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1.
Occup Environ Med ; 78(2): 142-144, 2021 02.
Artigo em Inglês | MEDLINE | ID: mdl-33067336

RESUMO

OBJECTIVES: Several studies have described peach tree (PT) as an occupational allergen. The aim of this work was to assess the effect of Prunus persica 9 (Pru p 9), a recently identified allergen from PT pollen, in exposed workers. METHODS: The study included people who reported respiratory symptoms after handling PT in orchards during the flowering period (Blanca village, Murcia region, south-east Spain). After completing a detailed questionnaire, participants underwent skin prick test (SPT) and nasal provocation test (NPT). The IgE response was analysed by SDS-PAGE and immunoblotting assays. RESULTS: A total of 21 cases were included (mean age 45 years; 57% women). Most were polysensitised to common pollens, although one person was sensitised only to PT pollen. All cases had a positive SPT to this pollen, and 43% also to Pru p 9. All participants reported having rhinitis, and six participants reported having also asthma. Immunoblotting showed a heterogeneous IgE pattern for several proteins, with Pru p 9 recognised in nine cases. Most participants sensitised to PT pollen and Pru p 9 had positive NPTs, while those who were not sensitised to Pru p 9 tested negative. CONCLUSIONS: We demonstrate for the first time that Pru p 9, an allergen from PT pollen, can induce respiratory symptoms following occupational exposure. This must be considered a relevant allergen when people working with PT cultivars develop respiratory symptoms.


Assuntos
Doenças dos Trabalhadores Agrícolas/imunologia , Asma Ocupacional/imunologia , Exposição Ocupacional/efeitos adversos , Pólen/imunologia , Prunus persica/imunologia , Rinite Alérgica Sazonal/imunologia , Testes de Provocação Brônquica , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Testes Cutâneos , Espanha
2.
Mol Nutr Food Res ; 64(19): e2000560, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-32875712

RESUMO

SCOPE: Chickpea (Cicer arietinum) allergy has frequently been reported particularly in Spain and India. Nevertheless, chickpea allergens are poorly characterized. The authors aim to identify and characterize potential allergens from chickpea. METHODS AND RESULTS: Candidate proteins are selected by an in silico approach or immunoglobuline E (IgE)-testing. Potential allergens are prepared as recombinant or natural proteins and characterized for structural integrity by sodium dodecyl sulfate polyacrylamide gel electrophoresis (SDS-PAGE), circular dichroism (CD)-spectroscopy, and mass spectrometry (MS) analysis. IgE-sensitization pattern of Spanish chickpea allergic and German peanut and birch pollen sensitized patients are investigated using chickpea extracts and purified proteins. Chickpea allergic patients show individual and heterogeneous IgE-sensitization profiles with extracts from raw and boiled chickpeas. Chickpea proteins pathogenesis related protein family 10 (PR-10), a late embryogenesis abundant protein (LEA/DC-8), and a vicilin-containing fraction, but not 2S albumin, shows IgE reactivity with sera from chickpea, birch pollen, and peanut sensitized patients. Remarkably, allergenic vicilin, DC-8, and PR-10 are detected in the extract of boiled chickpeas. CONCLUSION: Several IgE-reactive chickpea allergens are identified. For the first time a yet not classified DC-8 protein is characterized as minor allergen (Cic a 1). Finally, the data suggest a potential risk for peanut allergic patients by IgE cross-reactivity with homologous chickpea proteins.


Assuntos
Alérgenos/imunologia , Cicer/imunologia , Hipersensibilidade Alimentar/imunologia , Proteínas de Vegetais Comestíveis/imunologia , Adulto , Alérgenos/química , Criança , Pré-Escolar , Culinária , Eletroforese em Gel de Poliacrilamida , Feminino , Humanos , Soros Imunes , Imunoglobulina E/imunologia , Masculino , Pessoa de Meia-Idade , Proteínas de Vegetais Comestíveis/química , Pólen/imunologia
3.
PLoS One ; 15(3): e0230010, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32191737

