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2.
Int Arch Allergy Immunol ; 180(2): 113-119, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31390649

RESUMO

BACKGROUND: Data on the prevalence and clinical course of food protein-induced enterocolitis syndrome (FPIES) vary between populations and according to the culprit food. OBJECTIVE: To evaluate the incidence, clinical characteristics, and remission patterns of FPIES among children in a Greek pediatric allergy referral center. METHODS: We retrospectively studied children with acute FPIES. Data on age, sex, type of reaction, the implicated food, and oral food challenge (OFC) outcomes at baseline and upon reevaluation were analyzed. RESULTS: Between October 2010 and March 2017, 72 (38 males) out of 15,114 subjects who had been referred to our department due to any reported allergic symptoms were diagnosed with acute FPIES. The most commonly implicated foods were cow's milk (CM) (45.8%), fish (34.7%), rice (9.7%), egg (6.9%), and chicken (2.8%). The mean age at diagnosis was 7.1/19.3/9.1/18.7/8.7 months for those with CM/fish/rice/egg/chicken FPIES, respectively. Sixty-nine OFCs were performed, of which 8 were diagnostic and 61 for tolerance evaluation. The type of culprit food was significantly associated with the outcome of the tolerance OFCs. OFCs to fish resulted positive at a significantly higher rate (12/22; 54.5%) than OFCs to CM (4/29; 13.7%), rice (1/5; 20%), egg (0/3; 0%), and chicken (0/2; 0%) (p = 0.01). The time period between diagnosis and tolerance acquisition was prolonged in the fish FPIES cases (74.8 months; 95% CI: 57.9-91.6) compared to that with other foods such as CM (20.7 months; 95% CI: 17.3-24.1), rice (31.8 months; 95% CI: 21.9-41.7), and egg (24.3 months; 95% CI: 10.7-37.9), as shown in a Kaplan-Meier analysis (log-rank, p < 0.001). When the fish FPIES children were assessed for tolerance, OFCs were significantly more often positive than in CM FPIES children (52 vs. 18.1%; p = 0.03), despite the fact that the children were challenged at an older age (fish: 70.4 months, 95% CI: 58.3-82.5, vs. CM: 26.57 months, 95% CI: 21.1-32, p < 0.001). CONCLUSIONS: Acute FPIES had a low incidence in our population. CM and fish were the two most frequent elicitors. Significantly delayed presentation and prolonged remission was noted for FPIES caused by fish.


Assuntos
Proteínas na Dieta/imunologia , Enterocolite/epidemiologia , Enterocolite/imunologia , Hipersensibilidade Alimentar/epidemiologia , Pré-Escolar , Feminino , Hipersensibilidade Alimentar/diagnóstico , Grécia/epidemiologia , Humanos , Lactente , Masculino , Estudos Retrospectivos
3.
Mol Immunol ; 112: 330-337, 2019 08.
Artigo em Inglês | MEDLINE | ID: mdl-31247376

RESUMO

Shrimp is one of the predominant causes of food allergy among adults, often presenting with severe reactions. Current in vitro diagnostics are based on quantification of patient specific-IgE (sIgE) to shrimp extract. Tropomyosin is the known major shrimp allergen, but IgE sensitisation to other allergens is poorly characterised. In this study, the binding of IgE to various shrimp allergens, additional to tropomyosin, was investigated using sera from 21 subjects who had clinical reactions to one or more shellfish species. Total shrimp-sIgE was quantified using ImmunoCAP, while allergen-sIgEs were quantified using immunoblotting and mass spectrometry, and immuno-PCR to recombinant shrimp tropomyosin. Sixty-two percent of subjects (13/21) were positive to shrimp by ImmunoCAP. IgE from 43% of subjects (9/21) bound tropomyosin, while an additional 29% of subjects (6/21) demonstrated IgE-binding solely to other shrimp allergens, including sarcoplasmic calcium-binding protein, arginine kinase and hemocyanin. Furthermore, IgE sensitisation to other shrimp allergens was demonstrated in 50% of subjects (4/8) who were ImmunoCAP negative. The lack of standardised shrimp allergens and inadequacy of current extracts for shrimp allergy diagnosis is highlighted by this study. Comprehensive knowledge of less studied allergens and their inclusion in component-resolved diagnostics will improve diagnostic accuracy, benefitting the wider population suffering from shellfish allergy.


