Allergy to cypress and olive pollen: Clinical phenotypes and allergen recognition.

BACKGROUND AND OBJECTIVES: Cypress and olive pollen are the most prevalent sensitizer trees in the Mediterranean area. Some patients exhibit a dual sensitization which has not been well documented yet. To identify the allergens involved in the dual cypress and olive allergy (C+O) and study the relationship between phenotype and allergen sensitization. METHODS: C+O patients were selected. Monosensitized subjects to olive or cypress were used as reference. Specific IgE to whole extracts and purified allergens from olive and cypress were performed. Immunoblotting was done to analyze IgG and IgE-binding using olive polyclonal antibodies and patients' sera, respectively. Mutual immunoblotting inhibition of olive and cypress extracts, and inhibition of cypress extract immunoblotting with olive allergens were performed. Multiple correspondence analysis and hierarchical cluster classifications were conducted to analyze the relationships between C+O clinical presentation (symptoms, seasonality) and allergen profile. RESULTS: C+O patients were clustered in 4 phenotypes. The most frequent one (58.4%) was rhinoconjunctivitis in winter (February) and spring (May), with asthma in 38% of subjects. Ole e 1 and Cup s 1 were the major allergens. Homologous proteins to Ole e 1, Ole e 9 and Ole e 11 in cypress pollen were identified and these olive allergens inhibit IgE-binding to cypress extract. CONCLUSIONS: The exclusive C+O allergy results from co-sensitization to Cup s 1 and Ole e 1, and to cross-reactivity due to Ole e 1-like, Ole e 9-like and Ole e 11-like allergens not described previously, and translates into 4 clinical phenotypes of winter and/or spring or perennial rhinoconjunctivitis with and without asthma.

Association Between the Seed Storage Proteins 2S Albumin and 11S Globulin and Severe Allergic Reaction After Flaxseed Intake.

BACKGROUND: Given the increased popularity of flaxseed in meals, several cases of allergy to these seeds have been reported. Little is known about the allergens implicated in hypersensitivity reactions to flaxseed. The present study aimed to identify the allergens involved in IgE-mediated reactions in 5 patients with a clinical history of severe systemic symptoms after flaxseed consumption. METHODS: Proteins that were potential allergens with IgE-binding capacity were purified from flaxseed extract using chromatography and identified via MALDI-TOF mass spectrometry. Immunoassays were performed using the 5 allergic patients' sera tested individually and as a pool. RESULTS: Immunoblotting of the flaxseed extract revealed a low-molecular-mass protein (around 13 kDa) in 4 of the 5 patients, while a protein of approximately 55 kDa was detected in 2 patients. The proteins were identified by mass spectrometry as flaxseed 2S albumin, which is included in the WHO/IUIS allergen nomenclature as Lin u 1, and 11S globulin. Inhibition assays revealed in vitro IgE-mediated cross-reactivity between Lin u 1 and peanut and cashew nut proteins, while IgE-mediated recognition of 11S globulin by patients' sera was partially inhibited by several plant-derived sources. CONCLUSIONS: Seed storage proteins from flaxseed were involved in the development of severe symptoms in the 5 patients studied and exhibited cross-reactivity with other allergenic sources. Besides the severity of flaxseed allergy in patients sensitized to 2S albumin, this is the first time that 11S globulin has been identified as a potential allergen. Taking these data into account should ensure a more accurate diagnosis.

Association Between the Seed Storage Proteins 2S Albumin and 11S Globulin and Severe Allergic Reaction After Flaxseed Intake

Background: Given the increased popularity of flaxseed in meals, several cases of allergy to these seeds have been reported. Little is known about the allergens implicated in hypersensitivity reactions to flaxseed. The present study aimed to identify the allergens involved in IgE-mediated reactions in 5 patients with a clinical history of severe systemic symptoms after flaxseed consumption. Methods: Proteins that were potential allergens with IgE-binding capacity were purified from flaxseed extract using chromatography and identified via MALDI-TOF mass spectrometry. Immunoassays were performed using the 5 allergic patients’ sera tested individually and as a pool. Results: Immunoblotting of the flaxseed extract revealed a low-molecular-mass protein (around 13 kDa) in 4 of the 5 patients, while a protein of approximately 55 kDa was detected in 2 patients. The proteins were identified by mass spectrometry as flaxseed 2S albumin, which is included in the WHO/IUIS allergen nomenclature as Lin u 1, and 11S globulin. Inhibition assays revealed in vitro IgE-mediated cross-reactivity between Lin u 1 and peanut and cashew nut proteins, while IgE-mediated recognition of 11S globulin by patients’ sera was partially inhibited by several plant-derived sources. Conclusions: Seed storage proteins from flaxseed were involved in the development of severe symptoms in the 5 patients studied and exhibited cross-reactivity with other allergenic sources. Besides the severity of flaxseed allergy in patients sensitized to 2S albumin, this is the first time that 11S globulin has been identified as a potential allergen. Taking these data into account should ensure a more accurate diagnosis. (AU)

Antecedentes: Dada la creciente popularidad de la linaza en las comidas, se han notificado varios casos de alergia a estas semillas. La información acerca de los alérgenos implicados en las reacciones de hipersensibilidad a estas semillas es escasa. El presente trabajo pretende identificar los alérgenos implicados en las reacciones mediadas por IgE en cinco pacientes con una historia clínica de síntomas sistémicos graves tras el consumo de linaza. Métodos: Las proteínas susceptibles de ser alérgenos con capacidad de unir IgE se purificaron a partir del extracto de linaza mediante técnicas cromatográficas. Su identificación se realizó mediante espectrometría de masas MALDI-TOF. Se realizaron inmunoensayos con los sueros de los cinco pacientes alérgicos, utilizados de forma individual o como mezclas. Resultados: Cuatro de los cinco pacientes reconocieron una proteína de baja masa molecular (alrededor de 13 kDa) en inmunoensayos con extracto de linaza, mientras que dos pacientes reconocieron una proteína de aproximadamente 55 kDa. Se identificaron por espectrometría de masas como albúmina 2S de linaza, incluida en la nomenclatura de alérgenos de la OMS/IUIS como Lin u 1, y globulina 11S, respectivamente. Los ensayos de inhibición in vitro revelaron la existencia de reactividad cruzada de la Lin u 1 con las proteínas del cacahuete y del anacardo, mientras que el reconocimiento por parte de la IgE de la globulina 11S por parte de los sueros de los pacientes fue parcialmente inhibido por varias fuentes vegetales. Conclusiones: Las proteínas de almacenamiento de las semillas de lino estaban implicadas en el desarrollo de síntomas graves en cinco individuos y mostraron una reactividad cruzada con otras fuentes alergénicas. Además de la gravedad de la alergia a la linaza en los pacientes sensibilizados a la albúmina 2S, es la primera vez que se identifica la globulina 11S como un alérgeno potencial.