Oral Allergic Syndrome Research Articles

Features of the course of pollen allergy in children in the Nizhny Novgorod region

Due to its widespread distribution, the problem of pollen allergy does not lose its relevance for practical healthcare: the variety of clinical forms, the possibility of polyvalent sensitization and pathogenetic treatment in the form of allergen-specific immunotherapy determine the importance of studying its clinical and epidemiological features.Materials and methods. A retrospective analysis of 119 discharge summaries of children with diagnoses of “Allergic rhinoconjunctivitis”, “Bronchial asthma”, “Atopic dermatitis”, occurring with clinically significant pollen sensitization, was carried out in the period 2015–2022. The prevalence, clinical features, prevailing symptoms and atopic comorbidity of patients with pollen allergy living in the Nizhny Novgorod region were assessed.Results. Pollen allergy is characterized by a variety of clinical manifestations, which are mainly represented by allergic rhinoconjunctivitis, bronchial asthma, and oral allergic syndrome. In the study, in the majority of patients, polyvalent sensitization was combined with a pronounced variety of products that provoke oral allergic syndrome. Manifestations of pollen allergies requiring seeking medical help are equally distributed among residents of Nizhny Novgorod and the region’s villages.Conclusions. Clinical and epidemiological features of the course of pollen allergy are of great interest to the practicing physician. The variety of manifestations of pollen allergies determines the need for a clinically effective treatment method, which today is ASIT. One of the needs of modern healthcare is to increase the awareness of primary care physicians about atopic diseases, incl. pollen allergy, with the aim of timely referral of patients to a specialist. Currently, allergen-specific immunotherapy is the most effective method of treating manifestations of pollen allergies.

Characteristics of the molecular sensitization profiles in patients with birch pollen allergy and cross-reactive food allergy to PR-10 proteins

BACKGROUND: Birch pollen allergy is widespread and is the main allergic disease in Russia. Cross-reactive food allergy, often found in patients with birch pollen allergy, is an underestimated problem that complicates the course of pollinosis and requires further study to improve the quality of diagnosis and personalized recommendations for such patients.
 AIM: To study the features of the molecular sensitization profile of adult patients with birch pollen allergy and cross-reactive food allergy to PR-10 proteins.
 MATERIALS AND METHODS: Twenty-five adult patients with confirmed birch pollen allergy, with or without cross-reactive food allergy, were included in an open single-center interventional prospective controlled nonrandomized study. Specific IgE to 112 allergens was determined by multiplex analysis using ImmunoCAP ISAC (ThermoFisher, Sweden). Patients with cross-reactive food allergy completed a validated questionnaire on cross-reactive food allergy symptoms and causative allergens. The primary endpoint of the study was the assessment of the sensitization profile to Bet v 1 and PR-10 proteins (Mal d 1, Ara h 8, Cor a 1.0101, Cor a 1.0401, Act d 8, Api g 1, Pru p 1, and Gly m 4) and the clinical characteristics of the sensitized patients. The secondary endpoint was the comparison of patients with and without cross-reactive food allergy and the evaluation of how sensitization to Bet v 1 and PR-10 homologs can affect clinical manifestations of cross-reactive food allergy in patients.
 RESULTS: The study included 25 patients aged 18–55 years, from which two comparable groups were formed: group 1 consisted of 13 patients with cross-reactive food allergy symptoms and group 2 (without cross-reactive food allergy) consisted of 12 patients who had never experienced cross-reactive food allergy symptoms. Analysis of the sensitization profile to PR-10 allergens revealed similar patterns in both groups; however, sIgE concentrations to all allergens were significantly higher in group 1. A strong correlation was found between the number of triggering products and total IgE level with PR-10 proteins (r=0.81; p=0.001). The severity of cross-reactive food allergy symptoms correlated with the total level of IgE to PR-10 proteins (r=0.97; p 0.0001). The cutoff level for total sIgE to food PR-10 proteins, equal to 70 ISU-E, allowed us to distinguish patients with only oral allergic syndrome from those with systemic manifestations of cross-reactive food allergy.
 CONCLUSION: The results of the study are applicable in clinical practice and have prognostic value in determining the severity of cross-reactive food allergy.

