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Cross-reactivity Between Tomato And Pollen Extracts
S30 Abstracts
SATURDAY
100
Cross-reactivity Between Tomato And Other Fruit Allergen Extracts C. H. de Larramendi1, A. Ferrer2, J. Huertas3, J. Paga´n4, J. Bartra5, C. Andreu2, J. Garcı´a-Abujeta1, J. Lavı´n6, M. Lo´pez-Matas7, J. Carne´s7; 1 Unidad de Alergia. Hospital Marina Baixa and Centro de Especialidades Foietes, Alicante, Spain, 2Unidad de Alergia. Hospital de la Vega Baja, Orihuela (Alicante), Spain, 3Servicio de Alergia. Hospital Santa Marı´a del Rosell, Cartagena (Murcia), Spain, 4Unidad de Alergia, Hospital Virgen de la Arrixaca, Murcia, Spain, 5Servicio de Alergia. Hospital Clı´nico de Barcelona, Barcelona, Spain, 6Unidad de Alergia, Hospital General Ba´sico de la Defensa, Valencia, Spain, 7C.B.F. LETI S.A., Tres Cantos, Spain. RATIONALE: Cross-reactivity among fruits has been extensively demonstrated. The objective of this study was to analyze cross-reactivity between tomato and other common consumed fruits. METHODS: A serum pool from 18 individuals (9 males and 9 females; age 25.4 6 8.4) with positive skin prick test to peel tomato was prepared. Extracts from peach (peel and pulp), potato, carrot, kiwi, pineapple, banana, melon, avocado, nuts, (including chestnut, hazelnut and almond) and latex were prepared. Specific IgE to all extracts was measured by direct ELISA. Allergenic profile of different extracts was evaluated by Immunoblot. Percentage of cross-reactivity between extracts was analyzed by CAP inhibition and the allergens involved by immunoblot inhibition. RESULTS: Sensitization studies with fruits showed that 8 (44.4%) individuals were sensitized to nuts, 5 (27.8%) to peach, 4 (22.2%) to banana, 3 (16.7%) to kiwi and pineapple and 2 (11.1%) to melon. Only 1 patient was sensitized to latex. Specific IgE to tomato and peach peel was significantly higher than those obtained with the other allergen extracts. Tomato extract was inhibited 62.6% by peach, 46% by hazelnut, 45% by chestnut, 39% by avocado and 17% by melon. Other fruits and nuts tested inhibited less than 15%. No inhibition was detected with latex. Peach, chestnut and melon inhibited high molecular weight bands (between 32 and 45 kDa) and a band of about 10 kDa. CONCLUSIONS: Cross-reactivity between tomato and other fruits have been demonstrated, especially with peach, nuts and melon. Allergens with a molecular weight of 10, 32 and 45 KDa seem to be the responsible.
101
Correlation of Phenotypic Expression of Milk Sensitivity in Young Patients by the Simultaneous Determination of IgE to Whole Milk Extract and Milk Specific Allergenic Proteins V. Saper1, D. Innerst2, K. Nadeau1, E. Hoyte1, C. Vanichsarn1, E. Zychlinsky2; 1Stanford University Medical Center, Palo Alto, CA, 2Hitachi Chemical Diagnostics (HCD), Mountain View, CA. RATIONALE: Methods to assess IgE sensitivity to whole milk extracts can be inconclusive for practical correlation with disease expression. This pilot study aims to investigate the relationship between phenotypic expression of clinical milk hypersensitivity (CMH) and specific quantity and quality of milk fraction specific IgE antibodies (MFSA). METHODS: Whole milk extract, casein, a-casein, b-casein, k-casein, alactalbumin, b-lactoglobulin, BSA, and lactoferrin were immobilized on the OPTIGEN Ò device manufactured by HCD. This multiplex technology individually assesses allergen specific IgE to multiple allergens simultaneously. Sample volume per allergen is approximately 14 ul. Plasma from 10 patients with CMH and 2 with atopic dermatitis (AD) but without CMH were tested. Median age was 6 years. In addition to food allergy, diagnoses included: AD (8), anaphylaxis (2), asthma (5), allergic rhinitis (1) and eosinophilic esophagitis (1). Results of skin test (ST) and/or ImmunoCAP specific IgE to milk were available. RESULTS: CMH patients exhibited MFSA in increasing diversity and intensity as ImmunoCAP results to milk increased. Presence of AD or elevated total IgE had no bearing on MFSA. Strongly positive ST in 2 patients with a single component positive to b-lactoglobulin did not obviously correlate with CMH. The patient with eosinophilic esophagitis showed an unusual response pattern. Results suggest that a relative pattern of higher positive b-lactoglobulin compared with other MFSA may predict less severe or less likely CMH despite positive ST. CONCLUSIONS: Component based in-vitro assessment particularly in relationship with b-lactoglobulin response may prove useful in the diagnosis and care of patients with CMH.