RESUMO

Peach tree (PT) pollen sensitization is highly prevalent in subjects living in areas where this tree is widely cultivated. None of the allergens responsible for these sensitizations have been identified so far. Our aim was to identify the most relevant PT pollen allergens and analyze their capacity for inducing respiratory symptoms. We studied sixty-two individuals sensitized to PT pollen who developed symptoms after its exposure. The IgE binding profile on peach pollen extract by means of immunoblotting using sera from these subjects was analyzed. Protein extract was fractionated by anion-exchange chromatography and HPLC, fractions run in SDS-PAGE and proteins were identified from IgE-binding bands by mass spectrometry. Several allergenic proteins in the PT pollen extract were recognized by patients' IgE: a glucan endo-1,3-beta-glucosidase-like, a polygalacturonase, an UTP-glucose-1-phosphate uridylyltransferase and a PR-1a protein. This PR-1a protein is a novel allergen frequently recognized with a molecular mass of 18 kDa, named as Pru p 9 following the WHO-IUIS nomenclature. Skin Prick Test (SPT) performed with this allergen was positive in 41% of the PT pollen-sensitized clinical cases. Most of them had rhinitis or rhinoconjunctivitis, but a significant percentage experienced asthma with seasonal symptoms during the period of PT flowering. Nasal Provocation test (NPT) with Pru p 9 was positive in all cases with positive SPT to this new allergen eliciting nasal symptoms similar to those challenged with PT pollen. We demonstrate that PT pollen can induce sensitization and allergy in an exposed population, being Pru p 9 a relevant allergen responsible of respiratory symptoms. Considering the extensive peach worldwide production with a large number of people involved, our results add a great value for the diagnosis and management of subjects allergic to this pollen.


Assuntos
Alérgenos/imunologia , Pólen/imunologia , Prunus persica/imunologia , Sistema Respiratório/imunologia , Adulto , Sequência de Aminoácidos , Feminino , Humanos , Masculino
4.
Sci Rep ; 9(1): 15043, 2019 10 21.
Artigo em Inglês | MEDLINE | ID: mdl-31636285

RESUMO

The weed wall pellitory, Parietaria judaica, is one the most important pollen allergen sources in the Mediterranean area causing severe symptoms of hay fever and asthma in allergic patients. We report the expression of the major Parietaria allergens, Par j 1 and Par j 2 which belong to the family of lipid transfer proteins, in insect cells. According to circular dichroism analysis and gel filtration, the purified allergens represented folded and monomeric proteins. Insect cell-expressed, folded Par j 2 exhibited higher IgE binding capacity and more than 100-fold higher allergenic activity than unfolded Escherichia coli-expressed Par j 2 as demonstrated by IgE ELISA and basophil activation testing. IgE ELISA inhibition assays showed that Par j 1 and Par j 2, contain genuine and cross-reactive IgE epitopes. IgG antibodies induced by immunization with Par j 2 inhibited binding of allergic patients IgE to Par j 1 only partially. IgE inhibition experiments demonstrated that insect cell-expressed Par j 1 and Par j 2 together resembled the majority of allergenic epitopes of the Parietaria allergome and therefore both should be used for molecular diagnosis and the design of vaccines for allergen-specific immunotherapy of Parietaria allergy.


Assuntos
Alérgenos/metabolismo , Antígenos de Plantas/metabolismo , Epitopos/metabolismo , Extratos Vegetais/metabolismo , Proteínas de Plantas/metabolismo , Proteínas Recombinantes/metabolismo , Adolescente , Adulto , Sequência de Aminoácidos , Fenômenos Biofísicos , Linhagem Celular , Criança , Reações Cruzadas , Epitopos/química , Escherichia coli/metabolismo , Feminino , Humanos , Hipersensibilidade/imunologia , Imunoglobulina E/imunologia , Masculino , Pessoa de Meia-Idade , Proteínas de Plantas/química , Proteínas de Plantas/isolamento & purificação , Proteínas Recombinantes/química , Proteínas Recombinantes/isolamento & purificação , Adulto Jovem
5.
Int Arch Allergy Immunol ; 180(3): 212-220, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31533105

