1239208] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Affiliation(s)
- Sai Kranthi Vanga
- Department of Bioresource Engineering, Faculty of Agricultural and Environmental Sciences, McGill University, Sainte-Anne-de-Bellevue, Quebec, Canada
| | - Mohit Jain
- Department of Bioresource Engineering, Faculty of Agricultural and Environmental Sciences, McGill University, Sainte-Anne-de-Bellevue, Quebec, Canada
| | - Vijaya Raghavan
- Department of Bioresource Engineering, Faculty of Agricultural and Environmental Sciences, McGill University, Sainte-Anne-de-Bellevue, Quebec, Canada
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Patel A, Bahna SL. Hypersensitivities to sesame and other common edible seeds. Allergy 2016; 71:1405-13. [PMID: 27332789 DOI: 10.1111/all.12962] [Citation(s) in RCA: 50] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/21/2016] [Indexed: 12/18/2022]
Abstract
Several seeds have been increasingly incorporated in various food items, with consequent risk of hypersensitivity reactions that are often severe. Identification of the specific seed as the culprit is often not explored or is difficult to verify. In this article, we reviewed the English literature from January 1930 to March 2016 using PubMed and Google Scholar searching for publications relevant to hypersensitivity to common edible seeds, namely sesame, sunflower seed, poppy seed, pumpkin seed, flaxseed, and mustard seed. Considering the worldwide consumption of those seeds, the number of published articles on the subject was relatively small and was mainly as case reports rather than large series. Allergy to sesame was more reported than to other seeds, with an estimated prevalence of 0.1-0.2%. In this review, we summarize the information relevant to each of the six seeds and their oils regarding the manifestations, routes of exposure, identified major allergens, and cross-reactivity with other seeds or other foods. We also addressed the important role of a thorough history taking in suspecting seed allergy, the limited reliability of routine diagnostic procedures, and the importance of verification by appropriate challenge tests. At present, management is basically dietary avoidance and the use of symptomatic medications that may include epinephrine auto-injectors. We did not encounter any well-designed studies on immunotherapy for seed allergy, but it is hoped that such a gap be filled by the development of safe effective protocols in the near future.
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Affiliation(s)
- A. Patel
- Allergy & Immunology Section; Louisiana State University Health; Shreveport LA USA
| | - S. L. Bahna
- Allergy & Immunology Section; Louisiana State University Health; Shreveport LA USA
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Faber MA, Van Gasse AL, Decuyper II, Uyttebroek A, Sabato V, Hagendorens MM, Bridts CH, De Clerck LS, Fernandez-Rivas M, Pascal M, Diaz-Perales A, Ebo DG. IgE-reactivity profiles to nonspecific lipid transfer proteins in a northwestern European country. J Allergy Clin Immunol 2016; 139:679-682.e5. [PMID: 27522157 DOI: 10.1016/j.jaci.2016.06.016] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2016] [Revised: 05/18/2016] [Accepted: 06/03/2016] [Indexed: 11/19/2022]
Affiliation(s)
- Margaretha A Faber
- Department of Immunology, Allergology, and Rheumatology, University of Antwerp and Antwerp University Hospital, Antwerp, Belgium
| | - Athina L Van Gasse
- Department of Immunology, Allergology, and Rheumatology, University of Antwerp and Antwerp University Hospital, Antwerp, Belgium; Department of Paediatrics, University of Antwerp and Antwerp University Hospital, Antwerp, Belgium
| | - Ine I Decuyper
- Department of Immunology, Allergology, and Rheumatology, University of Antwerp and Antwerp University Hospital, Antwerp, Belgium; Department of Paediatrics, University of Antwerp and Antwerp University Hospital, Antwerp, Belgium
| | - Astrid Uyttebroek
- Department of Immunology, Allergology, and Rheumatology, University of Antwerp and Antwerp University Hospital, Antwerp, Belgium
| | - Vito Sabato
- Department of Immunology, Allergology, and Rheumatology, University of Antwerp and Antwerp University Hospital, Antwerp, Belgium
| | - Margo M Hagendorens
- Department of Immunology, Allergology, and Rheumatology, University of Antwerp and Antwerp University Hospital, Antwerp, Belgium; Department of Paediatrics, University of Antwerp and Antwerp University Hospital, Antwerp, Belgium
| | - Chris H Bridts
- Department of Immunology, Allergology, and Rheumatology, University of Antwerp and Antwerp University Hospital, Antwerp, Belgium
| | - Luc S De Clerck
- Department of Immunology, Allergology, and Rheumatology, University of Antwerp and Antwerp University Hospital, Antwerp, Belgium
| | | | - Mariona Pascal
- Immunology Department, Centre de Diagnòstic Biomèdic, Hospital Clínic, Universitat de Barcelona and Institut d'Investigacions Biomèdiques August Pi i Sunyer, Barcelona, Spain
| | | | - Didier G Ebo
- Department of Immunology, Allergology, and Rheumatology, University of Antwerp and Antwerp University Hospital, Antwerp, Belgium.
