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BackgroundThe involvement of IgE-mediated hypersensitivity reactions in the genesis of gastrointestinal symptoms after ingestion of foods containing wheat has been rarely reported. ObjectiveTo detect IgE specifically binding to wheat proteins in the sera of atopic and non-atopic patients suffering from gastrointestinal symptoms after ingestion of wheat and to evaluate the reliability of skin prick test and CAP in the diagnosis of food allergy to wheat. MethodsThe sera of patients (10 atopic and 10 non-atopic) previously diagnosed as suffering from irritable bowel syndrome and complaining of symptoms after wheat ingestion were analysed by immunoblotting for IgE binding to water/salt-soluble and insoluble wheat flour proteins. ResultsAll the atopic patients and only one of the non-atopic patients were positive to wheat CAP. For the patients tested, skin prick test was positive for all the atopic patients and for only one of the non-atopic patients. However, immunoblotting experiments showed the presence of specific IgE to wheat proteins in all the patients. Ten out of 11 of the wheat CAP-positive patients had IgE binding to a soluble 16-kDa band, but the same band was recognized, in a slighter way, by only two out of nine of the wheat CAP-negative patients. Moreover, although almost all of the patients were negative in CAP testing with gluten, 19 out of 20 recognized protein bands belonging to the prolamin fraction. ConclusionsFor the atopic patients the positivity to skin prick test and CAP to wheat was in accordance with the immunoblotting results and a food allergy to wheat could be diagnosed. In these patients a major allergen was a 16-kDa band corresponding to members of the cereal α-amylase/trypsin inhibitors protein family, the major allergens involved in baker's asthma. In the non-atopic patients the positive immunoblotting results contrasted with the responses of the allergologic tests, indicating that the allergenic wheat protein preparations... [ABSTRACT FROM AUTHOR]

Background: Allergy to almonds has been frequently reported, but data on the identification of the almond allergens, as well as on the reliability of the methods for in vitro detection of specific IgE for these allergens, are scant. This study aimed to identify the almond allergens and to evaluate the reliability of the CAP-FEIA as the standard system for detection of almond-specific IgE with clinical significance. Methods: Immunoblotting performed with an almond-protein extract was carried out on the sera of five patients who had previously been tested by the CAP-FEIA system; two of these patients had tested negative with the CAP-FEIA system but suffered life-threatening laryngeal edema after eating almonds, whereas the other three subjects, who had tested positive with CAP-FEIA, did not present any symptoms subsequent to almond ingestion. Results: The sera of the two symptomatic CAP-FEIA-negative patients had IgE that bound only to a 37-kDa protein in immunoblotting. On the contrary, the sera of the three asymptomatic subjects all showed IgE binding to two almond proteins of 62 and 50 kDa, corresponding to the glycosylated components of the extract. Conclusions: The results here presented suggest that, at least for the examined subjects, the positivity to almond, as measured with a standard laboratory method, is due to the presence of the 62/50-kDa glycoproteins with little or no immunologic significance, and not to the binding to the 37-kDa polypeptide, which appears to be a true almond allergen. [ABSTRACT FROM AUTHOR]

Several cases of by hypersensitivity pneumonitis (HP) have been described among cheese workers. Systemic and respiratory symptoms occur several hours after exposure to moldy cheese, serum precipitins against Penicillium species are present and bronchoalveolar lavage (BAL) analysis shows high-intensity lymphocytic alveolitis. In the study, BAL analysis was used in the follow-up of two patients with clinical evidence of cheese workers' HP. Case I was that of smokers who had work for 16 years in the production and cleaning of cheese, and who had been for complaints of nocturnal fever, dyspnea, and dry cough during the previous three years.