RESUMO

BACKGROUND: Although plant and fruit pollens are entomophilous and relevant in exposed workers, we have shown a high frequency of sensitisation and symptoms induction of peach tree pollen (PTP) and Prunus persica 9 (Pru p 9) in adults from areas of peach cultivars. METHODS: We studied the sensitisation and clinical relevance of PTP and Pru p 9 in a large group of children and adolescents aged 3-19 years. A detailed questionnaire plus skin prick testing to prevalent allergens, PTP, and Pru p 9 were carried out. The clinical relevance was established by nasal provocation test (NPT) and symptom score index. RESULTS: We evaluated 685 children (mean age 8.75 ± 3.3 years, median 9 years), 52% of them female. Sensitisation to PTP occurred in 20% of the cases following olive tree (33%) and Phleum pratense (26%). In a randomly selected subgroup of subjects sensitised to PTP, 30% were skin prick test-positive to Pru p 9. Most cases had rhinitis or rhinoconjunctivitis. NPT showed the relevance of PTP and Pru p 9 in the induction of symptoms. CONCLUSION: PTP and Pru p 9 are relevant in the induction of sensitisation and respiratory symptoms in children and adolescents. This allergen should be evaluated in children living in regions of peach tree cultivars.


Assuntos
Alérgenos/imunologia , Antígenos de Plantas/imunologia , Hipersensibilidade Alimentar/epidemiologia , Hipersensibilidade Alimentar/imunologia , Pólen/imunologia , Prunus persica/imunologia , Rinite Alérgica Sazonal/imunologia , Adolescente , Criança , Feminino , Humanos , Imunização , Masculino , Olea/imunologia , Phleum/imunologia , Espanha/epidemiologia
7.
Int Arch Allergy Immunol ; 177(4): 290-301, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30173224

RESUMO

BACKGROUND: Cross-reactivity reactions between allergenic polygalacturonases (PGs) from different biological sources, especially foods and pollens from the Oleaceae family, have been described using Salsola kali PG (Sal k 6). No PG from olive pollen has been characterized to date, hampering further knowledge about cross-reactions through PGs. OBJECTIVES: The aim of this work was to determine the potential allergenicity of the PG from olive pollen and clarify its role in cross-reactivity. METHODS: A cDNA-encoding olive pollen PG sequence was subcloned into the pET41b vector and used to transform BL21(DE3) Escherichia coli cells to produce a His-tag fusion recombinant protein. The allergenic properties of olive pollen PG were determined by immunoblotting and ELISA in comparison to Sal k 6. The cross-reactivity potential of the protein with other pollen sources was analyzed by inhibition immunoassays. RESULTS: The existence of other isoforms of Ole e 14 with different allergenicity was confirmed by proteomics and a meta-analysis of the recently reported olive genome. Sal k 6 showed a higher IgE recognition than Ole e 14 regardless of patient sensitization, suggesting the existence of more allergenic Ole e 14 isoforms in olive pollen. IgG and IgE inhibition assays supported the existence of cross-reactions between them and with other PGs from Oleaceae and Poaceae plant families. CONCLUSIONS: A new allergen from olive pollen, Ole e 14, has been identified, produced as a recombinant isoform, and structurally and immunologically characterized. Its role in cross-reactivity has been confirmed and, due to its smaller IgE binding capacity, it could have an important role for therapeutic purposes.


Assuntos
Alérgenos/metabolismo , Antígenos de Plantas/metabolismo , Poligalacturonase/metabolismo , Rinite Alérgica Sazonal/imunologia , Alérgenos/genética , Alérgenos/imunologia , Sequência de Aminoácidos/genética , Antígenos de Plantas/genética , Western Blotting , Clonagem Molecular , Reações Cruzadas , Ensaio de Imunoadsorção Enzimática , Imunoglobulina E/metabolismo , Olea/imunologia , Pólen/genética , Pólen/metabolismo , Poligalacturonase/genética , Isoformas de Proteínas/genética , Proteômica , Salsola/imunologia
8.
J Proteomics ; 187: 39-46, 2018 09 15.
Artigo em Inglês | MEDLINE | ID: mdl-29883846