Analysis of IgE antibody profiles to food and pollen plant allergens in children with birch allergy and oral allergic syndrome

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Expression and purification of 15N-labeled Fra a 1, a strawberry allergen, to prepare samples for NMR measurements

Raw strawberries contain allergens that cause oral allergic syndrome. Fra a 1 is one of the major allergens in strawberries and might decrease their allergenicity by heating, likely due to structural changes in the allergen leading to decreased recognition of the allergens in the oral cavity. In the present study, to understand the relationship between allergen structure and allergenicity, the expression and purification of 15N-labeled Fra a 1 were examined and the sample was used for NMR analysis. Two isoforms, Fra a 1.01 and Fra a 1.02, were used and expressed in E. coli BL21(DE3) in M9 minimal medium. Fra a 1.02 was purified as a single protein by using the GST tag approach, whereas histidine × 6-tag (his6-tag) Fra a 1.02 was obtained both as the full-length (∼20 kDa) and a truncated (∼18 kDa) form. On the other hand, his6-tag Fra a 1.01 was purified as a homogeneous protein. 1⁵N-labeled HSQC NMR spectra suggested that Fra a 1.02 was thermally denatured at lower temperatures than Fra a 1.01, despite the high amino acid sequence homology (79.4%) of these isoforms. Furthermore, the samples in the present study allowed us to analyze ligand binding that probably affects structural stability. In conclusion, GST tag was effective for obtaining a homogeneous protein when his6-tag failed to give a single form, and the present study provided a sample that could be used for NMR studies of the details of the allergenicity and structure of Fra a 1.

Gastrointestinal manifestations of food allergy in children: oral allergic syndrome

Oral allergic syndrome is a manifestation of an acute allergic reaction from the mucous membrane of the oropharynx in the form, itching and tingling on the oral mucosa, dysphonia, itching in the auricles, some patients may experience classic manifestations of hay fever in the form of rhinoconjunctival syndrome. Diagnostics of this disease includes collection of allergic anamnesis, allergy examination. The only pathogenetic method of therapy is carrying out specific immunotherapy with causally significant allergens.

Clinical and anamnestic characteristics of children with gastrointestinal food alergy

Summary. The prevalence of food allergy is increasing, especially among children. The clinical manifestations of food allergy are different, they depend on the mechanisms of pathogenesis. There is a need to improve diagnostic criteria and early diagnosis of gastrointestinal manifestations of food allergy. Objective. Evaluation of gastrointestinal manifestations in children with food allergies. Materials and methods. Clinical and anamnestic data of 29 children (12 girls, 17 boys) with gastrointestinal manifestations and food allergy were analyzed. Results. Most often, gastrointestinal manifestations of food allergies were found in children aged 4 to 7 years (55.17%, 16/29). Epigastric pain (62.07%, 18/29), meteorism (24.14%, 7/29), undecorated stool with undigested food particles and mucus (27.59%, 8/29%) were most common among children with food allergies. The onset of gastrointestinal intolerance by the age of 6 months was in 44.8% (13/29) of children, 76.9% (10/13) of whom were exclusively breastfed. The first gastrointestinal manifestations after the introduction of supplementary feeding were in 20.69% (6/29); 10.34% (3/29) of patients had gastrointestinal complaints from 3 years of age, and 6.9% (2/29) of patients from 7 years of age. Gastrointestinal disorders as the first manifestation of allergic "march" was observed in 20.69% (6/29%) of patients. IgE-mediated food allergy was found in 72.41% (21/29) of the examined children: immediate gastrointestinal hypersensitivity - 65.51% (19/29); oral allergic syndrome - 6.89% (2/29). Non-IgE-mediated food allergy is represented by protein-induced enterocolitis and proctosigmoiditis in 27.58% (8/29) of children. Conclusions. Clinical symptoms of gastrointestinal manifestations of food allergy in children depend on the immunological mechanisms of its occurrence, it should be taken into during of diagnostic. Gastrointestinal food allergy should be diagnosed in time to prevent the evolution and progression of allergic "march". Therefore, it is necessary to develop and search methods and markers for timely diagnosis of these conditions.

