allergy
Prediction of tolerance on the basis of quantification of egg white-specific IgE antibodies in children with egg allergy.

Boyano-Martinez T, Garcia-Ara C, Diaz-Pena JM, Martin-Esteban M.

Servicio de Alergia Infantil, Hospital Universitario La Paz, C/Ginzo de Limia 55, 9oC, 28034 Madrid, Spain.

BACKGROUND: It is thought that the natural evolution of food allergy has a good tolerance prognosis. However, there are few follow-up studies that determine the exact probability of tolerance to a given food or that analyze prognostic factors that can help us to understand the evolution of a child who begins life with a food allergy. OBJECTIVE: We sought to determine the likelihood that children younger than 2 years of age with allergy to egg would eventually have tolerance to it and to analyze several prognostic predictors using egg white-specific IgE level as the main variable. METHODS: We performed a prospective study of 58 children younger than 2 years of age with egg allergy, who were studied periodically until tolerance developed or until the end of the study. During the follow-up period, open challenge tests were carried out according to previously established criteria to verify tolerance to egg. Factors such as egg white-specific IgE level, serum total IgE level, symptoms after egg ingestion, size of skin prick test reactions to egg white, atopic dermatitis, and sex were analyzed as prognostic markers. Kaplan-Meier survival curves were used to calculate cumulative tolerance probability. Predictor influence and relative prognostic importance were estimated with the Cox proportional regression model. RESULTS: The median time from the appearance of the first symptoms to tolerance was 35 months. Cumulative tolerance probability was 16% at 12 months of follow-up, 28% at 24 months, 52% at 36 months, 57% at 48 months, and 66% at 60 months. The relative weight of prognostic factors, expressed as the hazard ratio, was 50.95 for symptoms and 3.74 for the size of skin prick test reactions, with both being independent effects. The hazard ratio was 1.173 for every 0.1-unit decrease in the concentration log (decimal logarithm) of specific IgE level, with this effect being associated with tolerance only in children with cutaneous symptoms. CONCLUSIONS: Half of the children younger than 2 years of age with egg allergy will tolerate the food at 35 months of follow-up, and the proportion could be 66% after 5 years. At that age, the main predictors were the symptoms experienced after egg ingestion, followed by the size of skin prick test reactions. In addition, the specific IgE antibody level is an important prognostic marker in children who only had cutaneous symptoms.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12170273&dopt=Abstract allergy medicine



allergy
Hypersensitivity to mugwort (Artemisia vulgaris) in patients with peach allergy is due to a common lipid transfer protein allergen and is often without clinical expression.

Pastorello EA, Pravettoni V, Farioli L, Rivolta F, Conti A, Ispano M, Fortunato D, Bengtsson A, Bianchi M.

Allergy Center, 3rd Division of General Medicine, Ospedale Maggiore IRCCS, Via Francesco Sforza 35, 20122 Milan, Italy.

BACKGROUND: The observation of mugwort-specific IgE antibodies in patients with peach allergy suggests that mugwort sensitization might play a role in sensitization to peach. OBJECTIVE: We sought to study the clinical manifestations of mugwort hypersensitivity in patients with peach allergy, identify the common allergens, and evaluate their IgE crossreactivity. METHODS: Patients with oral allergy syndrome for peach and specific IgE antibodies to mugwort were investigated for respiratory symptoms during the mugwort season. Peach and mugwort allergens were identified by means of SDS-PAGE and IgE immunoblotting. Immunoblotting inhibition experiments were done to study cross-reactivity between peach and mugwort and other pollens. RESULTS: Seventeen patients were studied, 10 with no seasonal respiratory symptoms and 7 with clear late summer respiratory symptoms. In IgE immunoblotting the 10 asymptomatic patients reacted only to a 9-kd allergen of both mugwort and peach, whereas the 7 patients with pollinosis reacted to other allergens. Ten patients with mugwort allergy, no history of allergy to peach, and negative results for peach-specific IgE antibodies were also studied. The mugwort 9-kd protein was identified as a lipid transfer protein (LTP) homologous to peach LTP. Immunoblotting inhibition showed that IgE binding to the peach 9-kd band was totally inhibited by 4 microg of peach LTP but only by 400 microg of mugwort LTP, whereas 4 microg of both mugwort and peach LTP totally inhibited the mugwort immunoblotting. The results were similar with other pollens. CONCLUSIONS: Patients sensitized only to the 9-kd LTP of mugwort do not present hay fever symptoms, and this sensitization is a consequence of the peach sensitization.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12170274&dopt=Abstract allergy medicine



allergy
An allergen from Olea europaea pollen (Ole e 7) is associated with plant-derived food anaphylaxis.