J ALLERGY CLIN IMMUNOL FEBRUARY 2009
102
Characterizing the Relationship Between Peanut and Sesame Allergy in Children L. M. Stutius1,2, W. J. Sheehan1,2, P. A. Rangsithienchai3, J. Walter1,2, L. C. Schneider1,2, W. Phipatanakul1,2; 1Children’s Hospital Boston, Boston, MA, 2Harvard Medical School, Boston, MA, 3McGaw Medical Center, Northwestern University, Evanston Program, Evanston, IL. RATIONALE: Sesame is an emerging food allergen in the US. There is hypothesized cross-reactivity between peanut and sesame, making sesame allergy a potential risk for peanut-allergic children. As a result, many allergists are screening peanut-allergic children for sesame allergy. We examined the relationship between sesame and peanut sensitization by skin prick test (SPT) and parent/guardian report of allergic reactions. METHODS: We performed a retrospective chart review of all children who underwent SPT to sesame at our program from December 2006 to March 2008. In these patients, we obtained SPT data for several other common food allergens and determined history of allergic reaction to peanut or sesame from the medical record. RESULTS: We identified 190 children who underwent SPT to sesame. Of these, 122 underwent SPT to peanut. The prevalence of sesame sensitivity in our cohort was 36.3% (N 5 69). Children sensitized to sesame had a high prevalence of sensitization to other foods, with peanut being the most common: peanut 84.8%, hazelnut 82.9%, egg 81.5%, walnut 80.6%, almond 76.3%. Further, 52.7% of children sensitized to peanut were sensitized to sesame. Children sensitized to peanut were significantly more likely to be sensitized to sesame (OR 6.53, 95% CI 2.59-16.42, p < 0.001). Children with reported history of peanut reaction were not more likely to have reported history of sesame reaction (OR 1.37, 95% CI 0.54-3.51, p 5 0.5). CONCLUSIONS: Children with peanut sensitivity are more likely to be sensitized to sesame. However, there does not appear to be a significant relationship between reported history of clinical reaction to peanut and sesame.