Ефективність алергенспецифічної імунотерапії пилковими алергенами в дітей із позиції молекулярної алергології

Мета роботи — встановити можливі причини неефективності алергенспецифічної імунотерапії (АСІТ) пилковими алергенами (бур’янів) у дітей із сезонним алергічним ринітом і/або бронхіальною астмою на підставі вивчення гіперчутливості до алергенів, аналізу анамнестичних даних. Матеріали та методи. Проведено алерготестування 192 дітей. 52 пацієнтам проведене анамнестичне опитування з акцентом на перехресну алергію та супутню патологію верхніх дихальних шляхів, а також на ефективність АСІТ. Статистична обробка результатів проведена в програмі Statistica for Windows 6.0. Результати. Серед хворих на поліноз переважала гіперчутливість до амброзії (56 %), циклахени (46 %) та соняшника (58 %). До злакових рослин (райграс, грястиця, вівсяниця) чутливі 10—20 % пацієнтів. 23 % дітей мають сенсибілізацію до 5 та більше алергенів (в середньому до 3,3 ± 0,4). 52 % дітей мають супутню харчову алергію, 15 % — синдром оральної алергії, третина дітей — аденоїдні вегетації, гіпертрофію глоткових мигдалин, у 13 % алергічний риніт ускладнювався синуситом. Незадовільний клінічний ефект АСІТ пилковими алергенами асоціювався з наявністю поєднаної пилково-грибкової сенсибілізації, перехресної харчової та пилкової алергії, із сенсибілізацією до 4 та більше пилкових алергенів, з полівалентною алергією, а також спостерігався при поєднанні алергічного риніту із синуситом (р < 0,05). Висновки. Перед початком АСІТ дітям із полінозами необхідно визначити групу ризику стосовно можливої неефективності цього методу терапії та рекомендувати їм визначення специфічних імуноглобулінів класу Е до мажорних та мінорних алергенів для прогнозування ефективності АСІТ.

Клінічні прояви гастроінтестинальної форми харчової алергії у дітей і підходи до її діагностики

Гастроінтестинальна харчова алергія обумовлена розвитком алергічного запалення в слизовій оболонці шлунково-кишкового тракту, механізмами якого є як імуноглобулін E (IgE)-опосередковані (оральний алергічний синдром, негайна гастроінтестинальна гіперчутливість.), так і не-IgE-опосередковані (білок-індукований ентероколітичний синдром, білок-індукована ентеропатія, білок-індукований алергічний проктоколіт) і змішані, IgE- та не-IgE-опосередковані реакції (еозинофільний езофагіт, еозинофільний гастрит, еозинофільний гастроентерит). Гастроінтестинальні прояви харчової алергії також поєднуються із симптомами атопічних захворювань, частіше з атопічним дерматитом, кропив’янкою й ангіонабряком. Клінічні прояви алергічного ураження шлунково-кишкового тракту різноманітні та не є специфічними. До загальних ознак гастроінтестинальної алергії належать: блювання (виникає від декількох хвилин до 4–6 годин після прийому їжі); коліки (одразу чи через декілька годин після вживання їжі); запори; діарея; відмова від їжі (від конкретного продукту або взагалі від прийому їжі); абдомінальний біль; метеоризм, наявність слизу та еозинофілів у випорожненнях; зниження апетиту; головний біль. Зважаючи на неспецифічність клінічних проявів гастроінтестинальної харчової алергії, диференціальну діагностику слід проводити з такими захворюваннями, як захворювання й аномалії розвитку травної системи, психічні та метаболічні порушення, інтоксикації, інфекційні хвороби, недостатність ендокринної функції підшлункової залози, целіакія, муковісцидоз, імунодефіцити, дисахаридазна недостатність, побічна дія лікарських засобів, ендокринна патологія, синдром подразненого кишечника. Існуючі методи діагностики гастроінтестинальної алергії є обмеженими та недосконалими, що вимагає подальших наукових пошуків і досліджень, спрямованих на вчасне виявлення цієї патології, профілактику виникнення у генетично схильних дітей, розробку оптимальних алгоритмів діагностики, запобігання прогресуванню клінічних проявів, вибору індивідуальної дієтотерапії й адекватного медикаментозного лікування. В огляді літератури наведені сучасні погляди щодо діагностики гастроінтестинальної харчової алергії у дітей. Розглянуто клінічні прояви та діагностичні підходи до окремих видів гастроінтестинальної алергії залежно від механізму їх виникнення.

