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Background: Peach gibberellin-regulated protein (peamaclein) has recently emerged as a relevant food allergen in cypress pollen-hypersensitive patients. Objective: We looked for mono-sensitization to peamaclein among Italian cypress-pollen allergic patients. Material and methods: 835 cypress pollen hypersensitive patients from 28 Italian allergy centers under went thorough interview for food-allergic reactions, and SPT with a commercial peach extracts containing peamaclein. In peach reactors, IgE to rPru p 3 was measured, and those scoring negative were enrolled as potentially mono-sensitized to peamaclein. IgE reactivity to rPru p 7 was evaluated by immunoblot and by an experimental ImmunoCAP with rPru p 7. Results: Peach SPT scored positive in 163 (19.5%) patients but 127 (77,9%) were excluded because Pru p 3 reactors. Twenty-four (14,7%, corresponding to 2.8% of the entire study population) were considered as potentially mono-sensitized to peamaclein. Their distribution did not show any geographic preference. Seventeen/24 (70,8%) had a history of food allergy, in most cases (n=15) to peach. Other offending foods included other Rosaceae, citrus fruits, fig, melon, tree nuts, and kiwi. On peach immunoblot, only 3/18 putative peamaclein allergic subjects reacted to a band at about 7kDa; 4 other patients reacted at about 50-60 kDa. Ten/18 (56%) scored positive for Pru p 7 on ImmunoCAP. Conclusion: Peamaclein allergy and sensitization prevalence seem rare in Italy. Most patients react to peach, albeit other Rosaceae fruits and several citrus fruits may also act as offending foods. Peach and cypress pollen probably share also cross-reacting allergens other than peamaclein.

Summary:Background and Objective. Sensitization and allergy to shrimp among Italian house dust mite allergic patients are not well defined and were investigated in a large multicenter study. Methods. Shrimp sensitization and allergy were assessed in 526 house dust mite (HDM)-allergic patients submitted to the detection of IgE to Der p 10 and 100 atopic control not sensitized to HDM. Results. Shrimp allergy occurred in 9% of patients (vs 0% of 100 atopic controls not sensitized to HDM; p minor 0.001). Shrimp-allergic patients were less frequently hypersensitive to airborne allergens other than HDM than crustacean-tolerant subjects (35% vs 58.8%; p minor 0.005). Only 51% of tropomyosin-sensitized patients had shrimp allergy, and these showed significantly higher Der p 10 IgE levels than shrimp-tolerant ones (mean 22.2 KU/l vs 6.2 KU/l; p minor 0.05). Altogether 53% of shrimp-allergic patients did not react against tropomyosin. Conclusions. Shrimp allergy seems to occur uniquely in association with hypersensitivity to HDM allergens and tropomyosin is the main shrimp allergen but not a major one, at least in Italy. Along with tropomyosin-specific IgE levels, monosensitization to HDM seems to represent a risk factor for the development of shrimp allergy among HDM allergic patients.

In order to test the hypothesis that endogenous opiates are at least partially responsible for hyperinsulinaemia in patients with polycystic ovarian disease (PCOD), the effect of naloxone ( an opiate receptor blocker) on the insulin response to oral glucose load (OGTT) was studied in 20 women with PCOD and 17 control subjects at days 5-8 of their follicular phase.After fasting overnight for 10-12 h, each woman received an i.v bolus injection (2mg) of naloxone or an equal volume of saline infusion followed by a constant infusion of naloxone or saline solution at rate of 8 ml/h (1mg/h of naloxone) for 5 h.OGTT (75 gr) was performed after the bolus injection.The naloxone study was performed 48 h after the saline study.Naloxone did not modify the insulin response to OGTT in either group.When the data were related to the insulin response, in PCOD hyperinsulinaemic patients,naloxone significantly reduced (P< 0.02) the insulin response to OGTT without any changes in glycaemic response curves. In control and PCOD normo insulinaemic patients, naloxone didi not change significantly either the glycaemia or the insulin levels after OGTT.No change of gonadotrophin and steroid secretion was found in any patient receiving naloxone.In conclusion, endogenous opiates may play a significant role in hyperinsulinaemia in PCOD.

In order to test the hypothesis that endogenous opiates are at least partially responsible for hyperinsulinaemia in patients with polycystic ovarian disease (PCOD), the effect of naloxone (an opiate receptor blocker) on the insulin response to oral glucose load (OGTT) was studied in 20 women with PCOD and 17 control subjects at days 5-8 of their follicular phase. After fasting overnight for 10-12 h, each woman received an i.v. bolus injection (2 mg) of naloxone or an equal volume of saline infusion followed by a constant infusion of naloxone or saline solution at a rate of 8 ml/h (1 mg/h of naloxone) for 5 h. OGTT (75 g) was performed 1 h after the bolus injection. The naloxone study was performed 48 h after the saline study. Naloxone did not modify the insulin response to OGTT in either group. When the data were related to the insulin response, in PCOD hyperinsulinaemic patients, naloxone significantly reduced (P less than 0.02) the insulin response to OGTT without any change in glycaemic response curves. In control and PCOD normoinsulinaemic patients, naloxone did not change significantly either the glycaemia or the insulin levels after OGTT. No change of gonadotrophin and steroid secretion was found in any patient receiving naloxone. In conclusion, endogenous opiates may play a significant role in hyperinsulinaemia in PCOD