Component-resolved diagnostics study on nut sensitization and cross-reactivity in China.

Component-resolved diagnosis of peach allergy and its relationship with prevalent allergenic pollens in China

A comprehensive analysis of the components of common weed pollen and related allergens in patients with allergic diseases in southern China

Component-Resolved Diagnosis (CRD) of Type I Allergy with Recombinant Grass and Tree Pollen Allergens by Skin Testing

Assessment of component-resolved in vitro diagnosis of celeriac allergy

<b>Background:</b> Mugwort, timothy, and birch are commonly spread pollen allergens across China. Although several studies have described the rates of sensitization to mugwort, timothy, and birch in China, most of them just focus on specific whole-allergen extracts but little is known about the co-sensitization characteristics of its allergen components. This study aimed to explore patterns of response to mugwort, timothy, birch, and their major allergen components. <b>Method:</b> Serum specific IgE levels of allergen components of mugwort, timothy, birch, and cross-reactive carbohydrate determinants (CCD) were detected in 160 patients whose serum showed at least positive one of mugwort, timothy, and birch allergens via EUROBlotMaster system. Latent class analysis was used to identify underlying patterns of sensitization to a series of allergen components and their corresponding extracts. <b>Results:</b> 88.8% of patients with allergic rhinitis and/or asthma were positive for mugwort-sIgE, 30% for timothy-sIgE, and 32.5% for birch-sIgE. By using the LCA model, three sensitization patterns as “Mugwort, Art v 4, Bet v 2 and Phl p 12 co-sensitized”, “Timothy, mugwort, and CCD co-sensitized”, “Mugwort and Art v 1 co-sensitized” were revealed based on optimal statistical fit in this study. The spearman’s coefficient between CCD and timothy is larger than the corresponding values of CCD with mugwort or birch. <b>Conclusion:</b> CCD and profilin, as minor allergens in pollens, are associated with other pollen sIgE false positives presumably due to cross-reactivity. Patients sensitized with profilin had a significantly higher risk of sensitization to other pollens.

Pollen is the most common outdoor allergen that causes allergic rhinitis and asthma, which seriously affects patient quality of life and extensive cross-reactivity occurs between pollen allergens. The study enrolled 84 patients with respiratory allergies and at least one pollen allergy who visited the clinic. Specific-IgE was detected via immunoblotting in the sera of patients with positive respiratory allergies to pollen. IgE of the components and cross-reactive carbohydrate determinants (CCD) were evaluated using a fluorescence-encoded microsphere assay. Our results suggest that Artemisia absinthium, Artemisia vulgaris, Humulus scandens, Amaranthus, Parietaria micrantha allergies are most common in the northern region, and that weed pollen remains the major pollen allergen in the northern region. Among the different age groups, the positive rate of Platanus pollen allergens was significantly higher in patients ≤18 years of age than in those aged >18 years (55.56% vs. 9.17%, χ² = 0.55, p < 0.027). Patients with allergic rhinitis and asthma had an increased positive rate for Betula pollen allergen (20.00% vs. 37.93 χ² = 7.87, p = 0.005) and Platanus pollen allergen (27.27% vs. 51.72%, χ² = 11.05, p = 0.0008) than those with allergic rhinitis alone, although the allergen positivity rate did not significantly differ between sexes. In addition, the positivity of sIgE of allergen components did not reveal a correlation with clinical symptoms and anti-CCD IgE positivity was 1.19% (1/84) among all patients. The study found the distribution characteristics of common pollen allergens in Beijing among patients of different ages and genders and with different allergic diseases, as well as the relationship between pollen allergen components and symptoms. The positivity rate of CCD for respiratory allergic diseases in Beijing was not high as well.

