Abstract
BackgroundThe extent of co-sensitization within and between food protein families in an adult population is largely unknown. This study aimed to identify the most frequently recognized components in the PR-10 and storage protein family, as well as patterns in (co-)sensitization, in a birch-endemic area.MethodsResults of ImmunoCAP ISAC, performed during routine care in Dutch adult outpatients suspected of food allergy, were collected.ResultsA total of 305 patients were selected, aged 16–79 years (median 32 years). Sensitization to one or more PR-10 proteins was most frequent (74% of all subjects), followed by 35% to storage protein and 15% to nsLTPs. Within the PR-10 family, subjects were most often sensitized to Bet v 1 (73% of 305), Cor a 1.04 (72%) and Mal d 1 (68%). Sensitization to PR-10s from soy, celery and kiwi occurred distinctively less often (< 55% of Bet v 1 sensitized subjects) compared to other food PR-10s (all > 70%). Subjects sensitized to these ‘less common PR-10 proteins’ were sensitized to more food and inhalant components on the ISAC, compared to subjects sensitized to ‘common PR-10 proteins’ (median 22 vs 13 out of 112, p < 0.0001). Seven subjects demonstrated sensitization to food PR-10 proteins, without concomitant sensitization to pollen PR-10s. Within the storage proteins, sensitization to multiple peanut allergens was most common (on average 3 out of 4).ConclusionsSensitization to PR-10 food proteins could occur without concomitant sensitization to common PR-10 from pollen in a subset of subjects. Less commonly recognized PR-10 proteins appear to be an indication of polysensitization.
Highlights
The extent of co-sensitization within and between food protein families in an adult population is largely unknown
In food allergy diagnostics, component-resolved diagnostics (CRD) allows the clinician to assess the presence of specific IgE to allergenic proteins, instead of crude extracts
The study population consisted of every adult patient that received diagnostic analysis using ImmunoCAP Immuno-Solid phase Allergen Chip (ISAC) 112 in our food allergy outpatient clinic of the Dermatology/Allergology department of our tertiary hospital in Utrecht, The Netherlands, between April 2012 and September 2016
Summary
The extent of co-sensitization within and between food protein families in an adult population is largely unknown. Component-resolved diagnostics (CRD) allows the clinician to assess the presence of specific IgE (sIgE) to allergenic proteins (components), instead of crude extracts. Important protein families include the pathogenesis related protein family 10 (PR-10) proteins, profilins, seed storage proteins and non-specific lipid transfer proteins (nsLTP). The amount of cross-reactivity between allergens from the same family varies between protein families. Clinical cross-reactivity between storage proteins of different plant foods appears to be limited, (in vitro) cross-reactivity within and between specific tree nuts and legumes has been described [15,16,17]. Co-sensitization, between different protein families, is a common phenomenon in daily practice [18]
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