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.

New allergens from spices in the Apiaceae family: anise Pimpinella anisum L. and caraway Carum carvi L.

Spices are gaining popularity in individual consumption, food industry, and medicine. While the incidence of allergies is constantly rising, those caused by consumption of herbs and spices are relatively rare. The allergic potential of spices added to many dishes and products is dangerous, as consumers may ingest them unknowingly. At particular risk are persons allergic to both birch and mugwort pollen because of cross-reactivity to proteins similar to birch allergen, Bet v 1 and profilins, who often exhibit a clinical condition termed "mugwort-celery-spice syndrome". The aim of our research was to analyze the extracts of anise and caraway for the presence of major pan-allergens, such as Bet v 1 analogues and profilins. Secondly, we analyzed the prevalence of reactions towards these pan-allergens among patients sensitive to spices. Finally, we tried to identify some of the previously unidentified allergenic proteins in these spices. In order to identify Bet v 1 analogues and profilins in anise and caraway, we conducted immunoblotting of the proteins extracted from the spices with anti-Bet v 1 and anti-profilin antibodies. The identification of new allergens was performed by initial selection of proteins through immunoblotting with sera of patients sensitive to spices. The proteins were subsequently characterized with LC-MS/MS. The presence of Bet v 1 analogues and profilins in anise was confirmed and a new allergen, glyceraldehyde 3-phosphate dehydrogenase, was identified. Moreover, new caraway allergens were found, including Bet v 1 analogue, profilin, and elongation factor α.

Impaired resolution of wheals in the skin prick test and low diamine oxidase blood level in allergic patients.

INTRODUCTION: Histamine is the major mediator of IgE- and non-IgE-mediated allergic reactions upon allergen or hapten contact. Reduced histamine degradation capacity was associated with atopic eczema as well as with non-immunological histamine intolerance. Higher blood serum histamine level concomitant with decreased intestinal diamine oxidase activity were observed in patients with food allergy. AIM: To evaluate the relationship between patients' blood diamine oxidase (DAO) activity/histamine status and their reactivity to time-resolved histamine skin prick test in respect to vulnerability to allergic diseases. MATERIAL AND METHODS: Fifty-three patients were examined with skin prick tests (SPT) and patch tests for suspected presence of either IgE- or non-IgE-mediated allergy. All individuals were skin prick tested with histamine and the resolution of the wheal was monitored for 50 min. Blood DAO activity and histamine concentration were measured with a radio-extraction radioimmunoassay. RESULTS: Time-resolved histamine skin prick testing revealed presence of wheals which were 35% larger in diameter in 47% of examined subjects at 20 min of the test. These patients exhibited significantly compromised time-course wheal resolution (wheal ≥ 3 mm at 50 min) compared to a group of patients with the normal-rate of wheal resolution (wheal = 0 mm at 50 min). Within a group of subjects exhibiting impaired wheal resolution, 61% of patients were diagnosed allergic compared to 50% in a group of patients with a normal rate of wheal resolution. Finally, allergic patients were characterized by a significantly lower DAO activity and higher histamine content compared to healthy subjects. CONCLUSIONS: The results of this study indicate that patients with IgE- or non-IgE-mediated allergy are likely to have low DAO blood activity and may concomitantly suffer from histamine intolerance. Furthermore, our results suggest that allergic patients are more likely to develop an excessive SPT reaction. Our results emphasize caution in interpretation of the SPT results in allergic patients with diagnosed histamine intolerance or histamine/DAO activity imbalance.

The Incidence of Delayed-Type Hypersensitivity Reactions to Apples Among Patients Allergic to Birch Pollen.

The major apple allergen Mal d 1 cross-reacts with the homologous birch pollen allergen Bet v 1 and causes immunoglobulin E (IgE)-mediated immediate-type allergic reactions. In some patients, delayed-type hypersensitivity to apples may develop within 72 hours without evidence of specific IgE or a positive skin prick test (SPT). The aim of the study was to evaluate the concomitance of delayed-type hypersensitivity reactions and immediate IgE-mediated reactions against high- and low-allergenic apple cultivars in patients with birch pollen allergy. Data were obtained from 45 adults with clinical symptoms of birch pollen allergy. Patients were exposed to apple pulp via atopy patch tests (APTs) and SPTs. Levels of IgE specific to Bet v 1 and Mal d 1 were measured with a radioallergosorbent test. Patients allergic to birch pollen showed the highest rate of positive SPT responses to Golden Delicious apples and the lowest rate to low-allergenic cultivar Grey French Reinette. Among these patients, 9% developed delayed hypersensitivity reactions to either Golden Delicious or Grey French Reinette apples; these reactions manifested clinically as erythema with papules (class ++). Fifty percent of APT-positive patients were concomitantly SPT-negative. Here, we show for the first time the clinical relevance of T cell-driven allergic reactions to apples. APTs may reveal type IV sensitization in patients who are negative for the corresponding type I sensitization tests. Thus, utilization of the APT procedure with fresh apple appears to be a valuable tool for the diagnosis of apple allergy and may improve the accuracy of food allergy diagnoses.

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.

[The influence of desloratadine on course of intermittens allergic rhinitis]. / Wplyw desloratadyny na przebieg przerywanego alergicznego niezytu nosa.

Influence of desloratadine (DL) therapy on intermittens allergic rhinitis was presented. Investigated group consisted of 60 patients, aged average 29, among them 23 women and 37 men. Score of nasal symptoms as discharge congestion, itching, sneezing and eye symptoms was evaluated. All measurements of nose airways resistance were performed by means of rhinomanometer Rhinotest 1000 (MES). The result was a significant statistic improvement both of separate nasal or eye symptoms, total nasal symptom score and global therapeutic assessments of response to DL therapy. At the beginning the investigation a statistically significant improvement after DL therapy was shown by rhinomanometry among patients with severe or moderate nasal resistance in contrast to low nasal resistance group.

[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.