Three patterns of sensitization to mugwort, timothy, birch and their major allergen components revealed by Latent class analysis

ObjectiveBermuda grass pollen is a common inhaled allergen. The aim of this study was to investigate the molecular sensitization patterns to major pollen allergens (Bermuda grass, Mugwort and Timothy grass) and cross-reactive carbohydrate determinants (CCD) in Bermuda grass sensitized patients in southern China.MethodsSerum specific IgE (sIgE) levels of Bermuda grass allergen components (Cyn d 1 and Cyn d 12), Timothy grass allergen components (Phl p 1, Phl p 4, Phl p 5, Phl p 7 and Phl p 12), Mugwort allergen components (Art v 1, Art v 3 and Art v 4) and CCD were detected in 78 patients sensitized to Bermuda grass via EUROBlotMaster system.ResultsCompared with CCD-positive patients, those with negative CCD results had significant higher positive rates of Cyn d 1 (47.8% vs 14.5%), Phl p 1 (26.1% vs 7.3%), Phl p 12 (21.7% vs 3.6%) and Art v 4 (26.1% vs 3.6%) (all p < 0.05). Patients <18 years old had the highest positive rate of Cyn d 1 (40.7%). Additionally, rhinitis patients had the highest positive rate of Cyn d 1 (60.0%), and all patients with Cyn d 12 sensitization (17.2%) were asthmatic patients. Optimal scale analysis showed that Phl p 1 and Cyn d 1 were closely related (Cronbach’s alpha = 85.1%).ConclusionThe highest positive rate of pollen allergen components was Cyn d 1 in Bermuda grass sensitized patients in southern China. Most patients were sensitized to CCD alone, and CCD may have less interference in the detection of Cyn d 1, Art v 4, Phl p 1 and Phl p 12. The sensitization patterns of pollen allergen components varied in different ages and diseases, and the diagnostic strategy of pollen allergen needs to be considered in the future.

ObjectivePeanut is one of the most frequently reported allergens causing severe allergies in western countries. In China, however, there have been few reports of severe allergies caused by peanuts. We investigated the peanut allergen components sensitization and cross-reaction with pollen allergen in Chinese Southerners with allergic rhinitis and/or asthma.MethodsTotal IgE (tIgE) and specific IgE (sIgE) antibodies against Ara h 1, Ara h 8, Juglans pollen, Platanus pollen, birch pollen, Bet v 1, Bet v 4, and cross-reactive carbohydrate determinant (CCD) of 58 allergic patients, of whom 33 were peanut-sIgE positive and 25 were negative, were detected by the ImmunoCAP system. The relationships between peanut allergen and pollen allergens were analyzed.ResultsA 9.1% (3/33) of the patients with peanut sensitization were sensitized to Ara h 8, while 21.2% (7/33) were sensitized to Ara h 1. The peanut-sensitized group had significantly higher positive rates for sIgE antibodies against CCD (69.7% vs 4.0%), Juglans pollen (87.9% vs 12.0%), Platanus pollen (90.9% vs 16.0%), and birch pollen (60.6% vs 4.0%) than the peanut tolerance group (all P < 0.05). Spearman correlation showed that peanut-sIgE were significantly correlated with sIgE to CCD (rs=0.859), Juglans pollen (rs=0.772), Platanus pollen (rs=0.838) and birch pollen (rs=0.816).ConclusionThe majority of patients sensitized to peanut allergen in Southern China tested positive for multiple pollen allergens. Peanut sensitization was highly correlated with Platanus, Juglans, and birch pollen sensitization, which suggested there may be cross-reactions between peanut and pollen allergens. Clinicians should pay attention to distinguish diagnosis in clinical peanut allergy diagnosis and treatment.

To investigate the major allergen components associated with birch pollen allergy in northern China and elucidate clinical relevance to pollen food allergy syndrome (PFAS). Fifty-eight patients were recruited for a cross-sectional study and categorized into two groups: PFAS group and non-PFAS group, as well as apple allergy group and non-apple allergy group. The sIgE levels of birch pollen and its components, namely Bet v 1, Bet v 2, Bet v 4, and Bet v 6, were analyzed. Among 58 participants, 44 individuals (75.9%) reported PFAS. 32 out of 44 (72.7%) participants reported apple allergy. Bet v 1 exhibited the highest sensitization rate at 82.8%, followed by Bet v 2 (29.3%) and Bet v 6 (1.7%). The combined sensitization rate for Bet v 1 and/or Bet v 2 was 93.1%. A total of 77.6% of the subjects demonstrated sensitization to single component, while 19.0% exhibited sensitization to two components. The sIgE levels of birch pollen and Bet v 1 were significantly elevated in PFAS group compared to non-PFAS group (p=0.001, p<0.001, respectively), as well as in apple-allergic and non-apple-allergic group (p<0.001, p<0.001, respectively). The optimal cut-off values for birch pollen and Bet v 1 sIgE were determined to be 7.09 kUA/L (with a sensitivity of 84.1% and specificity of 78.6%) and 5.11 kUA/L (with a sensitivity of 75.0% and specificity of 85.7%) when diagnosing PFAS. In terms of apple allergy, the optimal cut-off value were 9.40 kUA/L (with a sensitivity of 81.3% and specificity of 76.9%) and 6.53 kUA/L (with a sensitivity of 84.4% and specificity of 84.6%), respectively. The predominant sensitization pattern is mono-sensitization to Bet v 1, but when considering immunotherapy, Bet v 2 should also be taken into account. Bet v 1 serves as a valuable biomarker for diagnosing PFAS and apple allergy.

