Allergen-resolved diagnosis of food allergy may be essential in the clinical practice, particularly in patients allergic to foods that may contain both labile and stable allergens. However, presently available diagnostic tests are not... more
Allergen-resolved diagnosis of food allergy may be essential in the clinical practice, particularly in patients allergic to foods that may contain both labile and stable allergens. However, presently available diagnostic tests are not useful in this sense. To assess the clinical usefulness of SPT with a heat-processed apple peel extract as an easily available means to detect hypersensitivity to lipid transfer protein (LTP), an extremely stable and potentially hazardous apple allergen. Raw and heat-processed (100 degrees C x 10 min) apple peel extract (100 microg/ml) were used to carry out SPT in 23 patients with apple-allergy, 15 of which considered as probably sensitized to labile allergens (Maid 1, Mal d 4) and 8 to stable allergens (Mal d 3, LTP), respectively on the basis of the presence/absence of IgE reactivity to birch pollen. IgE reactivity to the heat-processed apple peel extract was further analyzed by immunoblot. Altogether SPT with raw apple extract scored positive in 20/23 (87%) patients, including 12/15 patients considered as probably sensitized to labile allergens and 8/8 patients considered as probably sensitized to LTP. In contrast, the heat-processed apple extract induced a wheal-and-flare reaction only in the 8 (100%) presumptive LTP reactors. Immunoblot analysis showed IgE reactivity to a 10 kDa protein (LTP) in heat-processed apple extract. The heat-resistance of stable apple allergens like LTP can be usefully exploited to prepare extracts for allergen-resolved diagnosis in-vivo.
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A woman, 68 yrs, developed an anaphylactic reaction after tasting a few pieces of gluten-free pasta. She was not celiac but was preparing a meal for her celiac nephew. The culprit pasta contained lupine flour and lupine proteins. Prick... more
A woman, 68 yrs, developed an anaphylactic reaction after tasting a few pieces of gluten-free pasta. She was not celiac but was preparing a meal for her celiac nephew. The culprit pasta contained lupine flour and lupine proteins. Prick test with lupine extract was positive. ELISA and immunoblot analysis showed the presence of specific IgE to lupine in patient's serum.
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J Investig Allergol Clin Immunol 2008; Vol. 18(6): 482-495 © 2008 Esmon Publicidad Quality of life improvement was manifest in all domains of the AQLQ (Figure). The overall AQLQ score increased from 2.88 (before treatment) to 4.66 at week... more
J Investig Allergol Clin Immunol 2008; Vol. 18(6): 482-495 © 2008 Esmon Publicidad Quality of life improvement was manifest in all domains of the AQLQ (Figure). The overall AQLQ score increased from 2.88 (before treatment) to 4.66 at week 16 and 5.81 at week 52. Skin prick tests repeated after 12 months were positive for grass pollens and Tyrophagus, and negative for other pollens, mites, and fl our. The total serum IgE level after 12 months was 782 IU/mL, and specifi c IgE results for mites and fl our were similar to baseline fi gures. The patient continued to work while receiving treatment with omalizumab. The patient’s clinical condition improved considerably, as was demonstrated by improved AQLQ scores, a reduction in the need for systemic corticosteroids, and fewer emergency visits. Changes in FEV 1 , PEF, and FeNO, however, were irregular. Although skin responses to aeroallergens decreased after 1 year of follow-up, total and specifi c IgE serum levels remained similar, as previous studies have shown [5,6].
