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Management of Natural Rubber Glove Sensitivity
Published in Robert N. Phalen, Howard I. Maibach, Protective Gloves for Occupational Use, 2023
The homologies between NRL and fruit (banana, kiwi, avocado) proteins (i.e. Hev b 6 and endochitinases) are associated with the cross-reactivity and the so-called “latex-fruit syndrome.”8 In Denmark, 52% of the NRL-sensitized patients had reported a history of reaction related to oral intake of fruits or vegetables. The most common fruits were kiwi, banana, and avocado. Most of the food-related symptoms were mild, primarily oral allergy syndrome (85%). Of note, the patients with NRL-related clinical symptoms were more likely to have more severe food-related symptoms compared to those who had only positive prick test responses to NRL. The same study showed that 64% of the patients had positive prick reactions to both NRL and birch pollen.11 This should be kept in mind as clinically non-relevant NRL sensitization might be associated with cross-reactivities.
Food Allergy
Published in Pudupakkam K Vedanthan, Harold S Nelson, Shripad N Agashe, PA Mahesh, Rohit Katial, Textbook of Allergy for the Clinician, 2021
Neha T Agnihotri, Jialing Jiang, Christopher M Warren, Ruchi S Gupta
Novel methods to improve diagnostic measures continue to remain under investigation. Component Resolved Diagnostics (CRD) are being used more as emerging literature shows their potential to improve diagnosis of a specific food allergy and even the predictive value in deciding to offer an OFC compared with standard testing. In allergen-specific IgE testing, the extract from the whole food is tested which contains a complex mixture of proteins, including both allergenic and non-allergenic molecules. CRD or component-based IgE testing uses individual proteins (purified or recombinant) within that food to detect specific IgE-binding epitopes. This allows for better means of distinguishing sensitization to proteins that are clinically relevant and may help determine risk of severity with some components better correlating with clinical reactivity. For example, sensitization to a heat-resistant protein is more likely to yield systemic reactions whereas sensitization to a heat-labile protein component may be less clinically relevant or allow for identification of cross-reactivity with similar pollen species (given the homologous nature of some proteins to aeroallergens causing the classic pollen-food or oral allergy syndrome). Predicative capabilities of these components do vary, however, according to population background.
Tree pollen allergens
Published in Richard F. Lockey, Dennis K. Ledford, Allergens and Allergen Immunotherapy, 2020
Rosa Codina, Fernando Pineda, Ricardo Palacios
Table 10.1 provides an overview of tree pollen allergens, grouped according to botanical classifications. Each of the different trees contains a spectrum of allergens. However, it appears that certain allergenic molecules occur in different tree species as proteins with significant sequence homology and cross-reactive epitopes. In general, it is possible to identify certain groups of cross-reactive allergens. For example, there are the Bet v 1–related allergens, Que e 1, Aln g 1, Cor a 1, Car b 1, Ost c 1, Fag s 1, and Cas s 1, that can be found in pollen from trees belonging to the order Fagales. These allergens are also expressed in the nuts of trees belonging to this same order and in fruits of unrelated trees belonging to the order Rosales (within the subclass Rosidae). Due to cross-reactivity, they might elicit symptoms of food allergy, particularly oral allergy syndrome, in pollen-allergic patients (Figure 10.5a).
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
An important aspect of food allergy are the cross-reactivity syndromes, caused by shared allergenic epitopes between inhalant and food allergens [133], inducing a wide range of symptoms from oral allergy syndrome to severe anaphylaxis. The elicitors are usually the members of the pan-allergen families. A well-known group of cross-reactive inhalant-plant allergens are the Bet v 1 homologues, belonging to the PR-10 family of proteins. These allergens are found in various sources (pollen, fruits, nuts, vegetables, and legumes). Exposure to foods containing these allergens may trigger allergy symptoms patients sensitized to Bet v 1. Shrimp allergy occurs in association with hypersensitivity to HDM or cockroach allergens, with tropomyosin being the main shrimp allergen [134,135]. Along with tropomyosin-specific IgE levels, monosensitization to HDM seems to represent a risk factor for the development of shrimp allergy among HDM allergic patients [135]. Lupine sensitization has been observed in 15–20% of individuals with known peanut allergy, with several molecules fueling peanut-lupine cross-reactivity [136].CRD helps to define if it is a primary sensitization or the symptoms are caused by a cross-reactivity between homologous proteins. The important molecular allergens with high degree of cross-reactivity between inhalant and food allergens can be assessed by different diagnostic platforms (Table 4).
Kidney-bean (Phaseolus Vulgaris) Dependent, Exercise-induced Anaphylaxis in Patients Comorbid with Mugwort (Artemisia Vulgaris) Pollinosis
Published in Immunological Investigations, 2021
Pollen-food allergy syndrome, or oral allergy syndrome, is a food allergy caused by cross-reacting allergens found in both pollen and food (Price et al. 2015). The most well-known symptoms of pollen-food allergy syndrome include irritation or swelling of the mouth and throat (Muluk and Cingi 2018). Mugwort pollen is a common cause of allergic rhinoconjunctivitis and asthma in China, and it is known to cross-react with some food (Popescu 2015). Mugwort pollen-food allergy is often observed in clinical practice. Mugwort-fennel, celery-mugwort-spice, mugwort-peach, mugwort-chamomile, and mugwort-mustard associations have been reported (Egger et al. 2006; Figueroa et al. 2005). Another association is mugwort-kidney bean syndrome, in which patients sensitized to mugwort may develop an allergy to kidney beans and experience anaphylaxis. The reaction is considered as a consequence of immunologic cross-reactivity between mugwort pollen allergen and structurally related protein from kidney bean. To date, cross-reactive allergen has not yet been identified.
Update on pollen-food allergy syndrome
Published in Expert Review of Clinical Immunology, 2020
Pascal Poncet, Hélène Sénéchal, Denis Charpin
PFAS, also named ‘Pollen-related food allergy’ [3] is an IgE-dependant allergic reaction directed toward fruits and plants linked to allergic sensitization to inhaled plant allergens, essentially pollen. Symptoms of PFAS may involve one or more target organs, including the oral mucosa, the skin, the gastrointestinal and respiratory tracts, and the cardio-vascular system. Contact urticaria of the oropharyngeal sites is by far the most frequent presentation of food allergy seen in adolescents and adult patients. Therefore, this allergic complaint was initially called oral allergy syndrome (OAS). Some authors still use both terms synonymously [4,5]. However, this designation does not seem to be appropriate because there may be symptoms other than those affecting the ear, nose, and throat (ENT) and, in the extreme, anaphylactic reactions. As Turner stressed in 2015 [4], the confusion between both terms (PFAS and OAS) is worrying because many patients with primary food allergy without pollinosis (type I food allergy) will exhibit oral symptoms to low doses of allergen and can thus progress to systemic symptoms and anaphylaxis. If such patients are diagnosed as suffering from OAS they may not benefit for a proper management and noticeably not be prescribed epinephrine injector.