Pollen food allergy syndrome (PFAS), also called oral allergy syndrome, is a form of food allergy in which uncooked foods cause allergic symptoms generally limited to the oral mucosa. It occurs in a subset of patients with pollen allergy, although not all patients have prominent rhinitis symptoms. PFAS is related to antigenic similarity between the pollen and food allergen. The size of skin test reactions in a group of subjects with pollen sensitivity with PFAS was compared with a group of subjects who were pollen sensitive and without PFAS. Self-reported rhinitis symptoms between the two groups were compared to identify if symptom severity differed. Twenty subjects with PFAS and 20 subjects with seasonal allergic rhinitis without PFAS were enrolled in the study. All the subjects underwent standard skin-prick testing to a panel of common allergens, including select fresh fruits and vegetables. The subjects completed a Mini Rhinoconjunctivitis Quality of Life Questionnaire as part of their clinical evaluation. The subjects with PFAS and those without PFAS were compared statistically. The subjects with PFAS had significantly larger-sized skin-prick test results specific to pollens (p < 0.05). Despite the larger-sized skin-prick test results, the subjects with allergic rhinitis and PFAS reported milder nasal symptoms in relation to pollen skin test result size when compared with allergic rhinitis controls without PFAS. Our study outlined basic differences between two seemingly similar patient groups with a particularly striking discordance between skin test result sizes and rhinitis symptoms. This discordance should be explored further to increase mechanistic understanding of allergen cross-reactivity in PFAS.

<b>Background:</b> Pollen allergen is a vital contributor to allergic diseases. We aimed to characterize the prevalence of components of the weed pollen allergens, birch, and walnut, and cross-reactive carbohydrate determinants (CCD)&nbsp;in Chinese pollen-sensitized patients with allergic diseases. <b>Methods:</b> Serum samples from 165 pollen-sensitized patients with allergic diseases were used to test 19 allergen crude extracts, their components. <b>Results:</b> The positive rate of CCD was 39.4%. 18.0%, 24.6%, and 24.6% of mugwort positive patients were positive for Art v 1, Art v 2, and Art v 3, respectively. The positive of Bet v 2 in birch positive patients were 40%. 91.9% of CCD-positive cases were polysensitized. CCD had high correlations with goosefoot, ragweed, and walnut tree (r&gt;0.8). Moreover, there was a&nbsp;strong correlation&nbsp;between the sIgE leves&nbsp;of Jug r 3 and Art v 3 (r=0.78). <b>Conclusions:</b> Good correlations were demonstrated between&nbsp;CCD and pollen crude extracts and the positive rate of major pollen allergen components was not high, which might be caused by cross-reaction.ways polysensitized.

Birch pollen sensitization and associated pollen-food syndrome among Chinese allergic patients have not been investigated. Sera from 203 allergic patients from the northern part of China and collected during February to July 2014 were investigated. Specific immunoglobulin E (IgE) against birch pollen extract Bet v and major birch pollen allergen Bet v 1 were measured using the ADVIA Centaur. The presence of major apple allergen Mal d 1 and soy bean allergen Gly m 4 specific IgE was measured by ImmunoCAP 100. Among the 203 sera, 34 sera (16.7%) had specific IgE to Bet v and of these, 28 sera (82.4%) contained Bet v 1-specific IgE. Among the 28 sera with Bet v 1-specific IgE, 27 sera (96.4%) contained Mal d 1-specific IgE and 22 sera (78.6%) contained Gly m 4-specific IgE. Of the 34 Bet v-positive sera, 6 sera (17.6%) contained no specific IgE for Bet v 1, Mal d 1, or Gly m 4. Almost all Bet v-positive sera were donated during the birch pollen season. The prevalence of birch allergy among patients visiting health care during pollen season can be as high as 16.7% in Tangshan City. The majority of Chinese birch allergic patients are IgE-sensitized to the major birch pollen allergen Bet v 1 as well as to the major apple allergen Mal d 1 and soy bean allergen Gly m 4. A relatively high number of patients (17.6%) are IgE-sensitized to birch pollen allergen(s) other than Bet v 1. The high prevalence of specific IgE to Mal d 1 and Gly m 4 among Bet v 1-sensitized patients indicates that pollen-food allergy syndrome could be of clinical relevance in China.

