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Background Most cases of beer allergy reported so far have been associated with hypersensitivity to the non-specific lipid transfer protein ( LTP). In view of the marked differences in brewing processes we assessed IgE reactivity as well as tolerance to many different beers in an allergic patient. Methods A 45 year-old man hypersensitive to grass pollen, cat dander and Alternaria tenuis with a history of urticaria and dyspnoea after drinking beer and a weak skin reactivity to commercial corn extract was studied. The patient underwent SPT with 36 different brands of beer and an open challenge with those scoring negative was performed. An immunoblot analysis was carried out using 2 SPT-positive beers, 2 SPT-negative beers, and barley, wheat, and maize extracts using both patient's serum and a maize LTP-specific in-house developed polyclonal antibody from rabbit. Further, the immune reactive LTP of one beer was separated by HPLC and the chromatogram was compared to that of purified maize LTP. Results Beer SPT scored positive in 30/36 cases. The immunoblot analysis showed IgE reactivity at about 10 kDa against the two SPT-positive beers and against maize with both patient's serum and the polyclonal anti- LTP rabbit serum, whereas the two SPT-negative beers, and barley extract scored negative. The immunodetected protein co-migrated with maize LTP. Conclusion In beer-allergic patients the diagnostic workup may point to the detection of some tolerated products that can be consumed risk-free. [ABSTRACT FROM AUTHOR]

Background: Buckwheat allergy is a rare food allergy in Europe and North America, whereas it is often described and studied in Asia. The aim of this study was to describe a series of patients with proven buckwheat allergy evaluated in an Italian allergy clinic. Co-sensitization to other food and inhalant allergens and immunoblotting profiles of buckwheat-allergic patients were studied. Methods: Patients with suspected buckwheat allergy who attended the allergy clinic between January 1, 2006, and September 30, 2008, were evaluated. All patients underwent skin prick tests for a standard panel of inhalant and food allergens, prick-by-prick with buckwheat flour, buckwheat-specific IgE determinations, and double-blind placebo-controlled food challenge (DBPCFC) with buckwheat flour. Immunoblotting with buckwheat flour extract was performed on sera from buckwheat- allergic patients. Results: Among 72 patients with suspected buckwheat allergy, 30 (41.7%) were sensitized to buckwheat and 24 had a positive DBPCFC. The mean buckwheat IgE level was 6.23 kUA/l (range, 0.16 to >100 kUA/l). Several IgE-binding proteins were identified and grouped into three patterns: a 16-kDa band in patients with predominantly gastrointestinal symptoms with grass and wheat flour co-sensitization, a 25-kDa band in patients with predominantly cutaneous symptoms and a low frequency of co-sensitization, and a 40-kDa band in patients with anaphylaxis and a low frequency of co-sensitization. Conclusions: Buckwheat allergy is an emerging food allergy in Italy. We identified three distinct patterns of clinical and laboratory characteristics, suggesting that specific allergens could be more frequently associated with clinical manifestations of different severity. [ABSTRACT FROM AUTHOR]

Background: Non-specific lipid transfer proteins (LTPs) are involved in allergy to fresh and processed fruits. We have investigated the effect of thermal treatment and glycation on the physico-chemical and IgE-binding properties of the LTP from apple (Mal d 3). Methods: Mal d 3 was purified from apple peel and the effect of heating in the absence and presence of glucose investigated by CD spectroscopy, electrospray and MALDI-TOF mass spectrometry. IgE reactivity was determined by RAST and immunoblot inhibition, SPT and basophil histamine release test. Results: The identity and IgE reactivity of purified Mal d 3 was confirmed. Mild heat treatment (90°C, 20 min) in the absence or presence of glucose did not alter its IgE reactivity. More severe heat treatment (100°C, 2 h) induced minor changes in protein structure, but a significant decrease in IgE-binding (30-fold) and biological activity (100- to 1000-fold). Addition of glucose resulted in up to four glucose residues attached to Mal d 3 and only a 2- and 10-fold decrease of IgE-binding and biological activity, respectively. Conclusions: Only severe heat treatment caused a significant decrease in the allergenicity of Mal d 3 but glycation had a protective effect. The presence of sugars in fruits may contribute to the thermostability of the allergenic activity of LTP in heat-processed foods. [ABSTRACT FROM AUTHOR]