Assuntos
Alérgenos/imunologia , Artemia/imunologia , Hipersensibilidade Alimentar/diagnóstico , Hipersensibilidade Alimentar/imunologia , Adulto , Animais , Arginina Quinase/imunologia , Proteínas de Ligação ao Cálcio/imunologia , Feminino , Hemocianinas/imunologia , Humanos , Imunoglobulina E/imunologia , Masculino , Pessoa de Meia-Idade , Alimentos Marinhos , Tropomiosina/imunologia , Adulto Jovem
4.
Medicina (Kaunas) ; 55(5)2019 Apr 26.
Artigo em Inglês | MEDLINE | ID: mdl-31035487

RESUMO

Non-celiac gluten sensitivity (NCGS) is a syndrome characterized by gastrointestinal and extraintestinal manifestations triggered after gluten ingestion in the absence of celiac disease and wheat allergy. Because of the lack of biomarkers for NCGS diagnosis, the cornerstone for its assessment is a single- or double-blind placebo-controlled (DBPC) gluten challenge. However, there are some non-standardized points in the diagnostic approach proposed by the experts. This complicate comparisons among the results published by different research groups. The gluten vehicle and placebo must be indistinguishable from each other, which entails sensory and technological evaluations of the designed gluten vehicle and placebo products. At the moment, there is no standardized method for the preparation of the gluten vehicle and placebo for carrying out DBPC gluten challenges for NCGS assessment. This review focuses on the challenges that researchers have to face, either for the development of an accepted gluten vehicle and placebo or for identifying NCGS cases on the basis of DBPC gluten challenges.


Assuntos
Glutens/uso terapêutico , Placebos/uso terapêutico , Hipersensibilidade a Trigo/tratamento farmacológico , Hipersensibilidade Alimentar/diagnóstico , Hipersensibilidade Alimentar/tratamento farmacológico , Humanos , Hipersensibilidade a Trigo/psicologia
5.
Afr J Prim Health Care Fam Med ; 11(1): e1-e5, 2019 Apr 29.
Artigo em Inglês | MEDLINE | ID: mdl-31038347

RESUMO

BACKGROUND: An allergic reaction to mammalian meat has recently been reported in rural parts of South Africa and throughout other parts of the world. The cause of this allergic reaction is because of an oligosaccharide antigen known as galactose-alpha-1, 3-galactose (alpha-gal) found in mammalian meat. Hard ticks in various parts of the world have been identified as a cause of sensitisation to the alpha-gal antigen. However, mechanisms of sensitisation in Africa are poorly understood. AIM: The aim of this article is to review current literature on the alpha-gal allergy and mammalian meat ingestion and the family physician's role in diagnosing and managing this condition. METHOD: Indexes were searched using the keywords in the following electronic databases: Elsevier Science Direct, Google Scholar, Medline and PubMed. RESULTS: Clinical presentation of the alpha-gal allergy occurs typically as a delayed anaphylaxis occurring within 3-6 hours after the ingestion of mammalian meat. A subset of patients described in South Africa presented with a rapid onset of symptoms occurring within 45 minutes. Furthermore, some of these patients present with abdominal symptoms only, which may be mistaken as food poisoning. Diagnosis is based on a history of reaction to mammalian meats (especially to fatty portions or organs) and serum specific alpha-gal antibodies. The main management of the alpha-gal allergy is avoidance of red meat and in mild reactions treatment with oral H1 receptor antihistamines. CONCLUSION: Sensitisation to the alpha-gal allergy results in adverse reactions to red meat, with tolerance to turkey, chicken and fish. A family physician can safely manage this condition.


