Apple allergy across Europe:: How allergen sensitization profiles determine the clinical expression of allergies to plant foods

JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY

卷:118

Article

Fernandez-Rivas, Montserrat ; Bolhaar, Suzanne ; Gonzalez-Mancebo, Eloina ; Asero, Riccardo ; van Leeuwen, Astrid ; Bohle, Barbara ; Ebner, Christof ; Rigby, Neil ; Sancho, Ana I. ; Miles, Susan ; Zuidmeer, Laurian ; Knulst, Andre ; Breiteneder, Heirno ; Mills, Clare ; Hoffmann-Sommergruber, Karin ; van Ree, Ronald

关键词: Apple;    Bet v 1;    birch pollen;    food allergy;    lipid transfer protein;    Mal d 1;    Mal d 2;    Mal d 3;    Mal d 4;    peach;   

DOI  :  10.1016/j.jaci.2006.05.012

来源: Elsevier

【 摘 要 】

Background: Allergy to a plant food can either result from direct sensitization to that food or from primary sensitization to pollen, latex, or another food. Objective: We sought to investigate the primary sensitizers in apple allergy across Europe, the individual allergens involved, and whether these differences determine the clinical presentation. Methods: Patients (n = 389) with positive case histories and skin prick test responses to fresh apple were selected in the Netherlands, Austria, Italy, and Spain. Skin prick tests and RASTs to a panel of pollens and plant foods were performed, as well as RASTs to Bet v 1 and the apple allergens Mal d 1, 2, 3, and 4. Results: In the Netherlands, Austria, and Italy apple allergy is mild (> 90% isolated oral symptoms) and related to birch pollinosis and sensitization to Bet v 1 and its apple homologue, Mal d 1, which has an odds ratio of local reactions of 2.85 (95% CI, 1.47-5.55). In Spain apple allergy is severe (> 35% systemic reactions) and related to peach allergy and sensitization to Mal d 3 (nonspecific lipid transfer protein), which has an odds ratio of systemic reactions of 7.76 (95% CI, 3.87-15.56). Conclusion: The analysis of individual apple allergens in a clinical context has provided insight into the sensitization pathway and into the intrinsic risk an allergen bears to induce mild or severe food allergy. Clinical implications: Information on the sensitization pathway is essential to develop preventive strategies in food allergy. The application of individual food allergens with a known intrinsic risk will improve the prognostic value of diagnostic tests.

【 授权许可】

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