Local nasal immunotherapy is accepted as an alternative to the injection route for allergic rhinitis. Despite this, little is known about the kinetics of the allergen after nasal delivery in allergic subjects. We aimed at assessing the biodistribution of 123I-radiolabelled Par j 1 in Parietaria-allergic subjects, in comparison with healthy volunteers. Purified Par j 1 was radiolabelled with 123I and sprayed into the nostrils of three control subjects and three Parietaria-allergic volunteers. Dynamic and static scintigraphic images of the head were recorded at serial times and blood samples were obtained to measure the plasma radioactivity, and to assess the presence of circulating radiolabelled species by gel chromatography. In Parietaria-sensitized subjects, the radiolabelled allergen was rapidly cleared from the nasal cavity and transported to pharynx, and little local persistence was seen. This differed from healthy subjects where nasal clearance of the tracer was slower and nasal radioactivity persisted up to 24 h. The increase in plasma radioactivity paralleled swallowing of the allergen in both groups, and plasma chromatographic profile did not differ between allergic and healthy volunteers. Sensitization to the allergen affects its local biodistribution. Gastrointestinal absorption is relevant also for the intranasal route. [ABSTRACT FROM AUTHOR]

Exposure and contact with bee moth ( Galleria mellonella) larvae (Gm) can cause an allergic reaction both in anglers and breeders. We described the case of an amateur fisherman who experienced an allergic reaction using Gm but not using heat-treated Gm (h-Gm) (mummies). The aim of this study was to demonstrate by immunoblotting and radioallergosorbent test (RAST)-inhibition experiments the loss of allergenic epitopes in h-Gm extracts. Galleria mellonella larvae and h-Gm were homogenized and extracted at 10% (w/v) in 0.5 M phosphate-buffered saline, pH 7.4 containing 0.5% NaN3 for 16 h at 4°C. Gm and h-Gm extracts were electrophoresed in a 10% polyacrylamide precast Nupage Bis–Tris gel at 180 mA for 1 h and the resolved proteins stained with 0.1% Coomassie brilliant blue and the molecular weight calculated. For the immunoblotting detection of allergenic components the resolved extracts were transferred onto a nitrocellulose membrane and incubated with the patient's serum. Bound specific-IgE was detected by peroxidase-conjugated anti-human IgE. RAST inhibition experiments were performed according to the Ceska method. The protein profile of Gm and h-Gm extracts resulted markedly different in number, intensity and the position of bands, indicating that heat-treatment modifies the chemical–physical characteristics of the protein contents. The Gm extract showed a strong-coloured band at 73 kDa and more than 20 components ranging from 12 to 133 kDa; h-Gm showed two main band at 77 and 38 kDa and about 15 faint bands between 20 and 133 kDa apparently without any correspondence to the bands present in the Gm extract. Immunoblotting with the patient's serum demonstrated several bands of reactivity with the Gm extract ranging from 20 to 100 kDa and no recognizable bands, but only a diffuse smear with h-Gm. When used in a RAST inhibition experiment the h-Gm extract demonstrated an inability to compete with the Gm one for the binding to patient's IgE serum. The h-Gm seems to lose the allergenic epitopes and has two advantages for anglers: to avoid new possible sensitizations as well as allergic symptoms in sensitized people, without interfering with their skills and satisfaction in their fishing performance. [ABSTRACT FROM AUTHOR]

Background: The use of ammoniated or nonammoniated latex extracts for the diagnosis of latex allergy is still a matter of debate. The aim of our study was to compare the characteristics of the two types of extracts by immunoblotting and RAST techniques in children with ascertained latex allergy. Methods: Ammoniated (AL) and nonammoniated latex (NAL) extracts were prepared and blotted on SDS-PAGE to resolve their components. Also a solid phase for RAST assays was prepared with the two extracts. The sera from 18 children (mean age 11.4 years, range 6–15 years), with ascertained latex allergy (clinical history, skin test, CAP-RAST and provocation) were used for the experiments. Results: The NAL extract is resolved in many bands (5–100 kDa), whereas AL showed only few components, likely Hev b 4, 6 and 7. IgE reactivity against AL was observed only in 5/18 patients, whereas 12/18 were positive with NAL. The blotting profile against NAL was complex and the IgE recognition pattern involved different bands. Conclusion: The extract obtained from NAL is able to detect specific IgE against a greater number of allergenic determinants, and therefore a greater diagnostic accuracy can be expected. [ABSTRACT FROM AUTHOR]