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Research Interests: Chemistry, Biology, Japan, Medicine, Humans, and 12 morePollen, Tandem Mass Spectrometry, Immunoglobulin E, High Performance Liquid Chromatography, Two-Dimensional Gel Electrophoresis, Hypersensitivity, Enzyme Linked Immunosorbent Assay, Pollinosis, Immunoblotting, Allergen, Humulus lupulus, and Medical and Health Sciences
Despite the wide use of pine nuts, the fruit of Pinus pinea, only a few reports of allergic reactions to them have been published. We present herein a case of food allergy to pine nuts in a patient who showed no clinical symptoms to pine... more
Despite the wide use of pine nuts, the fruit of Pinus pinea, only a few reports of allergic reactions to them have been published. We present herein a case of food allergy to pine nuts in a patient who showed no clinical symptoms to pine pollen despite the presence in her serum of specific IgE antibodies. In order to verify whether the reaction against pine nuts was IgE mediated, specific IgE against pine nuts and pollen were evaluated by skin-prick test, prick by prick and RAST. Immunoblotting and immunoblotting-inhibition were used to evaluate the allergenic components of both extracts and their cross-reactivity. Prick by prick with fresh pine nuts and RAST with pine nut and pine pollen extracts showed that the patient had high levels of specific IgE against both extracts. Immunoblotting experiments showed the presence in serum of IgE antibodies against several components in pine nuts and pollen. Immunoblotting-inhibition experiments demonstrated the presence of some cross-reacting components. These data confirm the existence of food allergy induced by pine nuts. This sensitization to pine nuts developed with no symptoms of pine pollinosis. Development of pollinosis may require a longer time of exposure to allergens. Based on the cross-reactivity between pine nut and pine pollen extracts, cosensitization to these two allergens could be possible.
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Background: Allergy to crustacean shellfish is one of the most common IgE-mediated food allergies, and tropomyosin has been identified as the major allergen. However, not all subjects affected by this allergy are IgE-positive to... more
Background: Allergy to crustacean shellfish is one of the most common IgE-mediated food allergies, and tropomyosin has been identified as the major allergen. However, not all subjects affected by this allergy are IgE-positive to tropomyosin. Aims: To evaluate whether sera of patients with shrimp allergy but negative for tropomyosin react to other allergen(s); and to evaluate the role such allergen(s) may play in cross-reactivity between crustaceans and house dust mites (HDMs). Methods: Three different pools of sera-one from subjects with shellfish allergy and HDMs positivity, but negative for recombinant and native tropomyosin (rPen a 1 and nPen m 1) (Pool 2); a second from subjects with tropomyosin and HDMs positivity (Pool 1); and the last from subjects allergic only to HDMs (Pool 3) were submitted to immunoblotting. Subsequently, a 20 kDa protein- enriched fraction of shrimp extract was used at two different concentrations (10 and 100 microg/mL) to pre-absorb the Pool 2 serum and to evaluate, by ELISA assay, the level of inhibition on shrimp and HDMs-coated wells, respectively. Results: The Pool 2 serum showed IgE reactivity against a 20 kDa component. Its pre-absorption with an enriched fraction of 20 kDa protein caused an inhibition of 56% in IgE binding to shrimp extract at a concentration of 100 microg/mL, and of 14% and 35% to HDMs extract at concentrations of 10 and 100 microg/mL, respectively, as measured by ELISA assay. Conclusions: The 20 kDa component seems to be a new crustacean allergen and it could play a role in cross-reactivity with HDMs.
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We describe two uncommon cases of oral allergy syndrome (OAS) after eating pistachio nuts (p.n.) in subjects (a 54-year-old man and a 3-year-old girl) with exclusive skin prick test (SPT) positivity to Parietaria (P.) and pistachio nut... more
We describe two uncommon cases of oral allergy syndrome (OAS) after eating pistachio nuts (p.n.) in subjects (a 54-year-old man and a 3-year-old girl) with exclusive skin prick test (SPT) positivity to Parietaria (P.) and pistachio nut (p.n.) allergens. Serologic P.- and p.n.-specific IgE determinations were also carried out. A double-blind, placebo-controlled food challenge (DBPCFC) was performed, for ethical reasons, only in the adult patient, but we observed a positive intraoral reaction only after slight scratching of the oral mucosa. Since this patient had put three whole p.n. with their shells into his mouth, breaking them with his teeth, before the onset of symptoms, we suggest that slight injury of the oral mucosa may enhance the local response. Preliminary results with SDS-PAGE and immunoblotting demonstrate the occurrence of a slight degree of cross-reactivity between these allergens, but further studies are necessary to obtain a definite conclusion.
