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Insect Venom Allergy
Published in Pudupakkam K Vedanthan, Harold S Nelson, Shripad N Agashe, PA Mahesh, Rohit Katial, Textbook of Allergy for the Clinician, 2021
William H Bermingham, Alex G Richter, Mamidipudi T Krishna
Double sensitization to bee and wasp venoms. This is frequently observed but ‘true’ dual clinical reactivity is rare. The frequency of double sensitization varies according to the test method used. SsIgE testing to whole venom is associated with rates as high as 50% but such a pattern is relatively lower with IDT and CRD (Sturm et al. 2011).Cross reactive Carbohydrate Determinants (CCDs) on hymenoptera venom hyaluronidases have been identified as a frequent cause of double sensitization (Hemmer et al. 2001).Basophil activation tests may be helpful in making this discrimination in some cases but a robust diagnostic test with 100% specificity for predicting clinical reactivity in sensitized individuals is not yet available (Jakob et al. 2017b).Skin tests may be negative in the immediate aftermath of anaphylaxis to insect-sting/s, so tests should be repeated after few weeks to reduce false negative results.
Grass pollen allergens
Published in Richard F. Lockey, Dennis K. Ledford, Allergens and Allergen Immunotherapy, 2020
Cross-reactive carbohydrate determinants (CCDs) of grass pollen allergens also are implicated in serological cross-reactions among a variety of pollen and vegetable foods [151–154]. The β (1–2)-xylose- and α-(1–3)-fucose-containing glycans on glycoproteins from several plants, molluscs, and insects are highly cross-reactive. The clinical significance of anticarbohydrate IgE antibodies is not established, and the role of CCD in allergic sensitization remains to be explored. In this regard, the grass group 11 allergens, Cyn d 4 (BG60), and Cyn d 24 may present a unique opportunity to investigate the role of both carbohydrate and peptide epitopes in allergenic cross-reactivity among glycoproteins from related and unrelated sources. The presence of conserved amino acids and cysteine positions in the primary structure of Lol p 11 suggests homology with pollen glycoproteins from maize, rice, tomato, olive tree, and privet.
Molecular Diagnosis in Contact Urticaria Caused by Proteins
Published in Ana M. Giménez-Arnau, Howard I. Maibach, Contact Urticaria Syndrome, 2014
The main allergens are the Bet v 1 homologue Cor a 1.04, the hazelnut profilin Cor a 2, and LTP Cor a 8.[75] Other molecules that have been investigated in connection with hazelnut allergy are the 11S globulin Cor a 9, the vicilin, Cor a 11, hazelnut oleosin, 2S albumins; and the specific carbohydrate structures, known as cross-reactive carbohydrate determinants (CCDs), for which bromelain has been used as source.[76] Sensitization to Cor a 1.04 is prevalent in the northern regions of Europe and is commonly associated with OAS. On the other hand, sensitization to hazelnut LTP (Cor a 8) is certainly more common in patients from southern Europe,[76] and these patients can develop either severe or mild allergic reactions to hazelnut. Polysensitization to hazelnut-allergen components is mostly observed in patients with severe symptoms.
Precision medicine in the allergy clinic: the application of component resolved diagnosis
Published in Expert Review of Clinical Immunology, 2022
Carmen Panaitescu, Laura Haidar, Maria Roxana Buzan, Manuela Grijincu, Daniela Elena Spanu, Catalina Cojanu, Alexandru Laculiceanu, Roxana Bumbacea, Ioana Agache
Seventy-six allergens are currently characterized from Hymenoptera venom [50]. In Europe, the most frequent elicitors of allergic reactions to venom are honeybees (Apis mellifera), yellow jackets (Vespula vulgaris) and paper wasps (Polistes dominula) [51]. Currently, 12 allergens from honeybee venom (Api m 1–12), and 5 from each paper wasp and yellow jacket (Pol d 1–5 and Ves v 1–3, 5, 6) have been characterized. These allergens show different abundances within venom extracts –Api m 1 (phospholipase) and Api m 4 (mellitin) are abundant (12%), while the others are below 1% [52]. Similarly in yellow jacket venom extract, Ves v 1 (phospholipase A1) and Ves v 5 (antigen 5) are more abundant [51]. These allergens also show some degree of cross-reactivity, partially due to protein glycosylation with cross-reactive carbohydrate determinants (CCDs), but also due to the homology among related insect species [53,54]. Api m 1–5 and 10, Ves v 1 and 5, Pol d 1 and 5 are commercially available as recombinant allergens for diagnosis [54]. sIgE against Api m 1, 3, 4, 10 is a useful marker for honeybee venom allergy. Yellow jacket venom allergy can be evaluated using Ves v 1 and Ves v 5, which are the most valuable for differentiation between honeybee and yellow jacket venom allergy, but they are cross-reactive with their homologues from paper wasp venom (Table 2) [51,55].
Alcohol use disorder and risk of sensitization to environmental allergens in Sub-Continental Asian Indian males
Published in Journal of Addictive Diseases, 2018
Yashwant Kumar, PVM Laxmi, Ranjana Walker Minz, Arnab Pal
Alcohol can induce allergic symptoms, particularly in asthmatics and is known to be associated with higher levels of circulating total IgE (tIgE).5–7 Nevertheless, studies favoring a link between alcohol, sensitization to environmental allergens, and allergic disorders are very few and inconclusive. Linneburg et al. followed 1200 adults with AUD (>14 drinks per week) from the age of 40 to 60 years and found that AUD was significantly associated with the prevalence of aeroallergen sensitization and atopic disease.8 Another study on 1469 individuals between 20 and 60 years of age showed alcohol consumption to be significantly associated with sensitization to aeroallergen D. ferinae.9 A Danish study, in contrast, did not find any relationship between AUD and risk of allergic disease despite an association with high plasma tIgE levels.10 Sensitization to cross-reactive carbohydrate determinants in drinkers can also occur and may cause false-positive results or interference with the interpretation of in-vitro allergy tests.11,12 Because of such conflicting results, more studies are required to conclude a true relation between alcohol and allergic diseases. India is home to one-sixth of the world’s population with high prevalence of both AUD and allergic diseases.13 A study of a representative cohort from such population is therefore ideal and may help in better understanding the relationship between the two, if any.
Establishing diagnostic strategies for cannabis allergy
Published in Expert Review of Clinical Immunology, 2022
Alessandro Toscano, Jessy Elst, Marie-Line van der Poorten, Michiel Beyens, Kevin Heremans, Ine I. Decuyper, Athina L. Van Gasse, Christel Mertens, Michel Van Houdt, Margo M. Hagendorens, Vito Sabato, Didier G. Ebo
Dosing whole hemp extract-specific IgE, although having a sensitivity higher than 80% still have an unsatisfactory specificity of only about 30% [19]. As for in vivo tests, this is caused by the interference of possible concomitant cross-sensitizations to other plant allergens such as PR-10, profilin and nsLTP. In addition, sensitization to cross-reactive carbohydrate determinants (CCDs), while only rarely affecting in vivo tests results, can interfere with in vitro tests based on extracts and native components, leading to false-positive results [27]. On a component level, specific IgE for Can s 3 seems to have a higher specificity compared to those for whole extract but have a lower sensitivity, namely a specificity of 87% and a sensitivity of 47% [19].