POLLEN–FOOD ALLERGY SYNDROME AMONG CHILDREN WITH SENSITIZED TO SPRING TREES
It is known that among 40–70 % of patients pollinosis can run in conjunction with pollen-food allergy syndrome (PFS), while development of PFS is associated with the consumption of fresh fruits, vegetables, nuts and spices. Clinical course and severity of the disease depend on the sensitization profile, which can be represented by proteins-panallergens (PR-10, profilins, nsLTPs). However, there is little information about the sensitization profiles of patients with pollinosis caused by pollen of spring trees in Ukraine.
Aim. To study the profiles of sensitization of children with spring pollinosis.
Methods. We examined 61 children (aged 4-17 years) with spring seasonal allergic rhinitis/rhinoconjunctivitis (SAR). To establish the diagnosis, all children were given questionnaires, skin prick tests (SPTs) with commercial pollen extracts, and prick to prick tests with fresh fruits, vegetables and nuts. Component resolved diagnosis (CRD) were detected using an ImmunoCAP system. (Phadia, 100).
Results. It has been found that in 43 children (70.5 %) had polinosis in combination with PFS, the main clinical manifestation of which was an oral allergic syndrome in 43 children (100 %). Among the causal food allergens that caused the manifestations of PFS were more apples, peaches, carrots and hazelnuts (consumption of which led to 11.6 % of children before the development of anaphylaxis). All of the examined children (100 %) had a positive IgE response to rBet v 1 at significant concentrations. In 9.3 % of children, panallergens were found at once from several botanical groups. Such panallergens: rBet v 2, rBet v 4, rPhl p 7, rPhl p 12, rArt v 3 are generally not defined in the control group children.
Conclusions. Birch related PFS are common in Ukrainian pollen-allergic children with nuts and fruits predominantly implicated. Sensitization profile of children with Birch-pollen syndrome is complex and associated with sensitization to panalergens. Clinicians should be worried of PFS in patients with a high degree of sensitization to birch pollen and even young children if they have birch sensitization.
Naumova, O. (2015). Prognostic value determination of sensitization to lipid transport proteins in patients with seasonal allergic rhinitis. Journal Pathologia, 2 (34), 110–113. doi: http://doi.org/10.14739/2310-1237.2015.2.51159
Ludman, S., Jafari-Mamaghani, M., Ebling, R., Fox, A. T., Lack, G., Du Toit, G. (2015). Pollen food syndrome amongst children with seasonal allergic rhinitis attending allergy clinic. Pediatric Allergy and Immunology, 27 (2), 134–140. doi: http://doi.org/10.1111/pai.12504
Sergeev, A. V., Mokronosova, M. A. (2011). Oral allergy syndrome. Medical Immunology, 13 (1), 17–28. doi: http://doi.org/10.15789/1563-0625-2011-1-17-28
Ebo, D. G., Bridts, C. H., Verweij, M. M., De Knop, K. J., Hagendorens, M. M., De Clerck, L. S., Stevens, W. J. (2010). Sensitization profiles in birch pollen-allergic patients with and without oral allergy syndrome to apple: lessons from multiplexed component-resolved allergy diagnosis. Clinical & Experimental Allergy, 40 (2), 339–347. doi: http://doi.org/10.1111/j.1365-2222.2009.03345.x
Bartra, J., Sastre, J., Cuvillo, A. D. et. al. (2009). From pollinosis to digestive allergy. Journal of Investigational Allergology and Clinical Immunology, 19 (1), 3–10.