Florido Lopez JF, Quiralte Enriquez J, Arias de Saavedra Alias JM, Saenz de San Pedro B, Martin Casanez E.

Unidad de Alergia, Hospital Universitario Ciudad de Jaen, Jaen, Spain.

BACKGROUND: Several cross-reacting proteins have been identified as responsible of the co-occurrence of pollinosis and plant-derived food allergy. This association has been mainly described in the birch-apple syndrome but other pollens such as Olea europaea and other fruits may also contain homologous proteins. OBJECTIVE: To evaluate the associations between sensitization to allergens of Olea europaea pollen and confirmed plant-derived food allergy, in addition to investigate if any pattern of clinical hypersensitivity of food allergy reaction (oral allergy syndrome (OAS) or anaphylaxis) and/or any fresh fruit or nut allergy, are associated to one or several Olea pollen allergen(s). METHODS: One-hundred and thirty-four consecutive patients diagnosed with pollinosis by Olea were studied. Of these patients only 40, reported adverse reaction to plant-derived food. Twenty-one (group A) were classified as OAS and 19 (group B) as anaphylaxis. Skin-tests with six Olea pollen allergens and several groups of fruits, were performed. Double-blind placebo-controlled food challenge (DBPCFC), confirmed the diagnostics of food allergy with the exception of patients who suffered previous anaphylactic reaction. RESULTS: All patients, showed a positive skin prick test (SPT), against one or more of Olea europaea allergens. Sensitization to Ole e 7, was more frequent (P = 0.02) in patients from group B. A total of 84 DBPCFC were performed with 44% positive results. Challenge confirmed at least the 50% of positive SPT in any case (peach: 68.42%; pear: 50%; melon: 71.42% and kiwi: 53.84%). In patients from group B, significant association with O. europaea pollen allergens were found between positive SPT to Rosaceae fruits and Ole e 3 (P = 0.045) and Ole e 7 (P = 0.03); Cucurbitaceae and Ole e 7 (P = 0.03) and Actinidiaceae with Ole e 3 (P = 0.04). CONCLUSIONS: The results of this study, establish a new spectrum of associations between pollens and plant-derived foods: sensitization to olive profilin (Ole e 2) is not more frequent in OAS patients. Patients with anaphylactic reaction after eating fruit are also sensitized to Ole e 7, a LTP present in Olea pollen, and suffer pollinic symptoms. Finally a polcalcin (Ole e 3) could be also associated to Olea pollen respiratory and food allergy.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12173271&dopt=Abstract allergy medicine



allergy
Nasal polyps in patients with rhinitis and asthma.

Grigoreas C, Vourdas D, Petalas K, Simeonidis G, Demeroutis I, Tsioulos T.

Department of Allergy and Clinical Immunology, 251 Air Force General Hospital, Athens, Greece.

The objective of this study was to investigate the prevalence of nasal polyposis in Greek patients with chronic rhinitis and asthma. We studied 3817 patients (2342 men and 1385 women) who were referred for allergy evaluation during 1990-1998 and diagnosed as having chronic rhinitis and asthma. Skin-prick tests with allergens common in Greece and controls were used in all subjects. A wheal with a mean diameter > or = 3 mm was considered as positive. According to the history of symptoms and the results of skin tests, patients were divided into the following groups: patients who have allergic rhinitis (seasonal, perennial), patients who have allergic asthma (seasonal, perennial), patients who have nonallergic rhinitis, and patients who have nonallergic asthma. All patients were examined for nasal polyps by anterior rhinoscopy and endoscopic investigation with a rigid or/and flexible endoscope. We found that 4.2% of the patients with chronic rhinitis and asthma (4.4% of the men and 3.8% of the women; p > 0.05) had nasal polyps. The prevalence of nasal polyps increased with age (p < 0.001) in both sexes. The prevalence of nasal polyps was 13% in patients with nonallergic asthma, 2.4% in patients with allergic asthma, 8.9% in patients with nonallergic rhinitis, and 1.7% in patients with allergic rhinitis. Nasal polyps were found in 3.6% of the patients with rhinitis and in 4.8% of the patients with asthma (p > 0.05). Nasal polyps were present more frequently (1) in patients with nonallergic respiratory disease (rhinitis, asthma) than in patients with allergic respiratory disease (10.8% versus 2.1%; p < 0.001) and (2) in patients with perennial respiratory allergy (rhinitis, asthma) than in patients with seasonal respiratory allergy (4.8% versus 0.4%; p < 0.001). We found that 4.2% of patients with chronic rhinitis and asthma had nasal polyps. Nasal polyps were present more frequently in nonallergic patients than in allergic patients and in patients with perennial allergy than in patients with seasonal allergy.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12125503&dopt=Abstract allergy medicine



allergy
[A report of 50 patients with artemisia pollenosis and plant food allergy]

[Article in Chinese]

Wen Z, Ye S.