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Research Interests: Chemistry, Immunology, Medicine, Allergy, Humans, and 7 moreAnaphylaxis, Female, Adult, Fabaceae, Immunoblotting, Pear, and food hypersensitivity
Background: Allergy to lipid transfer protein (LTP) is quite common in the Mediterranean countries but virtually absent in Northern Europe. The reasons for this latitude-dependent distribution are unclear. One hypothesis is that peach,... more
Background: Allergy to lipid transfer protein (LTP) is quite common in the Mediterranean countries but virtually absent in Northern Europe. The reasons for this latitude-dependent distribution are unclear. One hypothesis is that peach, the primary sensitizer to LTP, may lose in part its allergenicity as a consequence of treatments (handling, brushing, washing, and packaging) preceding marketing in Northern European. Peach surface fuzz might represent a potential vehicle of LTP. Objective: To detect LTP in peach fuzz, and compare IgE reactivity to peach fuzz and peel of sera from LTP-allergic patients. Methods: IgE reactivity to peach peel and peach fuzz extract was measured by ELISA using sera from 2 LTP-allergic PATIENTS. Purified peach LTP was used in inhibition studies. Results: Both sera strongly reacted both to peach peel and fuzz but reactivity to fuzz was stronger than to peel. Pre-absorption of one serum with peach LTP caused an 87% reduction of IgE reactivity to peach fuzz extract. Conclusion: Peach fuzz contains large amounts of LTP and might be a potential vehicle of this allergen causing sensitization in genetically predisposed subjects. Fuzz loss during pre-marketing handling of peaches might be at the basis of the geographic differences that characterize allergy to LTP.
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Background: Cupressaceae (cypress) pollens can cause pollinosis in winter. However, the lack of specific commercial extracts combined with the early pollination period of cypress trees make a precise diagnosis difficult. The need for a... more
Background: Cupressaceae (cypress) pollens can cause pollinosis in winter. However, the lack of specific commercial extracts combined with the early pollination period of cypress trees make a precise diagnosis difficult. The need for a reliable and effective cypress extract for diagnostic and therapeutic purposes is increasingly felt. Methods: Mixed or single Cupressus arizonica, lusitanica and sempervirens pollen extracts precipitated with ammonium sulfate (PPT) were compared by direct RAST, RAST inhibition and SDS-PAGE techniques. The major allergen of C. arizonica (Cup a 1), purified by anion exchange chromatography, was checked by immunoblotting experiments before chemical modification, in parallel with a C. arizonica extract, with potassium cyanate (KCNO) to obtain a monomeric allergoid. The allergoid extract was characterized for its biological, chemico-physical and immunological features by RAST inhibition, SDS-PAGE and ELISA assays. Results: Direct RAST, RAST inhibition, and SDS-PAGE data indicated that the PPT C. arizonica pollen extract showed the most allergenic potential, and it can be considered representative of the Cupressus spp. Immunoblotting data confirmed Cup a 1 as a major allergen. RAST inhibition and ELISA showed that modified PPT C. arizonica extract had less IgE reactivity than the native, non-modified extract, while preserving the immunogenic capacity typical for an allergoid. Finally, the SDS-PAGE profile of Cup a 1 allergoid was similar to native Cup a 1 allergen, suggesting the modified C. arizonica extract shows the characteristics of a monomeric allergoid. Conclusions: The PPT C. arizonica pollen extract shows good in vitro diagnostic potential and its chemically modified form offers the features of a monomeric allergoid. It might therefore lend itself to the development of a product to be administered by the sublingual or oromucosal route for immunotherapy of individuals with cypress pollinosis.
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... and food extracts (Lofarma, Milan, Italy) showed a weak reaction to grass pollen (food extracts included milk, egg, codfish, wheat, peanut ... florists, floHcuIturists, and green-house workers have an increased risk of devel-oping... more
... and food extracts (Lofarma, Milan, Italy) showed a weak reaction to grass pollen (food extracts included milk, egg, codfish, wheat, peanut ... florists, floHcuIturists, and green-house workers have an increased risk of devel-oping occupational allergies to decorative plants (1), The ...
