Abstract
Kiwifruit allergy has been described mostly in the adult population, but immunoglobulin (Ig)E-mediated allergic reactions to kiwifruit appear to be occurring more frequently in children. To date, 13 allergens from kiwifruit have been identified. Our aim was to identify kiwifruit allergens in a kiwifruit allergic-pediatric population, describing clinical manifestations and patterns of recognition. Twenty-four children were included. Diagnosis of kiwifruit allergy was based on compatible clinical manifestations and demonstration of specific IgE by skin prick test (SPT) and/or serum-specific IgE determination. SDS-PAGE and immunoblotting were performed with kiwifruit extract, and proteins of interest were further analyzed by mass spectrometry/mass spectrometry. For component-resolved in vitro diagnosis, sera of kiwifruit-allergic patients were analyzed by an allergen microarray assay. Act d 1 and Act d 2 were bound by IgE from 15 of 24 children. Two children with systemic manifestations recognized a protein of 15 kDa, homologous to Act d 5. Act d 1 was the allergen with the highest frequency of recognition on microarray chip, followed by Act d 2 and Act d 8. Kiwifruit allergic children develop systemic reactions most frequently following ingestion compared to adults. Act d 1 and Act d 2 are major allergens in the pediatric age group.
Highlights
Kiwifruit (Actinidia) is a plant native to the Yangtze Valley that at the beginning of the nineteenth century grew wild in China [1]
Diagnosis of kiwifruit allergy was based on a convincing history of an objective allergic reaction after green kiwifruit ingestion in at least two occasions and demonstration of specific IgE to kiwifruit by skin prick test (SPT) and/or serum specific IgE
There has been an increase in the incidence of kiwifruit allergy in the last few years with new cases more often affecting younger infants [4]
Summary
Kiwifruit (Actinidia) is a plant native to the Yangtze Valley that at the beginning of the nineteenth century grew wild in China [1]. Seeds of the green-fleshed kiwifruit, Actinidia deliciosa, were introduced into New Zealand in 1904 and exports to Europe and the USA started in 1962. Allergic reactions to kiwifruit were first described in 1981 [2]. There have been an increasing number of publications on kiwifruit allergy. In Spain, the prevalence of kiwifruit sensitization has been estimated at 1.8% of the general population [3]. From the few studies describing kiwifruit allergy in pediatric populations, it appears that children are more likely to react on the first known exposure and more frequently develop systemic manifestations than adults [4]. Kiwifruit allergy is most frequently associated with grass and birch pollen allergies [5], children are frequently mono-sensitized to kiwifruit, suggesting a role of primary digestive tract sensitization and a different pattern of IgE recognition of kiwifruit proteins than in adults
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