Белок профилин как клинически значимый паналлерген в развитии синдрома пыльцевой и пищевой аллергии

Профилин играет важную роль в качестве сенсибилизатора и фактора, представляющего трудности как в диагностике, так и в лечении пациентов с пыльцевой и растительной пищевой аллергией. В контролируемых исследованиях профилин доказал свою способность вызывать различные симптомы заболеваний верхних и нижних дыхательных путей. До конца не изучено клиническое значение профилинов в развитии респираторных заболеваний в реальных условиях воздействия, и в какой степени это способствует появлению симптомов. Крупные эпидемиологические исследования показали, что профилин является маркером тяжести заболевания и полисенсибилизации при аллергии на травы, а сенсибилизация к rPhl p 12 статистически связана с большей длительностью заболевания и оральным аллергическим синдромом к растительной пище. Роль профилина в развитии орального аллергического синдрома на растительные продукты питания была признана у пациентов с аллергией на пыльцу. Кроме того, профилин может вызывать системные реакции на растительную пищу в отдельных группах населения, которые обычно сталкиваются с сезонами с высоким уровнем пыльцы травы. Несмотря на то, что профилин считается второстепенным аллергеном, он является основным аллергеном некоторых растительных продуктов, например дыни (Cuc m 2), апельсина и сои. Аллергия на дыню, арбуз, цитрусовые, помидоры и бананы, как сообщается, является клиническим маркером гиперчувствительности к профилину. Его значение у лиц с аллергией на латекс остается низким или он вообще не имеет значения согласно некоторым публикациям. Невзирая на вышеупомянутую актуальность, не существует надежного терапевтического подхода к лечению аллергии на белок профилин. Более того, у пациентов с сенсибилизацией к профилину аллерген-специфическая иммунотерапия не показана ввиду недостаточного количества минорных компонентов в препаратах для данного вида терапии, а пищевая иммунотерапия недостаточно изучена. Таким образом, профилактические стратегии, а именно элиминационные мероприятия и симптоматическая терапия, могут быть оптимальным вариантом лечения для пациентов, чувствительных к профилину.

Comorbidity of atopic bronchial asthma and food allergy in adults

Adult patients with atopic bronchial asthma are susceptible to food allergy, in more than one third of cases, while asthma is a risk factor for severe life-threatening factors. The aim of the study was to determine the prevalence and relationship of food allergies with atopic bronchial asthma in adults living in Chelyabinsk. Materials and methods. An analysis of 313 outpatient case histories of patients with atopic bronchial asthma over the age of 18 was performed. Results. The presence of food allergy was a factor in the earlier onset of atopic bronchial asthma, which is consistent with the concept of comorbidity of these diseases. Patients with seasonal allergic rhinitis and pollen sensitization have an increased risk of developing food allergies (OR – 2.075 [1.27- 3.39]), p=0,004. The overall incidence of oral allergic syndrome among all patients with atopic asthma and plant sensitization was 33% [28; 37]. Plant products (fruits, honey, nuts) were the cause of food allergic reactions in 87% [80; 92] of adult cases. The main clinical manifestations were: oral allergic syndrome, urticaria, angioedema, shortness of breath. Sensitization to pollen of trees, grasses and weeds approximately equally increases the risk of developing an oral allergic syndrome, upon sensitization to tree pollen (OR – 3.08 [2.32-4.25]), to grass pollen (OR – 3.5 [2.23-5.61]), to weed pollen (OR – 2.86 [2.02-4.03]). The combination of several types of pollen sensitization increases by 4 times the risk of developing oral allergic syndrome to a wide range of foods. Conclusion. Data on the causes and clinical manifestations of food allergies in combination with bronchial asthma have been obtained. The notion of a significant risk of developing dangerous clinical manifestations of food allergy in patients with atopic bronchial asthma will make it possible to reasonably prescribe emergency drugs for independent use.