Research Interests: Chemistry, Immunology, Pepper, Medicine, Allergy, and 12 moreHumans, LaTeX, Female, Follow-up studies, Nurses, Fruit, Allergens, Latex Allergy, Adult, Capsicum, Cross Sensitivity, and PLANT PROTEINS
Background: Lipid transfer protein (LTP) is a widely cross-reacting plant pan-allergen, and sensitized patients may react to many foods. Although peanut allergy is frequently reported by LTP-allergic patients, the evidence of the presence... more
Background: Lipid transfer protein (LTP) is a widely cross-reacting plant pan-allergen, and sensitized patients may react to many foods. Although peanut allergy is frequently reported by LTP-allergic patients, the evidence of the presence of an allergen homologous to LTP in peanuts is limited. Objective: To assess the prevalence of peanut allergy in patients sensitized to LTP, detect any allergen homologous to LTP in peanuts, and assess its cross-reactivity with peach LTP. Methods: Spanish and Italian adults monosensitized to LTP were interviewed for possible peanut allergy and underwent skin prick tests (SPTs) with peanut extract. Sera from 32 peanut-allergic patients were assayed for peanut-specific IgE by direct ELISA and the Real Test; the serum showing the strongest reactivity was used in immunoblot analysis. Results: 74/114 (65%) patients were sensitized to peanuts, and 37 (32% of the whole population; 50% of those sensitized) were clinically allergic. Positive histories were validated by open oral food challenges in 13/13 cases. No SPT-negative patients reported clinical allergy to peanuts. Thus, in this selected population, sensitivity and negative predictive value of peanut SPTs were 100%, whereas specificity and positive predictive value were poor (52% and 32%, respectively). Only 2/32 sera scored positive in both in vitro assays and 4 reacted in the Real Test alone. In immunoblot, the serum studied reacted at about 10 kDa against the peanut extract; pre-adsorption with purified peach LTP totally inhibited such reactivity. Conclusions: Peanut sensitization is frequent among LTP-allergic patients and is clinically significant in about 50% of cases. Peanut tolerance should be assessed in LTP-allergic patients positive on peanut SPTs. Peanut LTP seemingly shares all allergenic determinants with peach LTP.
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Research Interests: Immunology, Asthma, Adolescent, Medicine, Allergy, and 12 moreHumans, Child, LaTeX, Female, Male, Allergens, Immunoglobulin E, Latex Allergy, Adult, Recombinant Proteins, Rhinitis, and Gloves Surgical
Previous studies suggest cross-reactivity between specific ragweed pollen and melon allergens. This study was designed to clarify the origin of the cross-reactivity between ragweed pollen and the gourd family. One thousand... more
Previous studies suggest cross-reactivity between specific ragweed pollen and melon allergens. This study was designed to clarify the origin of the cross-reactivity between ragweed pollen and the gourd family. One thousand ragweed-allergic subjects were interviewed about the presence of oral allergy syndrome (OAS) induced by melon or watermelon and were divided into reactive to ≤3 seasonal allergen sources or >3 seasonal allergen sources. Patients reporting melon and/or watermelon allergy underwent a skin-prick test (SPT) with fresh melon and, after 2006, also with profilin-enriched date palm pollen extract. Because no IgE reactivity to melon extract was detected in vitro, ELISA was performed using date palm pollen extract, and inhibition experiments were performed using grass pollen, date palm profilin, and bovine serum albumin (BSA) as inhibitors. Six hundred forty-six and 354 subjects reacted to ≤3 seasonal allergens or >3 seasonal allergens, respectively; 4/646 (1%) and 81/354 (23%) reported a history of melon/watermelon-induced OAS (p < 0.0001). Forty-three of 46 (93%) melon reactors scored positive on SPT with the profilin-enriched extract, which was positive in 0/2 (0%) versus 43/44 (98%) reactive to ≤3 or >3 seasonal allergen sources, respectively (p < 0.0001). in vitro, serum from melon-allergic subjects showed a strong IgE reactivity to the profilin-enriched date palm pollen extract, which was abolished by preabsorption with both grass pollen extract and date palm pollen extract, but not by BSA. In ragweed pollen-allergic subjects, melon allergy is most likely associated with cross-sensitization to the plant pan-allergen profilin and not to specific ragweed pollen allergens. This study confirms the association between profilin sensitization and melon allergy.
