Unraveling the Diagnosis of Kiwifruit Allergy: Usefulness of Current Diagnostic Tests.

OBJECTIVES: To determine the usefulness of the in vitro and in vivo methods used in the diagnosis of kiwifruit allergy and to specifically assess the impact of seed proteins on sensitivity. METHODS: We performed skin prick tests (SPTs) using various commercial extracts, homemade pulp, and seed extracts and prick-prick tests with kiwifruit on 36 allergic patients. The presence of specific IgE (sIgE) was assessed using the ImmunoCAP (kiwifruit extract), ELISA (Act d 1, Act d 2), ISAC, and FABER assays. Immunoblotting of seed extract was carried out, and a single-blind oral food challenge was performed with whole seeds in seed-sensitized individuals. RESULTS: The prick prick test with kiwifruit demonstrated the highest diagnostic capacity (81.8% sensitivity and 94.1% specificity) among the in vivo tests. The sIgE levels measured using ImmunoCAP (kiwifruit extract) showed a similar sensitivity to that of global ISAC and FABER (63.9%, 59.5%, and 58.3%, respectively). Act d 1 was the major allergen. Sensitization to Act d 1 was associated with positive sIgE results to whole kiwifruit extract detected by ImmunoCAP (P<.000). A positive SPT result to kiwifruit seeds was associated with severe symptoms induced by kiwifruit (P=.019) as a marker of advanced disease, but not with clinically relevant sensitization. Challenge testing with kiwifruit seeds performed on 8 seed-sensitized patients yielded negative results. CONCLUSION: Sensitization to Act d 1 is associated with a positive result in conventional diagnostic techniques, whereas kiwifruit seed sensitization does not increase the sensitivity of the diagnostic techniques evaluated.

Radionuclide concentration in tea, cabbage, orange, kiwi and soil and lifetime cancer risk due to gamma radioactivity in Rize, Turkey.

BACKGROUND: In this study, the activity concentrations of (232) Th, (238) U, (40) K and (137) Cs were measured in tea, cabbage, orange, kiwi and soil samples collected from different stations using gamma spectrometry with a high-purity germanium detector. RESULTS: The average activity concentrations of (232) Th, (238) U, (40) K and (137) Cs were found to be 8.2 ± 1.8, 17.3 ± 3.3, 465.8 ± 11.8 and 20.9 ± 3.8 Bq kg(-1) in food samples, and 72.4 ± 9.8, 51.1 ± 8.3, 229.3 ± 14.7 and 312.9 ± 11.5 Bq kg(-1) in farm soils, respectively. The internal effective dose to individuals and excess lifetime cancer risk from the consumption of the food type radioactivity ranged between 11.7 and 53.6 µSv y(-1) and between 0.05 × 10(-3) and 0.24 × 10(-3) , respectively. The annual external gamma effective dose and excess lifetime cancer risk in the farms due to soil radioactivity ranged between 94.1 and 139.8 µSv y(-1) and between 0.43 × 10(-3) and 0.64 × 10(-3) , respectively. The mean transfer factors of (232) Th, (238) U, (40) K and (137) Cs, from the soil to vegetables and fruit were 0.57, 0.32, 2.12 and 0.04, respectively. CONCLUSION: Annual effective gamma doses were found to be higher than the world's average in soil samples. The excess lifetime cancer risks were only found higher than the world's average in soil samples.

Component-resolved diagnosis of kiwifruit allergy with purified natural and recombinant kiwifruit allergens.

BACKGROUND: Kiwifruit is one of the most common causes of food allergic reactions. Component-resolved diagnostics may enable significantly improved detection of sensitization to kiwifruit. OBJECTIVE: To evaluate the use of individual allergens for component-resolved in vitro diagnosis of kiwifruit allergy. METHODS: Thirty patients with a positive double-blind placebo-controlled food challenge to kiwifruit, 10 atopic subjects with negative open provocation to kiwifruit, and 5 nonatopic subjects were enrolled in the study. Specific IgE to 7 individual allergens (nAct d 1-5 and rAct d 8-9) and allergen extracts was measured by ImmunoCAP. RESULTS: The diagnostic sensitivities of the commercial extract and of the sum of single allergens were 17% and 77%, respectively, whereas diagnostic specificities were 100% and 30%. A combination of the kiwi allergens Act d 1, Act d 2, Act d 4, and Act d 5 gave a diagnostic sensitivity of 40%, whereas diagnostic specificity remained high (90%). Exclusion of the Bet v 1 homolog recombinant (r) Act d 8 and profilin rAct d 9 from this allergen panel reduced sensitivity to 50% but increased specificity to 40%. Kiwifruit-monosensitized patients reacted more frequently (P < .001) with Act d 1 than polysensitized patients, whereas the latter group reacted more frequently with rAct d 8 (P = .004). CONCLUSION: Use of single kiwifruit allergen ImmunoCAP increases the quantitative test performance and diagnostic sensitivity compared with the commercial extract. Bet v 1 homolog and profilin are important allergens in pollen-related kiwifruit allergy, whereas actinidin is important in monoallergy to kiwifruit, in which symptoms are often more severe.

Kiwi fruit allergy: a review.

Allergy to kiwi fruit was first described in 1981, and there have since been reports of the allergy presenting with a wide range of symptoms from localized oral allergy syndrome (OAS) to life-threatening anaphylaxis. The article reviews the available information concerning the clinical features of kiwi fruit allergy and the role of clinical investigations for diagnosis. Work identifying the major allergens in kiwi fruit has resulted in conflicting results, the possible reasons for which are discussed. The clinical associations of kiwi fruit allergy with allergies to pollens or latex are reviewed.