Весенний поллиноз в период с 2001 по 2021 г. в Московском регионе. Основы терапии

The prevalence of pollinosis reaches as high as 39% in the population with a rare onset of the disease in the first 3 years of life. This can be probably attributed to increased pollination (birch, alder, hazel) in Moscow region and altered flowering rhythm of some trees. For example, there has been a change in the flowering rhythm of birch (the highest pollen level once every three years with a two-year break) since 2012, when the maximum concentration of pollen was observed in Moscow air over more than 10 years of observation (20,643 pollen grains per 1m3) to flowering once every other year. In 2019 it was recorded a 3-year high level of birch pollen at 5700 pollen grains per 1m3. We describe the specific characteristics of pollination of different trees on the basis of data obtained in 2011, the beginning of pollination of alder and hazel, then poplar, then birch and pine. The development of immediate hypersensitivity reactions manifests through respiratory symptoms and frequent oral allergic syndrome because of cross-reactivity with food allergens. This condition requires the administration of systemic antihistamines. The therapy for pollinosis usually includes local antihistamines, hormones, and barrier agents (such as Aqua Maris ectoin, Nasaval spay) that can restore nasal breathing. However, allergen-specific immunotherapy, capable of reducing immune sensitivity to pollen allergens, remains the main option of causal therapy for pollinosis. Key words: pollen, pollinosis, barrier agents, ectoin, antihistamines

Allergy to lemon: case of oral allergic syndrome associated with allergic otitis media and labyrinthitis in a patient with polysensibilization and multiple manifestations of allergy

Oral allergic syndrome is an IgEmediated allergic reaction to foods of plant origin in persons with sensitization to various pollen allergens. A clinical case of oral allergy syndrome caused by consumption of lemon in a 25-year-old woman with sensitization to many groups of allergens and presence of allergic otitis media and allergy-induced labyrinthitis is presented. The patient had a history of seasonal allergic rhinoconjunctivitis, bronchial asthma, contact allergic dermatitis, urticaria as a manifestation of drug allergy. In vivo (skin prick tests, prick-prick tests) and in vitro allergen specific diagnostics allowed to work out the individual diet and a hypoallergenic regime in this case.

POLLEN–FOOD ALLERGY SYNDROME AMONG CHILDREN WITH SENSITIZED TO SPRING TREES

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.

Seasonal Variation of the Major Allergen Fra a 1 in Strawberry Fruit

Strawberry (Fragaria × ananassa) contains a major allergen, Fra a 1, which causes oral allergic syndrome. Fra a 1 is a PR-10 homolog that is regulated by environmental conditions. The allergenicity of fruit caused by Fra a 1 may depend on the genotype or growing conditions. We analyzed the Fra a 1.01 transcript levels and Fra a 1.01 protein levels in strawberry fruits of several genotypes across all seasons. In the preliminary rough screening, we selected the line WH1 bearing white fruit and the red-fruited cultivar ‘Akihime’. Under the same environmental conditions, there was no significant difference in Fra a 1.01 levels between the two cultivars over several months, suggesting that receptacle color was not indicative of allergenicity caused by Fra a 1.01. Fruits cultivated under the same environmental conditions should be used for comparisons of the allergenicity among genotypes. Both ‘Akihime’ and WH1 accumulated significantly higher levels of Fra a 1.01 protein in winter than in spring. We investigated the effects of irradiation and low temperature as environmental factors controlling the accumulation of Fra a 1.01 in winter. A shading treatment on fruit did not significantly affect Fra a 1.01 protein accumulation in strawberry fruits. Regarding variations over time, the Fra a 1.01 protein content was higher in fruits harvested at midnight in January than in those harvested at other times and in other months. These findings suggested that the Fra a 1.01 protein accumulates in response to environmental factors such as cold stress.