Department of Allergy, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China.

OBJECTIVE: To study the patients with both artemisia pollenosis and plant food allergy. METHODS: The diagnosis of artemisia pollenosis was based on a history of summer-autumn pollenosis, and positive intradermal test with artemisia pollen (Ar) and serum specific IgE-Ar; the diagnosis of plant food allergy was based on a history of the symptoms occurred shortly after the intake of some plant foods, and positive skin prick test using some plant food, and positive specific IgE in some of them. RESULTS: A total of 50 patients with both artemisia pollenosis and plant food allergy was diagnosed. The average age of onset of artemisia pollenosis was 24 (7 approximately 56 yr), The average age of onset of allergy to plant food was 23 year 8 month (3 approximately 57 yr). Sex ratio (M:F) was 21:29 with female predominating. artemisia pollenosis occurred prior to food allergy in 50% of the patients, plant food allergy occurred prior to pollenosis in about 29% of the patients, both of them occurred simultaneously in 21%. The common offending food were legumes, peach and peanut and sunflower seeds etc, nasal symptoms by inhalation of Ar occurred in 96% (46/48) of the patients, followed by conjunctivitis and asthma, urticaria was not common, anaphylatic shock and gastrointestinal symptoms were rare. The common clinical manifestations caused by ingestion of plant food were urticaria and oral allergy syndrome (OAS) occurred in 66% (33/50) and 40% (20/50) of the patients respectively, followed by asthma, rhinitis and conjunctivitis, anaphylactic shock and gastrointestinal tract symptoms were much more frequently than artemisia pollenosis. but single oral mucosa symptoms only occurred in 3 patients. CONCLUSION: The patients with pollenosis must be in vigilance for the development of plant food allergy later, and vise versa. Single oral mucosa symptoms were rarely seen.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12133486&dopt=Abstract allergy medicine



allergy
Non-mutated tumor-rejection antigen peptides elicit type-I allergy in the majority of healthy individuals.

Ohkouchi S, Yamada A, Imai N, Mine T, Harada K, Shichijo S, Maeda Y, Saijo Y, Nukiwa T, Itoh K.

Cancer Vaccine Development Division, Kurume University Research Center for Innovative Cancer Therapy, Japan.

IgE-mediated type-I allergy is generally considered to be a hypersensitivity reaction to foreign antigens, and it is believed that self-antigens do not evoke this type of allergy. We report here, for the first time, that non-mutated self-antigen peptides identified as tumor-rejection antigen peptides recognized by HLA class I-restricted and tumor-specific cytotoxic T lymphocytes (CTLs) elicited a type-I allergy in the majority of healthy individuals. Peptide-specific IgE was detectable in sera from certain cases, although the levels did not always correlate with those of type-I allergy. Repeated vaccinations of nonallergic peptides derived from the same antigens possessing allergic peptides resulted in the suppression of both allergic peptide-specific IgE responses and type-I allergy, providing evidence for a new approach to the development of peptide-based desensitization.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12135424&dopt=Abstract allergy medicine



allergy
Screening for latex allergy with a questionnaire: comparison with latex skin testing in a group of dental professionals.

Katelaris CH, Widmer RP, Lazarus RM, Baldo B.

Department of Immunology and Allergy, Westmead Hospital, Sydney, New South Wales. chk allergyimmunol.com.au

BACKGROUND: Latex allergy has emerged as an important cause of allergic reactions particularly in health workers. Due to the lack of a standardized extract for objective skin testing a screening questionnaire was developed. METHODS: At the 1995 Australian Dental Association Conference, all attendees were invited to complete a questionnaire and undergo skin testing to assess the level of latex allergy in this population and to assess the performance of the questionnaire as a screening test for latex allergy. RESULTS: The questionnaire had high specificity but poor sensitivity compared to skin testing with latex extract. CONCLUSION: This study compares at risk individuals identified by a screening questionnaire with those identified by objective skin testing. A questionnaire designed to screen for latex allergy was reliable for identifying those with low risk while overestimating those at risk of true latex allergy, demonstrating the need for objective testing with reliable allergens.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12139270&dopt=Abstract allergy medicine