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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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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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Verrill L, Bruns R, Luccioli S. Prevalence of self-reported food allergy in U.S. adults: 2001, 2006, and 2010. Allergy Asthma Proc 2015; 36:458-67. [PMID: 26453524 DOI: 10.2500/aap.2015.36.3895] [Citation(s) in RCA: 60] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
BACKGROUND Epidemiologic evidence indicates that food allergies are increasing in the population. Information on a change in self-reported food allergy (srFA) in adults over time is lacking. OBJECTIVE To report the prevalence of srFA and compare differences at three time points over a decade. METHODS We analyzed srFA and reported physician-diagnosed food allergy in >4000 U.S. adults who participated in the 2010 U.S. Food and Drug Administration Food Safety Survey. Information on causative food(s), reaction severity characteristics, and various diagnostic factors was also analyzed. We compared 2010 Food Safety Survey data with 2006 and 2001 data, and highlighted relevant differences. RESULTS SrFA prevalence increased significantly, to 13% in 2010 and 14.9% in 2006 compared with 9.1% in 2001 (p < 0.001). Physician diagnosed food allergy was 6.5% in 2010, which was not significantly different compared with 7.6% in 2006 and 5.3% in 2001. SrFA increased in both men and women, non-Hispanic white and black adults, 50-59 year olds, and in adults with a high school or lower education. In 2010, milk, shellfish, and fruits were the most commonly reported food allergens, similar to 2001. Also, in 2010, 15% of reactions reportedly required a hospital visit and 8.4% were treated with epinephrine. Minor differences in reaction severity characteristics were noted among the surveys. CONCLUSIONS Analysis of survey results indicates that the prevalence of srFA increased among U.S. adults from 2001 to 2010 and that adults are increasingly self-reporting FAs without obtaining medical diagnosis. Improved education about food allergies is needed for this risk group.
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Affiliation(s)
- Linda Verrill
- Center for Food Safety and Applied Nutrition, Division of Public Health, Informatics, and Analytics, Consumer Studies Branch, U.S. Food and Drug Administration, College Park, Maryland, USA
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Nucera E, Mezzacappa S, Aruanno A, Pecora V, Rizzi A, Ricci AG, Ferraironi M, Buonomo A, Schiavino D. Hypersensitivity to major panallergens in a population of 120 patients. Postepy Dermatol Alergol 2015; 32:255-61. [PMID: 26366148 PMCID: PMC4565840 DOI: 10.5114/pdia.2015.53321] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2014] [Revised: 09/02/2014] [Accepted: 03/05/2015] [Indexed: 11/17/2022] Open
Abstract
INTRODUCTION Lipid transfer proteins (LTP), profilin and PR-10 are the most important panallergens in central and southern Italy. Lipid transfer proteins are stable molecules, predominantly present in the fruit peel, which can induce systemic symptoms after ingestion of vegetables. Profilin and PR-10 are randomly distributed in the pulp and peel. Both are labile proteins and usually determine reactions restricted to the oral cavity. Panallergens-specific IgE may cross-react with homologues from different plant sources, due to their conserved structure. AIM To assess the pattern of sensitization to panallergens and the correlation with the clinical history and the allergological evaluation of food and aeroallergens. MATERIAL AND METHODS One hundred and twenty patients with adverse reactions after vegetables ingestion underwent skin prick tests (SPT) with commercial extracts of plant-derived foods and inhalant allergens and commercial extracts of LTP, profilin and PR-10. RESULTS Many patients presented positive SPT with different plant-food allergens. We found that 76 patients were sensitized to LTP, 14 to profilin and 5 to PR-10. In the LTP-sensitized group, 64 (84%) patients suffered from systemic symptoms while the patients sensitized only to profilin referred the oral allergy syndrome. CONCLUSIONS This study shows a high rate of sensitization to LTP in our population according to the literature about food allergy in our geographical area and confirms the literature data about the symptoms referred by patients with sensitization to panallergens. Panallergens should be considered as clinically relevant food allergens.