Mastrorilli, C., Tripodi, S., Caffarelli, C., Perna, S., Di Rienzo-Businco, A. et. al. (2016). Endotypes of pollen-food syndrome in children with seasonal allergic rhinoconjunctivitis: a molecular classification. Allergy, 71 (8), 1181–1191. doi: http://doi.org/10.1111/all.12888
Werfel, T., Asero, R., Ballmer-Weber, B. K., Beyer, K., Enrique, E., Knulst, A. C. et. al. (2015). Position paper of the EAACI: food allergy due to immunological cross-reactions with common inhalant allergens. Allergy, 70 (9), 1079–1090. doi: http://doi.org/10.1111/all.12666
Ma, S., Wang, R., Nie, L., Yin, J. (2017). Pollen-food allergy syndrome in China. Food and Agricultural Immunology, 29 (1), 281–293. doi: http://doi.org/10.1080/09540105.2017.1372372
Skypala, I. J., Calderon, M. A., Leeds, A. R., Emery, P., Till, S., Durham, S. R. (2011). Development and validation of a structured questionnaire for the diagnosis of oral allergy syndrome in subjects with seasonal allergic rhinitis during the UK birch pollen season. Clinical & Experimental Allergy, 41 (7), 1001–1011. doi: http://doi.org/10.1111/j.1365-2222.2011.03759.x
Hoffmann-Sommergruber, K., Pfeifer, S., Bublin, M. (2015). Applications of Molecular Diagnostic Testing in Food Allergy. Current Allergy and Asthma Reports, 15 (9), 1–8. doi: http://doi.org/10.1007/s11882-015-0557-6
Popescu, F.-D. (2015). Cross-reactivity between aeroallergens and food allergens. World Journal of Methodology, 5 (2), 31–50. doi: http://doi.org/10.5662/wjm.v5.i2.31
Kim, K., Lee, B., Min, T. K., Lee, J., Pyun, B. Y., Jeon, Y. H. (2019). Clinical Characteristics of Oral Allergy Syndrome in Children with Atopic Dermatitis and Birch Sensitization: a Single Center Study. Journal of Korean Medical Science, 34 (2), 1–9. doi: http://doi.org/10.3346/jkms.2019.34.e11
Kelava, N., Ludovic-Mihic, L., Duvancic, T. et. al. (2014). Oral allergy syndrome – the need of a multidisciplinary approach. Acta Clinica Croatica, 53 (2), 210–219.
Breiteneder, H., Ebner, C. (2000). Molecular and biochemical classification of plant-derived food allergens. Journal of Allergy and Clinical Immunology, 106 (1), 27–36. doi: http://doi.org/10.1067/mai.2000.106929
Asero, R., Tripodi, S., Dondi, A., Di Rienzo Businco, A., Sfika, I. et. al. (2015). Prevalence and Clinical Relevance of IgE Sensitization to Profilin in Childhood: A Multicenter Study. International Archives of Allergy and Immunology, 168 (1), 25–31. doi: http://doi.org/10.1159/000441222
Movérare, R., Westritschnig, K., Svensson, M., Hayek, B., Bende, M., Pauli, G. et. al. (2002). Different IgE Reactivity Profiles in Birch Pollen-Sensitive Patients from Six European Populations Revealed by Recombinant Allergens: An Imprint of Local Sensitization. International Archives of Allergy and Immunology, 128 (4), 325–335. doi: http://doi.org/10.1159/000063855
Westman, M., Lupinek, C., Bousquet, J., Andersson, N., Pahr, S., Baar, A. et. al. (2015). Early childhood IgE reactivity to pathogenesis-related class 10 proteins predicts allergic rhinitis in adolescence. Journal of Allergy and Clinical Immunology, 135 (5), 1199–1206. doi: http://doi.org/10.1016/j.jaci.2014.10.042
McKenna, O. E., Asam, C., Araujo, G. R., Roulias, A., Goulart, L. R., Ferreira, F. (2016). How relevant is panallergen sensitization in the development of allergies? Pediatric Allergy and Immunology, 27 (6), 560–568. doi: http://doi.org/10.1111/pai.12589
Macchia, D., Melioli, G., Pravettoni, V., Nucera, E., Piantanida, M. et. al. (2015). Guidelines for the use and interpretation of diagnostic methods in adult food allergy. Clinical and Molecular Allergy, 13 (1). doi: http://doi.org/10.1186/s12948-015-0033-9
Hauser, M., Roulias, A., Ferreira, F., Egger, M. (2010). Panallergens and their impact on the allergic patient. Allergy, Asthma & Clinical Immunology, 6 (1). doi: http://doi.org/10.1186/1710-1492-6-1
Wolthers, O. D. (2012). Component-Resolved Diagnosis in Pediatrics. ISRN Pediatrics, 2012, 1–6. doi: http://doi.org/10.5402/2012/806920
Deng, S., Yin, J. (2019). Mugwort Pollen-Related Food Allergy: Lipid Transfer Protein Sensitization and Correlation With the Severity of Allergic Reactions in a Chinese Population. Allergy, Asthma & Immunology Research, 11 (1), 116–128. doi: http://doi.org/10.4168/aair.2019.11.1.116
San Nicoló, M., Braun, T., Eder, K., Berghaus, A., Gröger, M. (2016). Clinical Relevance of IgE to Profilin and/or Polcalcin in Pollen-Sensitized Patients. International Archives of Allergy and Immunology, 169 (2), 101–107. doi: http://doi.org/10.1159/000444279
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