Assuntos
Dissacarídeos/imunologia , Hipersensibilidade Alimentar/diagnóstico , Carne/efeitos adversos , Papel do Médico , Atenção Primária à Saúde/métodos , Animais , Anticorpos/sangue , Anticorpos/imunologia , Gerenciamento Clínico , Hipersensibilidade Alimentar/imunologia , Humanos , Mamíferos , Carne/análise , África do Sul
9.
Dev Period Med ; 23(1): 67-78, 2019.
Artigo em Polonês | MEDLINE | ID: mdl-30954984

RESUMO

Food protein-induced enterocolitis syndrome (FPIES) is a non-IgE-mediated food allergy with varying degrees of severity. The acute form of the disease is manifested by vomiting, lethargy and pallor, which usually appear within 1-4 hours after food ingestion, and can lead to shock. The most common trigger foods are: cow's milk, soy, rice and oats. Chronic FPIES is typical for infants fed with cow's milk or soy infant formula and is manifested by chronic vomiting, diarrhea and failure to thrive. In the vast majority of patients with FPIES, the analysis of the clinical history is sufficient to diagnose and identify trigger foods. If the history is unclear, use an oral food challenge to help confirm the diagnosis. Long-term management of patients with FPIES involves elimination of the trigger foods, monitoring for FPIES resolution and caregivers' education. The majority of children acquire food tolerance at the age of 3-5.


Assuntos
Enterocolite/etiologia , Hipersensibilidade Alimentar/complicações , Gerenciamento Clínico , Enterocolite/diagnóstico , Enterocolite/prevenção & controle , Hipersensibilidade Alimentar/diagnóstico , Hipersensibilidade Alimentar/prevenção & controle , Humanos , Lactente , Recém-Nascido , Doenças Raras
10.
BMC Bioinformatics ; 20(1): 206, 2019 Apr 23.
Artigo em Inglês | MEDLINE | ID: mdl-31014233

RESUMO

BACKGROUND: Oral immunotherapy (OIT) is a promising therapeutic approach to treat food allergic patients. However, concerns with regards to safety and long-term efficacy of OIT remain. There is a need to identify biomarkers that predict, monitor and/or evaluate the effects of OIT. Here we present a method to select candidate biomarkers for efficacy and safety assessment of OIT using the computational approaches Bayesian networks (BN) and Topological Data Analysis (TDA). RESULTS: Data were used from fructo-oligosaccharide diet-supported OIT experiments performed in 3 independent cow's milk allergy (CMA) and 2 independent peanut allergy (PNA) experiments in mice. Bioinformatical approaches were used to understand the data structure. The BN predicted the efficacy of OIT in the CMA with 86% and indicated a clear effect of scFOS/lcFOS on allergy parameters. For the PNA model, this BN (trained on CMA data) predicted an efficacy of OIT with 76% accuracy and shows similar effects of the allergen, treatment and diet as compared to the CMA model. The TDA identified clusters of biomarkers closely linked to biologically relevant clinical symptoms and also unrelated and redundant parameters within the network. CONCLUSIONS: Here we provide a promising application of computational approaches to a) compare mechanistic features of two different food allergies during OIT b) determine the biological relevance of candidate biomarkers c) generate new hypotheses to explain why CMA has a different disease pattern than PNA and d) select relevant biomarkers for future studies.


Assuntos
Dessensibilização Imunológica , Hipersensibilidade Alimentar , Animais , Biomarcadores , Biologia Computacional , Hipersensibilidade Alimentar/diagnóstico , Hipersensibilidade Alimentar/metabolismo , Hipersensibilidade Alimentar/terapia , Humanos , Camundongos
11.
Int Arch Allergy Immunol ; 179(3): 215-220, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30982049