Cross-reactive food allergy to PR-10 homologues in birch pollen sensitized patients

Pollen allergy (pollinosis) is one of the most common allergic diseases. Majority of pollen allergy patients (47-70%) have a cross-reactive food allergy to fruits, vegetables, nuts and seeds. Oral allergic syndrome is the most common clinical manifestation of cross-reactive food allergy. The article presents the data on cross-reactive food allergy to Pr-10 homologues in birch pollen sensitized patients.

Analysis of major paralogs encoding the Fra a 1 allergen based on their organ-specificity in Fragaria × ananassa.

Fra a 1protein in strawberry causes oral allergic syndrome. Over 39 Fra a 1 paralogs have been identified in strawberry genome. Fra a 1.01 is major accumulating protein in edible organs. Strawberry fruits contain allergenic proteins that cause oral allergic syndrome. The hypothesized major allergen is Fra a 1, an ortholog of the birch pollen allergen protein Bet v 1. We organized Fra a 1 genes and analyzed their localizations at the transcriptional and translational levels. In total, 15 new Fra a 1 proteins were identified from the genomic database, increasing the total number of Fra a 1 to 30 proteins encoded by 39 genes. Fra a 1.02 was mostly expressed in receptacles, and Fra a 1.01 in achenes, when analyzed by RNA sequencing. Immunoblotting showed that the Fra a 1.01 protein was broadly accumulated in strawberry organs, while the Fra a 1.02 protein was mostly expressed in receptacles. Recombinant Fra a 1.01 strongly reacted with human IgE. The mRNA and protein expression levels of Fra a 1 did not correlate, indicating the importance of protein levels when evaluating the abundance of allergens in strawberry. Based on the localizations, accumulation levels and reactivity to human IgE, we determined that Fra a 1.01 was the most important allergen, followed by Fra a 1.02, and then other Fra a 1 proteins. The information obtained here will be useful for selecting the target Fra a 1 paralogs when breeding hypoallergenic strawberry.

Molecular Recognition Profiles and Clinical Patterns of PR-10 Sensitization in a Birch-Free Mediterranean Area

Background: The order Fagales represents an important cause of tree-pollen allergy in northern countries. We investigated the IgE recognition profiles, mutual relationships, and association with clinical symptoms of a panel of allergens belonging to the PR-10 family, the main proteins responsible for Fagales allergy (Act d 8, Aln g 1, Api g 1, Ara h 8, Bet v 1, Cor a 1.0101, Cor a 1.0401, Gly m 4, Mal d 1, and Pru p 1). Methods: A total of 526 PR-10-reactive subjects living in central and southern Italy were studied by ImmunoCAP-ISAC-112 microarray analysis. Results: Overall, Bet v 1 reactivity was the most commonly (74%) observed among PR-10 proteins, but Cor a 1.0101 was the most prevalent in participants aged <6 years, and between 15 and 65 years. Overall, 26% of the PR-10-reactive persons were Bet v 1 negative, whilst 93.6% of the PR-10 polyreactive individuals were Bet v 1 positive. Among the 10 PR-10s evaluated, 100 combinations were recorded. The strongest association was observed between molecules with the highest sequence identities (Bet v 1 and Cor a 1.0101, Cor a 1.0401 or Aln g 1; Mal d 1 and Pru p 1). Bet v 1-, Cor a 1.0101-, and Aln g 1-specific IgE recognition was associated with respiratory symptoms, whilst Ara h 8, Cor a 1.0401, Gly m 4, Mal d 1, and Pru p 1 were selectively linked to an oral allergic syndrome. Conclusions: Testing IgE reactivity to a panel of PR-10s in a birch-free area discloses peculiar relationships between clinical phenotypes and sensitization profiles, allowing the identification of novel cluster patterns.

Expression Profiling of Strawberry Allergen Fra a during Fruit Ripening Controlled by Exogenous Auxin.