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Background: Presently, sublingual immunotherapy is widely used as an alternative to the injection route for respiratory allergy, but its pharmacokinetics in humans is poorly known, and data are available only for Par j 1 allergen. We... more
Background: Presently, sublingual immunotherapy is widely used as an alternative to the injection route for respiratory allergy, but its pharmacokinetics in humans is poorly known, and data are available only for Par j 1 allergen. We aimed at assessing the biodistribution of iodine-123-radiolabelled Der p 2 in allergic volunteers. Methods: Purified Der p 2 and its monomeric allergoid were radiolabelled with iodine-123 and administered sublingually to 7 allergic volunteers. The subjects were allowed to swallow 6 min after administration. Dynamic (up to 10 min) and static scintigraphic images (30 min, 1, 2, 3 and 20 h) were recorded, and blood samples were obtained at different time points to measure the plasma radioactivity and to assess the presence of circulating radiolabelled species by gel chromatography. Results: The local pharmacokinetics did not differ between allergen and allergoid. Plasma radioactivity began to increase only after swallowing and peaked at 1–2 h. Both the allergen and the allergoid persisted in the mouth for several hours, and traces could be detectable up to 20 h. At radioactivity plasma peak, gel chromatography showed that a fraction of the allergoid, but not the allergen, was absorbed as an intact molecule. Conclusions: These results indicate that the pharmacokinetics of sublingual administration is independent of the allergen used and characterized by the long persistence in the mouth. The contribution of enteric absorption of the allergoid in the mechanism of action of sublingual immunotherapy remains to be defined.
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found between TST and persistent allergic rhinitis (P = 0.023)/persistent atopic dermatitis (P = 0.002) but not in asthma (Table 1). There were no significant correlations between TST and ever allergic rhinitis, atopic dermatitis or... more
found between TST and persistent allergic rhinitis (P = 0.023)/persistent atopic dermatitis (P = 0.002) but not in asthma (Table 1). There were no significant correlations between TST and ever allergic rhinitis, atopic dermatitis or asthma. There were no significant association between Candida skin test (CST) and ever/persistent atopy. No significant association was found between TST/ CST and rate of positive specific IgE test (P > 0.05). There was no significant correlation between TST and log-transformed IgE levels at the age of six (P = 0.59). There was no significant correlation between TST and CST reactivity (P = 0.69). The objective methods as CAP allergen test and the validated questionnaire were used to identify ever/ persistent atopy. A significant inverse correlation was found between TST reactivity and persistent allergic rhinitis/ persistent atopic dermatitis but not in ever atopy or asthma. This suggests that TST may be useful for evaluating different types of atopic disorders in various severities. Most of the animal studies have shown that BCG infection was capable to reduce the allergic response, but as for humans, correlation between TST reactivity and atopy provided conflicting results (1, 5). The definition of positive TST showed great variation between studies and might lead to conflict results with atopic disorders. TST reaction positive rate (>5 mm in diameter) was low in this study (32.1%) and similar to a previous study in Taiwan that vaccinated children with BCG at birth (6). In conclusion, child with positive TST reactivity has an inverse association with persistent atopic dermatitis, and allergic rhinitis but not found in asthma or ever atopy. CST skin test did not have significant association with atopy.