RESUMO

BACKGROUND: Food protein-induced enterocolitis syndrome (FPIES) is a non-IgE-mediated gastrointestinal food hypersensitivity usually due to cow's milk or soy. Among the solid foods, rice is one of the most causative foods worldwide, but it varies depending on the geographic area. In the Mediterranean countries, fish is one of the most important triggers of FPIES. There is not a specific biological marker for the disease that allows us to confirm the diagnosis or to predict when tolerance to the offending food has been achieved, so all patients with a FPIES diagnosis undergo an oral food challenge (OFC) at least once. The OFC is a risky procedure and many patients develop severe symptoms. OBJECTIVE: We sought to evaluate the safety of a new OFC protocol in children with fish-FPIES. METHODS: A retrospective study was performed over a 22-year period (1996-2018). We compared two methodologies used in the OFC: Method 1 that consisted in giving several doses during the same day versus Method 2 that consisted in giving a unique dose per day on 2 or three non-consecutive days. RESULTS: A total of 75 positive OFC with fish done in 40 children were included. Forty-three (57.3%) OFC were performed following Method 1 and 32 (42.7%) with Method 2.The severity of the symptoms of the OFC done with Method 1 was mostly moderate (41.9%) followed by severe (39.5%) and mild (18.6%). The adverse reactions with Method 2 were mostly mild (68.8%) and only 18.8 and 12.5% presented moderate or severe symptoms, respectively. CONCLUSIONS: OFC performed in children with fish-FPIES are risky and many patients develop moderate or severe symptoms after this procedure. We propose a new protocol that has demonstrated to improve safety.


Assuntos
Proteínas na Dieta/administração & dosagem , Enterocolite/diagnóstico , Proteínas de Peixes/administração & dosagem , Peixes/imunologia , Hipersensibilidade Alimentar/diagnóstico , Administração Oral , Animais , Criança , Pré-Escolar , Proteínas na Dieta/efeitos adversos , Enterocolite/imunologia , Proteínas de Peixes/efeitos adversos , Hipersensibilidade Alimentar/imunologia , Humanos , Síndrome
12.
Clin Chim Acta ; 493: 73-78, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-30822401

RESUMO

BACKGROUND: Molecular allergy has significantly improved the quality of allergy diagnosis; however, the positioning of singleplex and multiplex assays in the diagnostic algorithm is still a matter of debate. METHODS: Aim of the study was to test the analytical performance of the recently commercialized Allergy Explorer-ALEX® in a selected population (105 allergic patients and 15 negative controls), comparing it with the reference ImmunoCAP® method and with skin prick test (SPT). RESULTS: Inter-assay qualitative comparison showed a substantial agreement between ALEX® and SPT (k = 0.64). A substantial agreement between ALEX® and ImmunoCAP® was shown on the detection of IgE to extracts (k = 0.64 for inhalants and k = 0.51 for food allergens), whereas a higher agreement was shown on detection of molecular components (k = 0.92 for inhalants and k = 0.72 for food allergens). Quantitative comparison showed a poor correlation between ALEX® and ImmunoCAP®. CONCLUSION: The simultaneous detection of both extracts and molecular components with ALEX® assay can potentially overcome some of the major limitations of the multiplex assay currently in use. However, before using ALEX® as routine method, the analytical performance (in particular for extracts) needs to be further investigated on a larger scale.


Assuntos
Alérgenos/análise , Hipersensibilidade Alimentar/diagnóstico , Testes Cutâneos , Adolescente , Adulto , Idoso , Algoritmos , Criança , Pré-Escolar , Feminino , Humanos , Itália , Masculino , Pessoa de Meia-Idade , Adulto Jovem
14.
Arerugi ; 68(1): 43-47, 2019.
Artigo em Japonês | MEDLINE | ID: mdl-30787242