Strawberry fruit contain the allergenic Fra a proteins, members of the pathogenesis-related 10 protein family that causes oral allergic syndrome symptoms. Fra a proteins are involved in the flavonoid biosynthesis pathway, which might be important for color development in fruits. Auxin is an important plant hormone in strawberry fruit that controls fruit fleshiness and ripening. In this study, we treated strawberry fruits with exogenous auxin or auxin inhibitors at pre- and post-harvest stages, and analyzed Fra a transcriptional and translational expression levels during fruit development by real-time PCR and immunoblotting. Pre-harvest treatment with 1-naphthaleneacetic acid (NAA) alone did not affect Fra a expression, but applied in conjunction with achene removal NAA promoted fruit pigmentation and Fra a protein accumulation. The response was developmental stage-specific: Fra a 1 was highly expressed in immature fruit, whereas Fra a 2 was expressed in young to ripe fruit. In post-harvest treatments, auxin did not contribute to Fra a induction. Auxin inhibitors delayed fruit ripening; as a result, they seemed to influence Fra a 1 expression. Thus, Fra a expression was not directly regulated by auxin, but might be associated with the ripening process and/or external factors in a paralog-specific manner.

Oral Allergic Syndrome and Recombinant Allergens rBet v 1 and rBet v 2

IgE cross-reactivity to Recombinant Allergens (RA) rBet v 1 and rBet v 2 (profilin) and food allergens may represent a basis for the development of oral allergic syndrome (OAS). We performed a retrospective study on 59 patients polisensitized to pollens and food allergens. They were given an assay of specific IgE against RA and, when positive, we calculated the percentage of these subjects who presented an OAS. As a result, 21 out of 59 patients (35.6%) were positive to rBet v 1, 23 out of 59 (38.9%) to profilin, and 5 out of 59 (8.4%) to both. Among RA positive patients 7 (33.3%) with specific IgE against rBet v 1 presented OAS, and 8 (34.7%) suffered from OAS. IgE to peanut and apple were mostly represented (57.1%) in patients positive to rBet v 1, while in subjects positive to profilin, we mainly observed IgE against peanut (75.0%). We suggest the importance of evaluating hypersensitivity to RA to predict the increase of OAS and, in particular, to reveal which fruits could be associated to OAS.

Relationship between Bet v 1 and Bet v 2 specific IgE and food allergy in children with grass pollen respiratory allergy

Grass allergy is the most common pollinosis in Northern Italy. Some patients with grass allergy show polysensitization against other pollens and plant-derived foods. In these patients oral allergic syndrome (OAS) is frequently associated. To evaluate the correlation between food allergy or food sensitization and specific IgE against panallergens such as Bet v 1 and Bet v 2, we studied 56 children (mean age: 8 years 5 months) suffering from respiratory allergy due to grass pollens were enrolled. Specific IgE against the most important food, inhalant allergen and Bet v 1, Bet v 2 were performed by ImmunoCAP technology (UniCAP 1000, Pharmacia Diagnostics, Uppsala, Sweden). We found 14 children (25%) sensitized to Bet v 1 and 13 (23%) to Bet v 2; in 24 cases (42.3%) a sensitization to at least one of the 2 panallergens was observed. Five of the 14 cases (36%) sensitized to Bet v 1 showed food allergy and 8 (57%) food sensitization; 6 (46%) of the 13 children sensitized to Bet v 2 showed food allergy and 7 (54%) food sensitization; only one case of Bet v 1 specific IgE without food allergy or sensitization was seen. Sixteen subjects (29%) showed food allergy (group A); 20 children (35.5%) multiple sensitizations to inhalant and at least one plant-derived food (group B); 20 subjects (35.5%) only inhalant allergens (group C). Sensitization to Bet v 1 ( P < 0.03) and Bet v 2 ( P < 0.009) is from a statistical point of view significantly higher in groups A and B than in group C. In the 16 patients with food allergy hazelnut was the major triggering food (50%), followed by peanut (38%), kiwi (31%), apple and walnut (19%). Specific IgE for Bet v 1 is more associated with nuts and legumes, while Bet v 2 is more related to fresh fruit and vegetables. In conclusion grass pollinosis is frequently associated with polysensitization to other pollen and food allergens. Bet v 1 and Bet v 2 specific IgE are significantly higher in these patients than in patients with grass monosensitization, and this sensitization may be considered a possible risk factors to evolve later into food allergy. Among the offending foods, legumes and the nut group are mostly related to Bet v 1, while vegetables and fresh fruits to Bet v 2.