Background: Lipid transfer proteins (LTP) are highly conserved and widely distributed throughout the plant kingdom. Recent studies demonstrated immunological cross-reactivity between LTP from many botanically unrelated fruits and vegetables and concluded that LTP are pan-allergens. This study aimed to evaluate the clinical relevance of such cross-reactivity in a group of subjects monosensitized to LTP. Methods: Twenty LTP-hypersensitive patients were selected from a population of about 600 subjects with history of Rosaceae allergy by means of: 1) negative skin prick test (SPT) with a commercial birch pollen extract; 2) positive SPT with a commercial plum extract, rich in LTP but virtually lacking both Bet v 1-like proteins and profilin; 3) in-vitro IgE reactivity to the 9–10 kDa fraction of peach peel or immunoblot with peach peel showing a single band at 10 kDa; and 4) total inhibition of reactivity to whole peach extract (containing Bet v 1-related allergen, profilin, and LTP) by purified peach LTP on enzyme-linked immunoassay (ELISA). Allergy to foods other than Rosaceae was ascertained by careful interview and analysis of medical recordings. SPT with a large series of plant-derived foods were carried out as well. The cross reactivity between LTPs from botanically unrelated plant-derived foods was assessed by ELISA inhibition tests using walnut and peanut extracts as substrate, and peach LTP as inhibitor. Results: All patients reported allergic reactions after the ingestion of at least one from a large number of vegetable foods other than Rosaceae , and in several cases clinical reactions were very severe (anaphylaxis, asthma, urticaria/angioedema). Nuts and peanuts were the most frequently reported causes of allergic reactions (80% and 40% of patients, respectively). All patients showed positive SPT to several non-Rosaceae food extracts. SPT with nuts, peanut, legumes, celery, rice, and corn were positive in the majority of patients. In ELISA... [ABSTRACT FROM AUTHOR]

Little is known about the pharmacokinetics of allergens for local immunotherapy. Thus, we studied the pharmacokinetics in allergic volunteers of a commercial allergenic vaccine in orosoluble tablets (LAIS®, Lofarma S.p.A). The carbamylated monomeric allergoid derived from Parietaria judaica major allergen (Par j 1), characterized by maintenance of the original molecular size, and the native allergen, were radiolabelled with 123I, then incorporated into the commercial soluble tablets and administered to allergic subjects. Early sequential and late static scintigraphic acquisitions were performed, and plasma radioactivity was measured at different time intervals. No difference in local pharmacokinetics was observed between the allergen and the allergoid: part of the tracer was retained in the mouth for at least 2 h after swallowing. No direct absorption through the oral mucosa could be detected, as plasma radioactivity increased only after swallowing and peaked at 2 h. However, the plasma peak attained with the allergoid in tablets was significantly higher with respect to the native allergen. Finally, some undegraded allergoid, but not the allergen, could be constantly detected in the bloodstream at plasma peak. The results showed a similar behaviour of the allergoid and the allergen in tablets as far as their local kinetics are concerned, whereas plasma peak was higher with the allergoid than with the allergen. Therefore we conclude that the chemical modification of the allergen may affect its pharmacokinetics, by making it less susceptible to enzymatic degradation. [ABSTRACT FROM AUTHOR]

Background: Allergens in Plantago lanceolata have not been characterized yet. The objective was to characterize some plantain-pollen allergens and to investigate the cross-reactivity between plantain and grass pollens. Methods: Sera from four patients monosensitive to plantain pollen and from eight grass-pollen-allergic patients showing strong skin reactivity to plantain pollen in the skin prick test (SPT) underwent immunoblot analysis with both Plantago and grass mix extract. Moreover, immunoblot inhibition experiments were done with grass mix extract as inhibitor. Results: All four sera from plantain-allergic patients reacted to two distinct bands at 17 and 19 kDa, and 2/4 sera showed further reactivity to a 40-kDa protein, which in one case represented the most prominent IgE-binding allergen. Plantain-monosensitive subjects did not show any reactivity to grass-pollen extract, and preabsorption of their sera with grass-pollen extract did not cause any loss of reactivity to plantain pollen. Sera from all eight grass-pollen-allergic controls reacted to a 30-kDa protein in plantain pollen, and some sera showed cross-reactivity to higher and lower molecular-weight structures as well. In all cases, plantain reactivity was totally abolished by preabsorption of sera with grass-pollen extract. A preliminary investigation by immunoblot showed that polyclonal IgG anti-Phl p 5 (but not polyclonal Phl p 1) from rabbit reacted to a 30-kDa protein in plantain pollen. Conclusions: Three specific allergens (of 17, 19, and 40 kDa, respectively) have been detected in plantain pollen. Further studies on a larger number of patients will determine whether these proteins may be considered major allergens. Cross-reactivity between grass and plantain pollen is mainly caused by a 30-kDa protein in plantain pollen. Group 5 grass-pollen allergen is probably responsible for most grass/plantain cross-reactivity. [ABSTRACT FROM AUTHOR]