103
Cross-reactivity Between Tomato And Pollen Extracts A. Ferrer1, J. Huertas2, C. H. de Larramendi3, J. Paga´n4, J. Garcı´a-Abujeta3, J. Lavı´n5, J. Bartra6, C. Andreu1, M. Lo´pez-Matas7, J. Carne´s7; 1Unidad de Alergia. Hospital de la Vega Baja, Orihuela (Alicante), Spain, 2Servicio de Alergia. Hospital Santa Marı´a del Rosell, Cartagena (Murcia), Spain, 3Unidad de Alergia. Hospital Marina Baixa and Centro de Especialidades Foietes, Villajoyosa (Alicante), Spain, 4Servicio de Alergia. Hospital Virgen de la Arrixaca, Murcia, Spain, 5Unidad de Alergia, Hospital General Ba´sico de la Defensa, Valencia, Spain, 6Servicio de Alergia. Hospital Clı´nico de Barcelona, Barcelona, Spain, 7C.B.F. LETI S.A., Tres Cantos, Spain. RATIONALE: Cross reactivity among fruits and different pollen species have been extensively described. The objective of this study was to analyze cross-reactivity between tomato and other common pollen extracts. METHODS: A serum pool from 18 individuals (9 males and 9 females; age 25.4 6 8.4) with positive skin prick test to peel tomato was prepared. Extracts from Olea europaea, Platanus acerifolia, Plantago lanceolata, Chenopodium album, Salsola kali, Betula alba, Artemisia vulgaris, Phoenix dactyliphera and grasses (Avena sativa and Poa pratensis) were prepared. Specific IgE was determined by direct ELISA. Allergenic profile of different extracts was evaluated by Immunoblot. Percentage of cross-reactivity between extracts was analyzed by CAP inhibition and the allergens implicated by immunoblot inhibition. RESULTS: Eleven individuals (61.1%) reported symptoms after ingestion and/or contact with tomato. Twelve (66.7%) individuals were sensitized to Chenopodiaceae, 11 (61.1%) to A. vulgaris, 10 (55.5%) to O. europaea, 3 (16.7%) to P. acerofila and 6 (33.3%) to grasses. The highest specific IgE levels were obtained to grasses, P. acerifolia, O. europaea and Chenopodiaceae. Most pollen extracts showed a similar capacity of inhibition (about 35%). A. sativa was capable to inhibit 53% and P. pratensis 47%. P. dactyliphera showed the less capacity of inhibition with 23.4%. The most strongly inhibited allergens corresponded to bands of 32 and 45 kDa. The band of 10 kDa was poorly inhibited by all extracts except by P. acerifolia. CONCLUSIONS: Cross-reactivity between tomato and pollen extracts have been demonstrated, especially in grasses. Allergens with high molecular weight range seem to be the responsible.
SATURDAY
100
Cross-reactivity Between Tomato And Other Fruit Allergen Extracts C. H. de Larramendi1, A. Ferrer2, J. Huertas3, J. Paga´n4, J. Bartra5, C. Andreu2, J. Garcı´a-Abujeta1, J. Lavı´n6, M. Lo´pez-Matas7, J. Carne´s7; 1 Unidad de Alergia. Hospital Marina Baixa and Centro de Especialidades Foietes, Alicante, Spain, 2Unidad de Alergia. Hospital de la Vega Baja, Orihuela (Alicante), Spain, 3Servicio de Alergia. Hospital Santa Marı´a del Rosell, Cartagena (Murcia), Spain, 4Unidad de Alergia, Hospital Virgen de la Arrixaca, Murcia, Spain, 5Servicio de Alergia. Hospital Clı´nico de Barcelona, Barcelona, Spain, 6Unidad de Alergia, Hospital General Ba´sico de la Defensa, Valencia, Spain, 7C.B.F. LETI S.A., Tres Cantos, Spain. RATIONALE: Cross-reactivity among fruits has been extensively demonstrated. The objective of this study was to analyze cross-reactivity between tomato and other common consumed fruits. METHODS: A serum pool from 18 individuals (9 males and 9 females; age 25.4 6 8.4) with positive skin prick test to peel tomato was prepared. Extracts from peach (peel and pulp), potato, carrot, kiwi, pineapple, banana, melon, avocado, nuts, (including chestnut, hazelnut and almond) and latex were prepared. Specific IgE to all extracts was measured by direct ELISA. Allergenic profile of different extracts was evaluated by Immunoblot. Percentage of cross-reactivity between extracts was analyzed by CAP inhibition and the allergens involved by immunoblot inhibition. RESULTS: Sensitization studies with fruits showed that 8 (44.4%) individuals were sensitized to nuts, 5 (27.8%) to peach, 4 (22.2%) to banana, 3 (16.7%) to kiwi and pineapple and 2 (11.1%) to melon. Only 1 patient was sensitized to latex. Specific IgE to tomato and peach peel was significantly higher than those obtained with the other allergen extracts. Tomato extract was inhibited 62.6% by peach, 46% by hazelnut, 45% by chestnut, 39% by avocado and 17% by melon. Other fruits and nuts tested inhibited less than 15%. No inhibition was detected with latex. Peach, chestnut and melon inhibited high molecular weight bands (between 32 and 45 kDa) and a band of about 10 kDa. CONCLUSIONS: Cross-reactivity between tomato and other fruits have been demonstrated, especially with peach, nuts and melon. Allergens with a molecular weight of 10, 32 and 45 KDa seem to be the responsible.