RESUMO

The allergenic non-specific lipid transfer protein Ole e 7 from olive pollen is a major allergen associated with severe symptoms in areas with high olive pollen levels. Despite its clinical importance, its cloning and recombinant production has been unable by classical approaches. This study aimed at determining by mass-spectrometry based proteomics its complete amino acid sequence for its subsequent expression and characterization. To this end, the natural protein was in-2D-gel tryptic digested, and CID and HCD fragmentation spectra obtained by nLC-MS/MS analyzed using PEAKS software. Thirteen out of the 457 de novo sequenced peptides obtained allowed assembling its full-length amino acid sequence. Then, Ole e 7-encoding cDNA was synthesized and cloned in pPICZαA vector for its expression in Pichia pastoris yeast. The analyses by Circular Dichroism, and WB, ELISA and cell-based tests using sera and blood from olive pollen-sensitized patients showed that rOle e 7 mostly retained the structural, allergenic and antigenic properties of the natural allergen. In summary, rOle e 7 allergen assembled by de novo peptide sequencing by MS behaved immunologically similar to the natural allergen scarcely isolated from pollen. SIGNIFICANCE: Olive pollen is an important cause of allergy. The non-specific lipid binding protein Ole e 7 is a major allergen with a high incidence and a phenotype associated to severe clinical symptoms. Despite its relevance, its cloning and recombinant expression has been unable by classical techniques. Here, we have inferred the primary amino acid sequence of Ole e 7 by mass-spectrometry. We separated Ole e 7 isolated from pollen by 2DE. After in-gel digestion with trypsin and a direct analysis by nLC-MS/MS in an LTQ-Orbitrap Velos, we got the complete de novo sequenced peptides repertoire that allowed the assembling of the primary sequence of Ole e 7. After its protein expression, purification to homogeneity, and structural and immunological characterization using sera from olive pollen allergic patients and cell-based assays, we observed that the recombinant allergen retained the antigenic and allergenic properties of the natural allergen. Collectively, we show that the recombinant protein assembled by proteomics would be suitable for a better in vitro diagnosis of olive pollen allergic patients.


Assuntos
Alérgenos , Antígenos de Plantas/imunologia , Olea/imunologia , Proteínas de Plantas/imunologia , Proteínas Recombinantes/imunologia , Rinite Alérgica Sazonal/imunologia , Alérgenos/análise , Alérgenos/química , Alérgenos/imunologia , Sequência de Aminoácidos , Mapeamento de Epitopos/métodos , Humanos , Olea/química , Mapeamento de Peptídeos/métodos , Proteínas de Plantas/análise , Proteínas de Plantas/química , Pólen/química , Pólen/imunologia , Isoformas de Proteínas/química , Isoformas de Proteínas/imunologia , Proteômica/métodos , Proteínas Recombinantes/química , Rinite Alérgica Sazonal/etiologia , Espectrometria de Massas em Tandem
9.
Pediatr Allergy Immunol ; 25(2): 129-35, 2014 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-24118194

RESUMO

BACKGROUND: Allergen-specific immunotherapy (IT) is widely used to treat allergic diseases. The molecular mechanisms have not been clarified yet completely. The present work was undertaken to analyze the effect of IT in the activation of NF-κB. METHODS: Neutrophils from 15 pollen-allergic IT-treated patients, 10 untreated pollen-allergic patients, and 10 healthy donors were in vitro stimulated with LPS. NF-κB activation (p65/p52) was measured in their nuclear extracts by enzyme-linked immunosorbent assay (ELISA). IκBα phosphorylation, NF-κB-repressing factor (NRF) activation, and thromboxane A2 (TXA2 ) and Interleukin-8 (IL-8) release were measured by ELISA. RESULTS: There was a positive correlation between the score of symptoms and NF-κB activation in human neutrophils. IT significantly decreased NF-κB activation levels in neutrophils compared with neutrophils from untreated patients. IκBα phosphorylation and NRF activation levels were, respectively, significantly lower and higher in neutrophils from IT-treated patients than from untreated patients. IL-8 and TXA2 release were significantly lower in neutrophils from IT-treated patients than from untreated patients. CONCLUSIONS: IT positive effects are at least in part mediated by the negative regulation of NF-κB activation in human neutrophils. These observations represent a novel view of neutrophils as possible cell target to treat IgE-dependent diseases through NF-κB downmodulation.