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Affiliation(s)
- Eleonora Nucera
- Allergy Unit, Università Cattolica del Sacro Cuore - Policlinico "A. Gemelli", Rome, Italy. Head of the Unit: Domenico Schiavino
| | - Simona Mezzacappa
- Allergy Unit, Università Cattolica del Sacro Cuore - Policlinico "A. Gemelli", Rome, Italy. Head of the Unit: Domenico Schiavino
| | - Arianna Aruanno
- Allergy Unit, Università Cattolica del Sacro Cuore - Policlinico "A. Gemelli", Rome, Italy. Head of the Unit: Domenico Schiavino
| | - Valentina Pecora
- Allergy Unit, Università Cattolica del Sacro Cuore - Policlinico "A. Gemelli", Rome, Italy. Head of the Unit: Domenico Schiavino
| | - Angela Rizzi
- Allergy Unit, Università Cattolica del Sacro Cuore - Policlinico "A. Gemelli", Rome, Italy. Head of the Unit: Domenico Schiavino
| | - Anna Giulia Ricci
- Allergy Unit, Università Cattolica del Sacro Cuore - Policlinico "A. Gemelli", Rome, Italy. Head of the Unit: Domenico Schiavino
| | - Manuela Ferraironi
- Allergy Unit, Università Cattolica del Sacro Cuore - Policlinico "A. Gemelli", Rome, Italy. Head of the Unit: Domenico Schiavino
| | - Alessandro Buonomo
- Allergy Unit, Università Cattolica del Sacro Cuore - Policlinico "A. Gemelli", Rome, Italy. Head of the Unit: Domenico Schiavino
| | - Domenico Schiavino
- Allergy Unit, Università Cattolica del Sacro Cuore - Policlinico "A. Gemelli", Rome, Italy. Head of the Unit: Domenico Schiavino
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Update on the understanding, diagnosis and tailored management of anaphylaxis: making progress. Curr Opin Allergy Clin Immunol 2015; 14:307-8. [PMID: 24936852 DOI: 10.1097/aci.0000000000000081] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Van Winkle RC, Chang C. The biochemical basis and clinical evidence of food allergy due to lipid transfer proteins: a comprehensive review. Clin Rev Allergy Immunol 2014. [PMID: 23179517 DOI: 10.1007/s12016-012-8338-7] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
Plant lipid transfer proteins (LTPs) are ubiquitous proteins that are found in divergent plant species. Although the exact function of LTPs is not fully understood, LTPs are conserved across a broad range of plant species. Because LTPs share structural features, there is an increased probability for significant allergic cross-reactivity. The molecular features of LTPs also decrease the probability of degradation due to cooking or digestion, thereby increasing the probability of systemic absorption and severe allergic reactions. LTP allergy, unlike other forms of anaphylaxis, tends to occur more frequently in areas of lower latitude. The geographic distribution of LTP allergy, along with evidence of increased sensitization after respiratory exposure, has led to the hypothesis that LTP-related food allergy may be secondary to sensitization via the respiratory route. Clinical reactions associated with LTPs have broad clinical phenotypes and can be severe in nature. Life-threatening clinical reactions have been associated with ingestion of a multitude of plant products. Component-resolved diagnosis has played a significant role in research applications for LTP allergy. In the future, component-resolved diagnosis may play a significant role in day-to-day clinical care. Also, quantitative analysis of LTPs in foodstuffs may allow for the identification and/or production of low-LTP foods, thereby decreasing the risk to patients with LTP allergy. Furthermore, sublingual immunotherapy may provide a therapeutic option for patients with LTP allergy.
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Affiliation(s)
- R Christopher Van Winkle
- Division of Allergy and Immunology, Thomas Jefferson University, Nemours/A.I. duPont Hospital for Children, Philadelphia, PA, USA
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