101
Correlation of Phenotypic Expression of Milk Sensitivity in Young Patients by the Simultaneous Determination of IgE to Whole Milk Extract and Milk Specific Allergenic Proteins V. Saper1, D. Innerst2, K. Nadeau1, E. Hoyte1, C. Vanichsarn1, E. Zychlinsky2; 1Stanford University Medical Center, Palo Alto, CA, 2Hitachi Chemical Diagnostics (HCD), Mountain View, CA. RATIONALE: Methods to assess IgE sensitivity to whole milk extracts can be inconclusive for practical correlation with disease expression. This pilot study aims to investigate the relationship between phenotypic expression of clinical milk hypersensitivity (CMH) and specific quantity and quality of milk fraction specific IgE antibodies (MFSA). METHODS: Whole milk extract, casein, a-casein, b-casein, k-casein, alactalbumin, b-lactoglobulin, BSA, and lactoferrin were immobilized on the OPTIGEN Ò device manufactured by HCD. This multiplex technology individually assesses allergen specific IgE to multiple allergens simultaneously. Sample volume per allergen is approximately 14 ul. Plasma from 10 patients with CMH and 2 with atopic dermatitis (AD) but without CMH were tested. Median age was 6 years. In addition to food allergy, diagnoses included: AD (8), anaphylaxis (2), asthma (5), allergic rhinitis (1) and eosinophilic esophagitis (1). Results of skin test (ST) and/or ImmunoCAP specific IgE to milk were available. RESULTS: CMH patients exhibited MFSA in increasing diversity and intensity as ImmunoCAP results to milk increased. Presence of AD or elevated total IgE had no bearing on MFSA. Strongly positive ST in 2 patients with a single component positive to b-lactoglobulin did not obviously correlate with CMH. The patient with eosinophilic esophagitis showed an unusual response pattern. Results suggest that a relative pattern of higher positive b-lactoglobulin compared with other MFSA may predict less severe or less likely CMH despite positive ST. CONCLUSIONS: Component based in-vitro assessment particularly in relationship with b-lactoglobulin response may prove useful in the diagnosis and care of patients with CMH.
