Poppy Seed Allergy: Molecular Diagnosis and Cross-Reactivity With Tree Nuts.

BACKGROUND: Poppy seed (PS) can be a cause of severe allergic reactions, especially in individuals with concurrent allergy to tree nuts and other seeds, but diagnostic criteria and sensitization patterns are lacking. OBJECTIVE: To assess the role of PS extract and individual allergens in diagnosing PS allergy and their cross-reactivities with tree nuts and buckwheat. METHODS: Our retrospective study included 36 PS-sensitized patients; 10 with a positive and 26 with a negative oral food challenge (OFC). We identified individual PS allergens and compared the diagnostic performance of specific IgE (sIgE) to PS extract with its allergens. Cross-reactivities between PS and related allergens from other seeds were assessed by a competitive enzyme-linked immunosorbent assay. RESULTS: We identified 4 novel PS allergens: Pap s 1 (vicilin), Pap s 1 (27-424) (α-hairpinin), Pap s 2 (legumin), and Pap s 3 (small hydrophilic seed protein). A positive OFC correlated with higher PS-sIgE levels and elevated sIgE levels for the PS allergens, except for Pap s 3. PS and α-hairpinin-sIgE effectively differentiated allergic from tolerant patients, with area under the curve values of 0.95 and 0.94. PS-sIgE >10.00 kUA/L exhibited 90% sensitivity and 73% specificity, whereas α-hairpinin-sIgE >2.60 kUA/L showed 100% sensitivity and 77% specificity. PS vicilin and legumin highly cross-reacted with hazelnut and buckwheat homologs, whereas α-hairpinin-sIgE cross-reacted with the related almond allergen. CONCLUSIONS: This is the most extensive study on PS allergy to date. PS and α-hairpinin-sIgE are highly sensitive indicators of clinical reactivity to PS, whereas vicilin and legumin-sIgE contribute to concurrent sensitization to hazelnut and buckwheat.

Molecular allergology and its application in prevention, diagnosis and therapy.

Allergic diseases represent a relevant global health problem, affecting adults and children and posing a significant burden for health care systems. In addition, the disease is still under-recognized and harmonized diagnostic tools and management plans for patients are still lacking. In this review the most important aspects of the diagnosis of allergic diseases are summarized and the contribution of Molecular allergology to this area is highlighted.

Cow's Milk Processing-Friend or Foe in Food Allergy?

Cow's milk (CM) is an integral part of our daily diet starting in infancy and continuing throughout our lifetime. Its composition is rich in proteins with a high nutritional value, bioactive components, milk minerals including calcium, and a range of immunoactive substances. However, cow's milk can also induce a range of immune-mediated diseases including non-IgE-mediated food allergies and IgE-mediated food allergies. Cow's milk allergens have been identified and characterized and the most relevant ones can be assigned to both, the whey and casein fraction. For preservation a range of processing methods are applied to make cow's milk and dairy products safe for consumers. However, these methods affect milk components and thus alter the overall immunogenic activity of cow's milk. This review summarizes the current knowledge on cow's milk allergens and immunoactive substances and the impact of the different processes up- or downregulating the immunogenicity of the respective proteins. It highlights the gaps of knowledge of the related disease mechanisms and the still unidentified beneficial immunomodulating compounds of cow's milk.