Assuntos
Alérgenos/uso terapêutico , Dactylis/imunologia , Dessensibilização Imunológica/métodos , Mediadores da Inflamação/metabolismo , Lipopolissacarídeos/farmacologia , NF-kappa B/metabolismo , Neutrófilos/efeitos dos fármacos , Pólen/imunologia , Rinite Alérgica Sazonal/terapia , Adolescente , Estudos de Casos e Controles , Células Cultivadas , Regulação para Baixo , Feminino , Humanos , Proteínas I-kappa B/metabolismo , Interleucina-8/metabolismo , Masculino , Inibidor de NF-kappaB alfa , Subunidade p52 de NF-kappa B/metabolismo , Neutrófilos/imunologia , Neutrófilos/metabolismo , Fosforilação , Proteínas Repressoras/metabolismo , Rinite Alérgica Sazonal/diagnóstico , Rinite Alérgica Sazonal/imunologia , Transdução de Sinais/efeitos dos fármacos , Tromboxano A2/metabolismo , Fator de Transcrição RelA/metabolismo , Resultado do Tratamento
10.
Immunotherapy ; 5(7): 755-68, 2013 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-23829626

RESUMO

Food allergy is an increasing problem in western countries, with strict avoidance being the only available reliable treatment. However, accidental ingestion can occur and anaphylactic reactions still happen. In recent years, many efforts have been made to better understand the humoral and cellular mechanisms involved in food allergy, and to improve the strategies for diagnosis and treatment. This review focuses on IgE-mediated food hypersensitivity and provides an overview of the diagnostic strategies and treatment advances. Specific immunotherapy, including different routes of administration and allergen sources, such as natural, recombinant and T-cell epitopes, are analyzed in detail. Other treatments such as anti-IgE monoclonal antibody therapy, adjuvant therapy and Chinese herbs will also be described.


Assuntos
Alérgenos/uso terapêutico , Dessensibilização Imunológica/métodos , Hipersensibilidade Alimentar/diagnóstico , Hipersensibilidade Alimentar/terapia , Imunoglobulina E/imunologia , Alérgenos/imunologia , Animais , Anticorpos Monoclonais/uso terapêutico , Dessensibilização Imunológica/tendências , Diagnóstico Diferencial , Vias de Administração de Medicamentos , Medicamentos de Ervas Chinesas/uso terapêutico , Epitopos de Linfócito T/imunologia , Hipersensibilidade Alimentar/imunologia , Humanos , Proteínas Recombinantes/imunologia
11.
PLoS One ; 7(12): e50799, 2012.
Artigo em Inglês | MEDLINE | ID: mdl-23272072

RESUMO

The study of cross-reactivity in allergy is key to both understanding. the allergic response of many patients and providing them with a rational treatment In the present study, protein microarrays and a co-sensitization graph approach were used in conjunction with an allergen microarray immunoassay. This enabled us to include a wide number of proteins and a large number of patients, and to study sensitization profiles among members of the LTP family. Fourteen LTPs from the most frequent plant food-induced allergies in the geographical area studied were printed into a microarray specifically designed for this research. 212 patients with fruit allergy and 117 food-tolerant pollen allergic subjects were recruited from seven regions of Spain with different pollen profiles, and their sera were tested with allergen microarray. This approach has proven itself to be a good tool to study cross-reactivity between members of LTP family, and could become a useful strategy to analyze other families of allergens.


Assuntos
Alérgenos/imunologia , Antígenos de Plantas/imunologia , Proteínas de Transporte/imunologia , Proteínas de Plantas/imunologia , Análise Serial de Proteínas/métodos , Alérgenos/química , Reações Cruzadas/imunologia , Eletroforese em Gel de Poliacrilamida , Epitopos/química , Alimentos , Hipersensibilidade Alimentar/imunologia , Geografia , Humanos , Imunoensaio/métodos , Lipídeos/química , Modelos Estatísticos , Pólen , Proteínas Recombinantes/química , Espanha , Espectrometria de Massas por Ionização e Dessorção a Laser Assistida por Matriz
12.
PLoS One ; 7(9): e44088, 2012.
Artigo em Inglês | MEDLINE | ID: mdl-22970164