RESUMO

OBJECTIVE: There are few epidemiological reports of anaphylaxis since childhood. We herein examined cases of anaphylaxis diagnosed in our department. METHODS: One hundred-thirty-two patients who were examined at the Dermatology Department of Tokyo Medical University Hospital between January 2011 and March 2017 and were prescribed epinephrine autoinjector (EpiPen®) for treatment were enrolled. The referral institution if any, severity of anaphylaxis, diagnostic method, causative antigen, and recurrence rate was examined. RESULTS: The referral rate was 54% while 46% of patients requested examination of their own accord. Anaphylaxis severity was mild to moderate in 75% of cases. Food allergy accounted for 71% of the symptoms, with wheat as the most common causative antigen, followed by Anisakis allergy. After diagnosis only 37% of patients continued periodic consultations, and 16 patients recurred anaphylaxis of the diagnosis. CONCLUSION: Wheat and WDEIA were the most frequent causes of anaphylaxis diagnosed in our department. We also found that as many as 15% of patients had Anisakis allergy, suggesting that it may be an important item in antigen testing.


Assuntos
Anafilaxia/diagnóstico , Dermatologia , Hipersensibilidade Alimentar/diagnóstico , Animais , Anisakis , Criança , Epinefrina , Hospitais Universitários , Humanos , Tóquio
15.
Arerugi ; 68(1): 48-53, 2019.
Artigo em Japonês | MEDLINE | ID: mdl-30787243

RESUMO

A 16-year-old male high-school student experienced generalized itchy wheal and dyspnea during physical exercise after lunch. Each food material of his lunch was examined using a prick-prick test, allergen-specific IgE test (ImmunoCAP®), and provocation test. The prick-prick test was positive for black tiger shrimp (raw and heated) and white leg shrimp (heated). Allergen-specific IgE test (ImmunoCAP®) showed absolutely negativity for all suspected foods. The food-exercise provocation test using heated black tiger shrimp with additional aspirin intake finally induced anaphylaxis.We studied the IgE-binding molecules from shrimp using a purification procedure and Western blotting, with sera from the patient and several controls. A 40-kDa protein, corresponding to FBA, was found to be the major IgE-binding allergen component in this patient. Currently, the precise history and the prick-prick test using both raw and heated shrimps are useful to diagnose shrimp-induced FDEIA. Because the allergen-specific IgE test is insufficient to diagnose the cause of the symptoms, a component allergen-specific IgE test after the identification of the causative allergenic protein, such as FBA, is required.


Assuntos
Anafilaxia/diagnóstico , Asma Induzida por Exercício/diagnóstico , Hipersensibilidade Alimentar/diagnóstico , Frutose-Bifosfato Aldolase , Adolescente , Alérgenos , Animais , Exercício , Frutose , Humanos , Imunoglobulina E , Masculino , Penaeidae , Alimentos Marinhos
17.
Allergol. immunopatol ; 47(1): 64-72, ene.-feb. 2019. graf
Artigo em Inglês | IBECS | ID: ibc-180774

RESUMO

Background: Component resolved diagnosis (CRD) allows to precisely identify the sensitization to specific molecules of a given allergenic source, resulting in an important improvement in clinical management, particularly of polysensitized subjects. This will end in the correct prescription of allergen immunotherapy (AIT) for respiratory allergy and in adequate avoidance diets or prescription of self-injectable adrenaline in food allergy. Objective: The aim of this multicenter, real life study is to evaluate the percentage change of the diagnostic-therapeutic choice in polysensitized patients with respiratory allergy and in patients with food allergy, after using CRD compared to a first level diagnosis, along with an economic analysis of the patient's overall management according to the two different approaches. Methods: An overall number of 462 polysensitized patients, as suggested by skin prick tests (SPT), and with clinical symptoms related to a respiratory (275 pts) or food (187 pts) allergy, were recruited. All patients underwent CRD for specific IgE against food or inhalant recombinant molecules, which were chosen according to medical history and positivity to SPT. The first diagnostic-therapeutic hypothesis, based only on medical history and SPT, was recorded for each patient while the final diagnostic-therapeutic choice was based on the results from CRD. The rate of change of the diagnostic-therapeutic choice from the first hypothesis to the final choice was statistically evaluated. The economic impact of CRD on the overall management of the allergic patients was analyzed to evaluate whether the increase in the diagnostic costs would be compensated and eventually exceeded by savings coming from the improved diagnostic-therapeutic appropriateness. Results: An approximate 50% change (k index 0.54) in the prescription of AIT for respiratory allergy as well as a change in the prescription of self-injectable adrenaline (k index 0.56) was measured; an overall saving of financial resources along with a higher diagnostic-therapeutic appropriateness was also detected. Conclusion: There is moderate agreement concerning prescription of AIT and self-injectable adrenaline before and after performing CRD: this highlights the usefulness of CRD, at least in polysensitized patients, in indicating the risk assessment and therefore the correct therapy of respiratory and food allergy, which results in a cost-saving approach


