Higher Risk for Sensitization to Commonly Consumed Herbs among Adults and Youngsters Suffering from Birch, Mugwort or Grass Pollinosis.

Background: According to recent findings, mugwort and birch pollen-allergic patients represent a high-risk group for developing adverse allergic reactions to herbal spices due to cross-reacting allergens found in both pollen and raw herbs. Such associations are known as a pollen-plant food allergy syndrome. Objective: The aim of the study was to evaluate the extent of sensitization to commonly consumed herb species representing Lamiaceae, Apiaceae and Brassicaceae families in Polish patients with suspected birch, mugwort or grass pollen allergy. Materials and Methods: Data were obtained from 180 patients, adults and children with suspected allergy to aeroallergens. Skin prick tests (SPT) were performed with standard birch, mugwort, grass mixture or dust mite extracts. Prick by prick tests were performed with fresh extracts of popular herbs: basil, oregano, lemon balm, mint, salvia, rosemary, thyme, anise, caraway and mustard. Results: Twenty-nine percent of patients were characterized by concomitant positive skin prick reactions to both herbs and pollens extracts. The concomitant pollinosis significantly increased the risk of SPT reaction to all tested herbs in adults (odds ratio, OR = 2.15−7.35) and children (OR = 5.3−28). The extent of SPT responses to herbs from Lamiaceae + Apiaceae were strongly correlated with SPT responses to pollens in the pediatric group (r = 0.685/p < 0.001). Conclusion: The study demonstrates that youngsters suffering from pollinosis are at high risk of developing allergic reactions to herbs and highlights the importance of including native skin prick tests with herbs in the diagnostic work-up for suspected food allergy.

Accelerated Up-Dosing of Subcutaneous Immunotherapy with a Registered Allergoid Birch Pollen Preparation.

BACKGROUND: Early pollen flight and new allergens prolonging the pollen season means that the time for up-dosing of allergen-specific subcutaneous immunotherapy (SCIT) outside the pollen season becomes shorter. Hence, for patients who wish or need to be up-dosed faster, an accelerated induction regimen would provide a useful treatment option. METHODS: An accelerated up-dosing regimen (0.1-0.3-0.5 mL at weekly intervals) was compared to conventional up-dosing (0.05-0.1-0.2-0.3-0.4-0.5 mL at weekly intervals) using an allergoid birch pollen SCIT preparation. After up-dosing, the maintenance dose (0.5 mL) was given 3 times at biweekly intervals. The multicenter study was performed according to an open randomized, parallel-group design. RESULTS: A total of 123 birch pollen-allergic patients (81 adults and 42 adolescents) presenting with rhinitis or rhinoconjunctivitis with or without mild asthma (FEV1 >70%) were randomized to either the conventional registered up-dosing or an accelerated regimen. In total, 96.7 and 98.4% successfully reached the maintenance dose for the conventional and accelerated regimen, respectively, without relevant differences between adults and adolescents. Both regimens were safe and well tolerated. Furthermore, significant increases (similar in size) in specific IgG and IgG4 after 3 months of treatment were observed in both groups, independent of age. CONCLUSION: The accelerated SCIT regimen was revealed to be as safe as the conventional regimen, and the immunological effects of both regimens are similar. Accordingly, the accelerated regimen may be used to up-dose patients of adult as well adolescent age within 2 weeks.

Allergy to apple cultivars among patients with birch pollinosis and oral allergy syndrome.

BACKGROUND: Oral allergy syndrome (OAS) is caused by cross-reacting allergens found in pollen, raw fruits, vegetables, and some tree nuts. The major apple allergen, Mal d 1, is a cause of food allergic reactions in birch pollen sensitized patients. OBJECTIVE: To explore the allergenicity of the most popular and commonly consumed apple cultivars in Poland in patients with birch pollen allergy with or without OAS. METHODS: Data were obtained from 46 adults with clinical symptoms of birch allergy and allergic rhinitis or rhinoconjunctivitis. Patients were divided into 2 groups according to the occurrence of OAS to apple. Skin prick tests (SPTs) were performed with pulp from the 11 most popular apple cultivars in Poland. Specific IgE (sIgE) to Bet v 1 was measured by radioallergosorbent test. RESULTS: Patients with OAS had more positive responses to apple SPT vs patients without OAS (odds ratios, 4.8-11.96). Patients with OAS had distinctive responses to apple cultivars. Szara Reneta and Cortland induced positive responses in 50% and 83% of patients, respectively. Patients with OAS vs patients without OAS who were allergic to apples vs nonallergic had 2-fold (P = .008) and 7-fold (P = .03) higher blood concentrations of sIgE Bet v 1, respectively. There were different profiles of correlations of sIgE Bet v 1 with wheal diameter for low and high allergenic cultivars in patients without and with OAS. CONCLUSION: We noted a substantial role for Bet v 1 sensitization in the allergic response based on evaluation of the allergenicity of 11 apple cultivars. The sIgE Bet v 1 and SPT results of patients with and without OAS allowed differentiation between low and high allergenic cultivars.

[Anaphylactic reaction caused by conjunctival provocation with birch recombinant allergen rBet v 1a Mut1-6--case report]. / Reakcja anafilaktyczna wywolana prowokacja spojówkowa z rekombinowanym alergenem brzozy rBet v 1a mut1-6--opis przypadku.

UNLABELLED: Conjunctival provocations with recombinant allergens are new kind of examinations in allergology but they are estimated as safe. The aim of the work was to present a case of anaphylactic reaction caused by birch recombinant allergen with theoretically decreased allergenity. RESULTS: A patient allergic to birch pollen revealed strong local and anaphylactic reaction (I/II stage) after conjunctival provocation with recombinant allergen rBet v 1a Mut1-6. CONCLUSIONS: Provocation tests with allergens are at risk of anaphylaxis and that is why they should be conducted with caution and with resuscitation procedures for a patient safety.

[Oral allergy syndrome (OAS)--diagnostic values of skin prick test]. / Ustny zespól uczuleniowy (UZU)--wartosc diagnostyczna skórnych testów punktowych.

The authors presented results of allergological investigation concerning 58 patients with OAS and tree pollenosis versus 27 persons with isolated tree pollenosis. Commercial skin prick tests presented lower diagnostic usefulness, in comparison to test with fresh or boiled crude foods.