J ALLERGY CLIN IMMUNOL FEBRUARY 2009
102
Characterizing the Relationship Between Peanut and Sesame Allergy in Children L. M. Stutius1,2, W. J. Sheehan1,2, P. A. Rangsithienchai3, J. Walter1,2, L. C. Schneider1,2, W. Phipatanakul1,2; 1Children’s Hospital Boston, Boston, MA, 2Harvard Medical School, Boston, MA, 3McGaw Medical Center, Northwestern University, Evanston Program, Evanston, IL. RATIONALE: Sesame is an emerging food allergen in the US. There is hypothesized cross-reactivity between peanut and sesame, making sesame allergy a potential risk for peanut-allergic children. As a result, many allergists are screening peanut-allergic children for sesame allergy. We examined the relationship between sesame and peanut sensitization by skin prick test (SPT) and parent/guardian report of allergic reactions. METHODS: We performed a retrospective chart review of all children who underwent SPT to sesame at our program from December 2006 to March 2008. In these patients, we obtained SPT data for several other common food allergens and determined history of allergic reaction to peanut or sesame from the medical record. RESULTS: We identified 190 children who underwent SPT to sesame. Of these, 122 underwent SPT to peanut. The prevalence of sesame sensitivity in our cohort was 36.3% (N 5 69). Children sensitized to sesame had a high prevalence of sensitization to other foods, with peanut being the most common: peanut 84.8%, hazelnut 82.9%, egg 81.5%, walnut 80.6%, almond 76.3%. Further, 52.7% of children sensitized to peanut were sensitized to sesame. Children sensitized to peanut were significantly more likely to be sensitized to sesame (OR 6.53, 95% CI 2.59-16.42, p < 0.001). Children with reported history of peanut reaction were not more likely to have reported history of sesame reaction (OR 1.37, 95% CI 0.54-3.51, p 5 0.5). CONCLUSIONS: Children with peanut sensitivity are more likely to be sensitized to sesame. However, there does not appear to be a significant relationship between reported history of clinical reaction to peanut and sesame.
103
Cross-reactivity Between Tomato And Pollen Extracts A. Ferrer1, J. Huertas2, C. H. de Larramendi3, J. Paga´n4, J. Garcı´a-Abujeta3, J. Lavı´n5, J. Bartra6, C. Andreu1, M. Lo´pez-Matas7, J. Carne´s7; 1Unidad de Alergia. Hospital de la Vega Baja, Orihuela (Alicante), Spain, 2Servicio de Alergia. Hospital Santa Marı´a del Rosell, Cartagena (Murcia), Spain, 3Unidad de Alergia. Hospital Marina Baixa and Centro de Especialidades Foietes, Villajoyosa (Alicante), Spain, 4Servicio de Alergia. Hospital Virgen de la Arrixaca, Murcia, Spain, 5Unidad de Alergia, Hospital General Ba´sico de la Defensa, Valencia, Spain, 6Servicio de Alergia. Hospital Clı´nico de Barcelona, Barcelona, Spain, 7C.B.F. LETI S.A., Tres Cantos, Spain. RATIONALE: Cross reactivity among fruits and different pollen species have been extensively described. The objective of this study was to analyze cross-reactivity between tomato and other common pollen extracts. METHODS: A serum pool from 18 individuals (9 males and 9 females; age 25.4 6 8.4) with positive skin prick test to peel tomato was prepared. Extracts from Olea europaea, Platanus acerifolia, Plantago lanceolata, Chenopodium album, Salsola kali, Betula alba, Artemisia vulgaris, Phoenix dactyliphera and grasses (Avena sativa and Poa pratensis) were prepared. Specific IgE was determined by direct ELISA. Allergenic profile of different extracts was evaluated by Immunoblot. Percentage of cross-reactivity between extracts was analyzed by CAP inhibition and the allergens implicated by immunoblot inhibition. RESULTS: Eleven individuals (61.1%) reported symptoms after ingestion and/or contact with tomato. Twelve (66.7%) individuals were sensitized to Chenopodiaceae, 11 (61.1%) to A. vulgaris, 10 (55.5%) to O. europaea, 3 (16.7%) to P. acerofila and 6 (33.3%) to grasses. The highest specific IgE levels were obtained to grasses, P. acerifolia, O. europaea and Chenopodiaceae. Most pollen extracts showed a similar capacity of inhibition (about 35%). A. sativa was capable to inhibit 53% and P. pratensis 47%. P. dactyliphera showed the less capacity of inhibition with 23.4%. The most strongly inhibited allergens corresponded to bands of 32 and 45 kDa. The band of 10 kDa was poorly inhibited by all extracts except by P. acerifolia. CONCLUSIONS: Cross-reactivity between tomato and pollen extracts have been demonstrated, especially in grasses. Allergens with high molecular weight range seem to be the responsible.