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Inhaled furosemide has been shown to prevent bronchoconstriction induced by inhalation of ultrasonic nebulization of distilled water (UNDW) in bronchial asthma. To evaluate whether inhaled furosemide also prevents the increase in serum... more
Inhaled furosemide has been shown to prevent bronchoconstriction induced by inhalation of ultrasonic nebulization of distilled water (UNDW) in bronchial asthma. To evaluate whether inhaled furosemide also prevents the increase in serum neutrophil chemotactic activity (NCA) observed during UNDW bronchoconstriction, we measured NCA during UNDW challenge without (control) and immediately after inhalation of furosemide (40 mg) or placebo (saline) in 10 asthmatics responsive to UNDW, in a randomized, double-blind study. NCA was assessed by measuring the maximal distance reached by neutrophils in a filter when challenged with the subject serum in a Boyden chamber ("leading front"). UNDW inhalation produced a significant increase in NCA in each subject. Gel filtration chromatography on S400 column indicated that the NCA released were 600 to 700 kD. Saline had no effect on bronchoconstriction nor on NCA increase induced by UNDW in nine patients. Furosemide did not change baseline FEV1, but it prevented bronchoconstriction and NCA increase in nine patients. In the whole group the maximal decrease in FEV1 after UNDW was -31.1%, SEM 4.7 after saline and -7.5%, SEM 5.2 after furosemide, p less than 0.001, the maximal increase in NCA after UNDW was +52.9%, SEM 9.2 after saline and +3.8%, SEM 3.1 after furosemide, p = 0.001. These results indicate that inhaled furosemide prevents both the bronchoconstriction and the NCA increase induced by UNDW inhalation in most asthmatic patients. This finding adds support to the suggestion that furosemide acts on mast cells.
Research Interests: Water, Asthma, Medicine, Humans, Female, and 10 moreMale, Ultrasonics, American, Middle Aged, Neutrophils, Adult, Inhalation, Saline, Furosemide, and Random Allocation
Limonium tataricum (Lt) is a plant belonging to the family of Plumbaginaceae. The role of this family and in particular, that of dried flowers (but not of the pollen) in occupational allergy has already been described. We have observed a... more
Limonium tataricum (Lt) is a plant belonging to the family of Plumbaginaceae. The role of this family and in particular, that of dried flowers (but not of the pollen) in occupational allergy has already been described. We have observed a farmer with asthma occurring in the presence of fresh flowers. Standard methacoline test demonstrated that the patient was a true asthmatic. The allergenicity of Lt pollen was thus investigated Skin prick tests (SPT) were carried out using both standard allergens and the Lt extract and the patient's mucosal reactivity was evaluated by nasal provocation test with the pollen extract. In vitro studies were also performed on the patient's serum by evaluating routine specific anti-allergen IgE on raw extracts and on Microarray Allergen Chip (ISAC). Finally, the raw extract of the fresh Lt pollen was also used in ELISA inhibition test, immunoblotting and Basophil Activation Test (BAT). The specific sensitization was demonstrated by Skin Prick test and nasal provocation test. The sensitization was also confirmed by specific IgE and by in vitro activation of basophils in the presence of the pollen. By using RAST inhibition test, the presence of cross-reactivity with other pollens was ruled out. According to our results, Lt extracts contain an allergenic activity not only as dried flowers, but also as fresh pollen. For its role in occupational asthma, this allergen should be included in any allergy screening at least in farmers or in the flower industry employers.
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: Allergic diseases have increased worldwide during the last century and are a major disease burden globally. Several substances can induce allergic sensitization and elicit allergic symptoms in sensitized individuals. Pollen grains are... more
: Allergic diseases have increased worldwide during the last century and are a major disease burden globally. Several substances can induce allergic sensitization and elicit allergic symptoms in sensitized individuals. Pollen grains are one of the main causes of allergic rhinitis and asthma, and the prevalence of different pollen species depends on the climate, geographical regions, flora, and seasons. In addition to avoiding exposure to pollens, anti-allergic drugs are commonly used to mitigate the symptoms of allergies. However, these drugs need to be administered repeatedly as long as the symptoms prevail, usually life-long. Allergen immunotherapy (AIT) is currently the only disease-modifying approach that can prevent the natural progression of the disease (also known as an allergic march), provide a long-lasting therapeutic effect, and prevent the worsening of the symptoms and the occurrence of new sensitizations in allergic individuals. Since the pioneering clinical studies conducted more than 100 years ago using subcutaneously administered pollen extract to treat hay fever, significant advances have been made in the field of AIT. Starting from this pioneering approach, in this review, we have discussed the evolution of the products used for AIT with particular emphasis on pollen allergoids, the chemically modified pollen extracts characterized by lower allergenicity and comparable immunogenicity, and the different routes of administration used for AIT.