No disponible


Assuntos
Humanos , Masculino , Feminino , Pré-Escolar , Criança , Adolescente , Adulto Jovem , Adulto , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Asma/diagnóstico , Uso de Medicamentos/estatística & dados numéricos , Hipersensibilidade Alimentar/diagnóstico , Imunoterapia/economia , Asma/epidemiologia , Asma/terapia , Custos e Análise de Custo , Epinefrina/uso terapêutico , Hipersensibilidade Alimentar/epidemiologia , Hipersensibilidade Alimentar/terapia , Imunoterapia/estatística & dados numéricos , Itália/epidemiologia , Patologia Molecular/estatística & dados numéricos , Testes Cutâneos , Melhoria de Qualidade
18.
Allergol. immunopatol ; 47(1): 73-78, ene.-feb. 2019. tab
Artigo em Inglês | IBECS | ID: ibc-180775

RESUMO

Background: Serum IgE evaluation of peanut, hazelnut and walnut allergens through the use of component-resolved diagnosis (CRD) can be more accurate than IgE against whole food to associate with severe or mild reactions. Objectives: The aim of the study was to retrospectively define the level of reaction risk in children with peanut, hazelnut and walnut sensitization through the use of CRD. Methods: 34 patients [n = 22 males, 65%; median age eight years, interquartile range (IQR) 5.0-11.0 years] with a reported history of reactions to peanut and/or hazelnut and/or walnut had their serum analyzed for specific IgE (s-IgE) by ImmunoCAP(R) and ISAC(R) microarray technique. Results: In children with previous reactions to peanut, the positivity of Arah1 and Arah2 s-IgE was associated with a history of anaphylaxis to such food, while the positivity of Arah8 s-IgE were associated with mild reactions. Regarding hazelnut, the presence of positive Cora9 and, particularly, Cora14 s-IgE was associated with a history of anaphylaxis, while positive Cora1.0401 s-IgE were associated with mild reactions. Concerning walnut, the presence of positive Jug r 1, Jug r 2, Jug r 3 s-IgE was associated with a history of anaphylaxis to such food. ImmmunoCAP® proved to be more useful in retrospectively defining the risk of hazelnut anaphylaxis, because of the possibility of measuring Cor a14 s-IgE. Conclusions: Our data show that the use of CRD in patients with allergy to peanut, hazelnut and walnut could allow for greater accuracy in retrospectively defining the risk of anaphylactic reaction to such foods


No disponible


Assuntos
Humanos , Masculino , Feminino , Pré-Escolar , Criança , Adolescente , Anafilaxia/epidemiologia , Hipersensibilidade Alimentar/diagnóstico , Imunoglobulina E/sangue , Alérgenos/imunologia , Anafilaxia/etiologia , Arachis/imunologia , Hipersensibilidade Alimentar/complicações , Imunização , Itália/epidemiologia , Estudos Retrospectivos , Juglans/imunologia
19.
Med J Aust ; 210(2): 94-99, 2019 02.
Artigo em Inglês | MEDLINE | ID: mdl-30656696