It is known that among 40–70 % of patients pollinosis can run in conjunction with pollen-food allergy syndrome (PFS), while development of PFS is associated with the consumption of fresh fruits, vegetables, nuts and spices. Clinical course and severity of the disease depend on the sensitization profile, which can be represented by proteins-panallergens (PR-10, profilins, nsLTPs). However, there is little information about the sensitization profiles of patients with pollinosis caused by pollen of spring trees in Ukraine. Aim. To study the profiles of sensitization of children with spring pollinosis. Methods. We examined 61 children (aged 4-17 years) with spring seasonal allergic rhinitis/rhinoconjunctivitis (SAR). To establish the diagnosis, all children were given questionnaires, skin prick tests (SPTs) with commercial pollen extracts, and prick to prick tests with fresh fruits, vegetables and nuts. Component resolved diagnosis (CRD) were detected using an ImmunoCAP system. (Phadia, 100). Results. It has been found that in 43 children (70.5 %) had polinosis in combination with PFS, the main clinical manifestation of which was an oral allergic syndrome in 43 children (100 %). Among the causal food allergens that caused the manifestations of PFS were more apples, peaches, carrots and hazelnuts (consumption of which led to 11.6 % of children before the development of anaphylaxis). All of the examined children (100 %) had a positive IgE response to rBet v 1 at significant concentrations. In 9.3 % of children, panallergens were found at once from several botanical groups. Such panallergens: rBet v 2, rBet v 4, rPhl p 7, rPhl p 12, rArt v 3 are generally not defined in the control group children. Conclusions. Birch related PFS are common in Ukrainian pollen-allergic children with nuts and fruits predominantly implicated. Sensitization profile of children with Birch-pollen syndrome is complex and associated with sensitization to panalergens. Clinicians should be worried of PFS in patients with a high degree of sensitization to birch pollen and even young children if they have birch sensitization.

Oral allergy syndrome (OAS) is an IgE-mediated immediate food allergy that is localized to the oral mucosa. Pollen food allergy syndrome (PFAS), a pollinosis-associated OAS, is caused by cross-reactivity between food and pollen allergens. However, we need to more precisely understand the underlying pathogenesis of OAS/PFAS. In the present study, we developed a method to comprehensively identify cross-reactive allergens by using murine model of OAS and protein microarray technology. We focused on lip angioedema, which is one of the most common symptoms of OAS, and confirmed that mast cells reside in the tissues inside the lower lip of the mice. Interestingly, when the food allergen ovalbumin (OVA) was injected inside the lower lip of mice with high levels of OVA-specific IgE followed by an intravenous injection of the Evans blue dye, we found immediate dye extravasation in the skin of the neck in a mast cell-dependent manner. In addition, the degree of mast cell degranulation in the oral cavity, reflecting the severity of oral allergic responses, can be estimated by measuring the amount of extravasated dye in the skin. Therefore, we used this model of OAS to examine IgE cross-reactive allergens in vivo. Protein microarray analysis showed that serum IgE from mice intraperitoneally sensitized with ragweed pollen, one of the major pollens causing pollinosis, bound highly to protein extracts from several edible plants including black peppercorn and fennel. We confirmed that the levels of black pepper-specific IgE and fennel-specific IgE were significantly higher in the serum from ragweed pollen-sensitized mice than in the serum from non-sensitized control mice. Importantly, analysis of murine model of OAS showed that the injection of black pepper or fennel extract induced apparent oral allergic responses in ragweed pollen-sensitized mice. These results indicate IgE cross-reactivity of ragweed pollen with black pepper and fennel. In conclusion, we developed mouse model of OAS to identify IgE cross-reactive pollen and food allergens, which will help understand the pathogenesis of OAS/PFAS.