Research Interests: Immunology, Asthma, Medicine, Allergy, Pollen, and 4 moreHay Fever, Disease, Sensitization, and Immunogenicity
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We describe two uncommon cases of oral allergy syndrome (OAS) after eating pistachio nuts (p.n.) in subjects (a 54-year-old man and a 3-year-old girl) with exclusive skin prick test (SPT) positivity to Parietaria (P.) and pistachio nut... more
We describe two uncommon cases of oral allergy syndrome (OAS) after eating pistachio nuts (p.n.) in subjects (a 54-year-old man and a 3-year-old girl) with exclusive skin prick test (SPT) positivity to Parietaria (P.) and pistachio nut (p.n.) allergens. Serologic P.- and p.n.-specific IgE determinations were also carried out. A double-blind, placebo-controlled food challenge (DBPCFC) was performed, for ethical reasons, only in the adult patient, but we observed a positive intraoral reaction only after slight scratching of the oral mucosa. Since this patient had put three whole p.n. with their shells into his mouth, breaking them with his teeth, before the onset of symptoms, we suggest that slight injury of the oral mucosa may enhance the local response. Preliminary results with SDS-PAGE and immunoblotting demonstrate the occurrence of a slight degree of cross-reactivity between these allergens, but further studies are necessary to obtain a definite conclusion.
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The authors review the status of knowledge on absorption and kinetic of allergens administered on nasal mucosa. Intranasal administration is well known in pharmacology, and has been used for a long time for peptide drugs, mainly hormones.... more
The authors review the status of knowledge on absorption and kinetic of allergens administered on nasal mucosa. Intranasal administration is well known in pharmacology, and has been used for a long time for peptide drugs, mainly hormones. The immunological response to intranasally administered antigens have been studied in some experimental models: bovine Rnase, dextran, KLH, tetanus toxoid. These studies showed in atopic people a greater absorption of antigens by nasal mucosa compared to normal individuals, a difference that might be of importance in the pathogenesis of atopic diseases. The absorption rate of peptides through nasal mucosa has been studied biologically by PK‐test with Rnase and peanut allergen, and a consistent passage of intact molecules has been observed. Using as tracer 125I‐labelled human albumin, transport across the nasal mucosa has been demonstrated in 319 normal subjects, 1/9 patients with extrinsic asthma and 9/10 patients with atopic rhinitis. In experimental animals (rabbits) the assage of allergens through the nasal mucosa has been confirmed using 125I‐labelled Parietaria allergens that showed a peak in the bloodstream 60 min after administration. It is concluded that peptide molecules such as allergens can be absorbed through the nasal mucosa and reach the bloodstream, and that in atopic patients nasal permeability is enhanced.
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Seed storage proteins are extremely stable allergens in nuts, seeds, and legumes and are responsible for the most severe allergic reactions to these foods. The cross-reactivity between seed storage proteins from different sources has not... more
Seed storage proteins are extremely stable allergens in nuts, seeds, and legumes and are responsible for the most severe allergic reactions to these foods. The cross-reactivity between seed storage proteins from different sources has not been studied at a molecular level so far. This study aimed to ascertain the cross-reactivity between walnut and hazelnut seed storage proteins using recombinant allergens. Sera from 13 consecutive patients with severe primary walnut and/or hazelnut allergy and hypersensitive to both nuts were studied. IgE specific for rCor a 9, rCor a 14, and rJug r 1 was measured, and inhibition experiments were carried out by measuring IgE reactivity after absorption of patients’ sera with freshly prepared walnut extract. All 13 sera showed strong IgE reactivity against walnut 2S albumin, Jug r 1, 12 reacted to hazelnut 2S albumin, Cor a 14, and 8 to the hazelnut legumin, Cor a 9. In inhibition experiments, absorption of sera with whole walnut extract led to the complete disappearance of IgE reactivity to Jug r 1 in 12/13 cases, as expected, but also to the complete disappearance of specific IgE to Cor a 14 in 9/12 sera, and of IgE reactivity to Cor a 9 in 7/8. In the remaining cases a dramatic drop in IgE reactivity was observed. The study shows that patients primarily allergic to either walnut or hazelnut showing a skin or serological reactivity to the other nut also are potentially at risk of severe allergic reactions caused by cross-reactivity between 2S albumins and legumins.