RESUMO

Food protein-induced enterocolitis syndrome (FPIES) is a poorly understood non-IgE gastrointestinal-mediated food allergy that predominantly affects infants and young children. Cells of the innate immune system appear to be activated during an FPIES reaction. Acute FPIES typically presents between one and 4 hours after ingestion of the trigger food, with the principal symptom being profuse vomiting, and is often accompanied by pallor and lethargy. Additional features can include hypotension, hypothermia, diarrhoea, neutrophilia and thrombocytosis. In Australia, the most commonly reported foods responsible for FPIES are (in descending order) rice, cow's milk, egg, oats and chicken. Most children with FPIES react to only one food trigger, and thus, avoidance of multiple foods is often not indicated. FPIES is often misdiagnosed as sepsis or gastroenteritis. However, a diagnosis of FPIES is favoured if there is rapid resolution of symptoms within hours of presentation, an absence of fever, and a lack of a significant rise in C-reactive protein at presentation. Diagnosis is often hampered by the lack of awareness of FPIES, absence of reliable biomarkers, the non-specific nature of the presenting symptoms, and the delay between allergen exposure and symptoms. Although some national peak allergy bodies have attempted to improve the diagnosis and management of FPIES, up until 2017 there were no internationally agreed guidelines for its diagnosis and management.


Assuntos
Enterocolite , Hipersensibilidade Alimentar , Austrália , Pré-Escolar , Proteínas na Dieta/efeitos adversos , Enterocolite/diagnóstico , Enterocolite/etiologia , Enterocolite/terapia , Hipersensibilidade Alimentar/complicações , Hipersensibilidade Alimentar/diagnóstico , Hipersensibilidade Alimentar/terapia , Humanos , Lactente , Guias de Prática Clínica como Assunto , Síndrome
20.
Clin Chim Acta ; 493: 25-30, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-30689985

RESUMO

INTRODUCTION: Identifying the target molecule in food allergies, helps to assess the risk of anaphylaxis in a patient. Lipid Transfer Protein is the most frequent cause of food allergies in the Mediterranean area. The diagnosis based on allergenic extracts, suffers from a high variability in the results because some important allergenic molecules are lacking. This study was disegned to assess whether Pru p 3 and Ara h 9 molecules are quantitative and qualitative enough present in their whole allergenic extracts. METHODS: 943 patients with a clinical history of suspected peach and/or peanut food allergies were recruited and underwent measurement of a specific serum IgE (ImmunoCAP system (Thermofisher/Phadia Diagnostics, Uppsala, Sweden) to the following allergens and molecules: peach (f95) and/or peanut (f13), Pru p 3 (f420), Pru p 1 (f419), Pru p 4 (f421), Ara h 1 (f422), Ara h 2 (f423) Ara h 3 (f424) and Ara h 9 (f427). RESULTS: Out of the 943 patients included in this study, 122 were positive to sIgE to peanut extract. At a cut-off point of 0.35 kIU/L, 62 patients were positive to sIgE to Ara h 9 but negative to peanut extract. Increasing the cut-off point of Ara h 9 at 10 kIU/L, 15 patients were only positive to sIgE to Ara h 9. 244 out of the 943 patients were positive to sIgE to peach extract. At a cut-off point of 0.35 kIU/L, 27 patients were negative to sIgE to Pru p 3 and positive to sIgE to peach extract, whilst 11 patients were peach extract sIgE positive and sIgE negative to Pru p 1, Pru p 3 and Pru p 4. Only 12 patients resulted positive to Pru p1 and/or Pru p 4. CONCLUSION: Our data strongly suggests to include the measurement of sIgE to Ara h 9 into the diagnostic algorithm of peanut sensitization. 4.5% of the sicilian population suspected of peach sensitization were positive to peach extract and negative to all the available molecules.


Assuntos
Alérgenos/isolamento & purificação , Hipersensibilidade Alimentar/diagnóstico , Imunoglobulina E/isolamento & purificação , Adolescente , Adulto , Alérgenos/química , Criança , Pré-Escolar , Feminino , Humanos , Imunoglobulina E/química , Masculino , Pessoa de Meia-Idade , Adulto Jovem
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