RESUMO

Cross-reactivity of plant foods is an important phenomenon in allergy, with geographical variations with respect to the number and prevalence of the allergens involved in this process, whose complexity requires detailed studies. We have addressed the role of thaumatin-like proteins (TLPs) in cross-reactivity between fruit and pollen allergies. A representative panel of 16 purified TLPs was printed onto an allergen microarray. The proteins selected belonged to the sources most frequently associated with peach allergy in representative regions of Spain. Sera from two groups of well characterized patients, one with allergy to Rosaceae fruit (FAG) and another against pollens but tolerant to food-plant allergens (PAG), were obtained from seven geographical areas with different environmental pollen profiles. Cross-reactivity between members of this family was demonstrated by inhibition assays. Only 6 out of 16 purified TLPs showed noticeable allergenic activity in the studied populations. Pru p 2.0201, the peach TLP (41%), chestnut TLP (24%) and plane pollen TLP (22%) proved to be allergens of probable relevance to fruit allergy, being mainly associated with pollen sensitization, and strongly linked to specific geographical areas such as Barcelona, Bilbao, the Canary Islands and Madrid. The patients exhibited >50% positive response to Pru p 2.0201 and to chestnut TLP in these specific areas. Therefore, their recognition patterns were associated with the geographical area, suggesting a role for pollen in the sensitization of these allergens. Finally, the co-sensitizations of patients considering pairs of TLP allergens were analyzed by using the co-sensitization graph associated with an allergen microarray immunoassay. Our data indicate that TLPs are significant allergens in plant food allergy and should be considered when diagnosing and treating pollen-food allergy.


Assuntos
Reações Cruzadas/imunologia , Hipersensibilidade Alimentar/imunologia , Proteínas de Plantas/imunologia , Análise Serial de Proteínas , Adolescente , Adulto , Criança , Feminino , Alimentos/efeitos adversos , Hipersensibilidade Alimentar/sangue , Frutas/imunologia , Geografia , Humanos , Imunização , Imunoensaio , Imunoglobulina E/imunologia , Masculino , Pessoa de Meia-Idade , Peso Molecular , Proteínas de Plantas/isolamento & purificação , Pólen/imunologia , Espanha , Adulto Jovem
14.
J Allergy Clin Immunol ; 124(5): 1005-11.e1, 2009 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-19796796

RESUMO

BACKGROUND: Evidence exists of a new form of local allergic rhinitis (LAR) with local production of specific IgE (sIgE) and a positive response to nasal allergen provocation test (NAPT) in patients previously diagnosed with idiopathic rhinitis. However, the immunologic mechanisms involved are still poorly understood. OBJECTIVE: We explored the involvement of nasal sIgE, eosinophil, and mast cell activation in the response to NAPT with grass pollen (NAPT-grass) in a group of patients already classified with LAR. METHODS: Out-of-spring NAPT-grass was performed in 30 patients with LAR and 30 healthy controls. Nasal symptoms, acoustic rhinometry, and nasal lavage were performed at baseline and 15 minutes and 1, 6, and 24 hours post-NAPT. Tryptase, eosinophilic cationic protein (ECP), and total and sIgE to grass pollen were measured in nasal lavage by immunoassays. RESULTS: NAPT-grass was positive in all patients with LAR. We detected significant increases of tryptase and ECP in 40% and 43%, respectively, at 15 minutes and 1, 6, and 24 hours post-NAPT compared with baseline (P < .05). sIgE was increased in 30%, with significant increases at 1 and 6 hours (P < .05) and 24 hours (P = .002) post-NAPT. The maximum release of tryptase was detected 15 minutes after NAPT, whereas the maximum release of ECP and sIgE was detected 24 hours after challenge. NAPT-grass was negative in all healthy controls, with no increase in tryptase, ECP, total IgE, or sIgE. CONCLUSION: These results demonstrate that patients with LAR had local production of sIgE and mast cell/eosinophil activation induced by nasal exposure to grass pollen.


Assuntos
Alérgenos , Imunoglobulina E/imunologia , Pólen/imunologia , Rinite Alérgica Sazonal/imunologia , Adulto , Alérgenos/imunologia , Proteína Catiônica de Eosinófilo/imunologia , Proteína Catiônica de Eosinófilo/metabolismo , Eosinófilos/imunologia , Eosinófilos/metabolismo , Feminino , Humanos , Imunoglobulina E/sangue , Masculino , Mastócitos/imunologia , Mastócitos/metabolismo , Pessoa de Meia-Idade , Lavagem Nasal , Testes de Provocação Nasal , Poaceae/imunologia , Rinite Alérgica Sazonal/diagnóstico , Triptases/imunologia , Triptases/metabolismo
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