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Research Interests: Dermatology and Medicine
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An unusual case of both banana and tomato allergy is reported. In vitro tests showed that both co-sensitization to and co-recognition of allergen in the two fruits were present. Interestingly, the patients showed IgE reactivity to... more
An unusual case of both banana and tomato allergy is reported. In vitro tests showed that both co-sensitization to and co-recognition of allergen in the two fruits were present. Interestingly, the patients showed IgE reactivity to hitherto not described, high molecular weight allergens.
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Background and Objective. Single SLIT studies with native allergen extracts support a dose-response effect for clinical and immunological outcomes. Conversely for carbamylated allergoids this dose-response effects is less evident, likely... more
Background and Objective. Single SLIT studies with native allergen extracts support a dose-response effect for clinical and immunological outcomes. Conversely for carbamylated allergoids this dose-response effects is less evident, likely because the threshold for efficacy is more easily reached through the enhanced bioavailability of the extract consequent to the selective chemical modification. Thus this pilot study investigates the dose-response effect on nasal specific reactivity and safety of two unusual doses of carbamylated allergoid in patients mono-sensitized to house dust mites. Methods. A prospective open randomized study involved 6-65 year-old Italian patients with clinically relevant sensitization to house dust mites and positive response to nasal provocation challenge. Monomeric carbamylated allergoid was delivered once daily at the dose of 1000 AU or 2000 AU from June to September 2009, during the lowest level of mites exposure. Primary outcomes were the change of the threshold of allergen concentration for a positive nasal provocation test (NPT) before and after the treatment and the product safety. Secondary outcome was the change in the mean percentage fall of peak nasal inspiratory flow (PNIF) following nasal challenge. Results. Thirty-four patients were enrolled. Fifteen in group 1 and 14 in group 2 concluded the study. After 12 weeks all patients treated in group 1 and all but one in group 2 showed an increase in the threshold dose provoking a positive NPT. Those with no symptoms onset with the highest dose delivered were 80% in group 1 and 78.6% in group 2 (p=0.92). From first to second challenge, the mean percentage fall of PNIF was reduced with no statistical difference between groups (p=0.95), and with no difference between the final mean percentage falls (p=0.65). No serious adverse reactions occurred and the frequency of events, all mild, was similar in the two groups. Conclusions. Twelve weeks of carbamylated sublingual allergoid delivered at 1000AU or 2000AU once daily appear equally safe and show comparable effect in increasing the threshold of allergen concentration for a positive nasal provocation test, confirming the apparent absence of a dose response effect for the used doses.
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No abstract is available. To read the body of this article, please view the Full Text online. ... ☆ From a the Department of Chest Diseases, Division of Pneumology and Allergology, Hospital “A. Cardarelli”, Naples; and b Lofarma... more
No abstract is available. To read the body of this article, please view the Full Text online. ... ☆ From a the Department of Chest Diseases, Division of Pneumology and Allergology, Hospital “A. Cardarelli”, Naples; and b Lofarma Laboratories, Milan. ... ☆☆ Reprint requests: ...
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Research Interests: Immunology, Biology, Medicine, Allergy, Humans, and 6 moreAnimals, Male, Immunoglobulin E, Adult, Immunoblotting, and food hypersensitivity
Additional file 1. Additional material and figures.