Airborne pollen grains and small plant particles of respirable size are the main causes of rhinitis and asthma in pollinosis patients. Consequently, it could be useful to quantify atmospheric variations in these biological aerosols and their allergenic activity as a basis for establishing correlations with the clinical symptoms in these allergic subjects. Our study was conducted in Naples from May lo August 1992 and from May to August 1993 and concentrated on Parietaria Judaica (Par j) the most important hay fever-provoking plant in southern Italy. The aim of this study was to evaluate the day-to-day variation in counts of Par j. pollen, the day-to-day variation in allergenic activity specific for this plant, and to relate these two variables to symptom scores in patients with respiratory allergy to Par j. The airborne pollen grains were collected by a Hirst-like volumetric trap and examined through an optical microscope, while the allergenic activity of particles trapped on glass fibre filters in a high volume air-sampler was determined by immunochemical assay. The two devices were placed on the flat roof of the ‘A. Cardarelli’ Hospital. The results of this preliminary study suggest that both methods could have useful clinical relevance, since these two biological parameters were significantly correlated with the symptom scores of allergic patients. However, pollen count with morphological quantification of grains/m³ of air is a more simple technique. [ABSTRACT FROM AUTHOR]

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 3/9 normal subjects, 1/9 patients with extrinsic asthma and 9/10 patients with atopic rhinitis. In experimental animals (rabbits) the passage of allergens through the nasal mucosa has been confirmed using 125I-labelled Parietaria allergens that showed a peak in the bloodstream 60 mm 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. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

Allergenic extracts (Der p, grass, and Parietaria) or single allergens such as Par j I (the major allergen of Parietaria) and ovalbumin (OA), a food allergen widely used in animal models, were chemically modified by reaction with potassium cyanate (KCNO), which transforms the epsilon-amino group of the lysine of proteinaceous allergens into ureido groups. KCNO-modified (carbamylated) allergens have low allergenic potency, as demonstrated in vitro (RAST inhibition) and in vivo (passive cutaneous anaphylaxis). When used to immunize rabbits, carbamylated allergens still induce IgG antibodies able to cross-react with native allergens (immunoblotting experiments). An interesting feature distinguishing carbamylated allergens from other chemically modified allergens is the preservation of the native monomeric dimension as demonstrated by SDS-PAGE analysis. Results are discussed from the perspective of clinical application of carbamylated allergens. [ABSTRACT FROM AUTHOR]

Local intranasal immunotherapy relieves the allergic symptoms of rhinitic patients but little is known about the absorption and distributon of inhaled allergens in the body. The aim of this study was to establish whether allergenic proteins arc able to reach the bloodstream by penetrating through the nasal mucosa when aqueous P. judaica extract was administered into the nostrils of normal rabbits. Optimal conditions for a sensitive modified RAST (immunocapture RAST) were set up and the method was used to detect clinically relevant allergenic activity in the systemic circulation. The kinetic profile after intranasal treatment was compared with the profile after intravenous injection of the allergenic extract. The findings are discussed in relation to the mechanism by which local immunotherapy acts. [ABSTRACT FROM AUTHOR]

Food-dependent exercise induced anaphylaxis (FDEIA), a form of physical allergy occurring in association with exercise, and characterized by collapse, upper respiratory tract obstruction, and/or urticaria/angioedema, is increasingly being reported inn medical literature. The reasons why patients with FDEIA tolerate well the offending foods at rest are poorly understood; one hypothesis is that FDEIA represents the clinical expression of food allergy in patients whose immunologic reactivity is low and who need an additional trigger for their symptoms to appear.

This article cites a case study of a 16 year old girl, who was presented at this allergy unit because of recurrent episodes of itching and angioedema of the lips and oral mucosa which appeared a few minutes after she had eaten several kinds of pork, the first symptoms had been noted about 2 years before, and each episode lasted up to 15 mm. The patient underwent diagnostic SPTs with a large series of both respiratory and food allergens. Wheals equal to or greater than 2 + were considered positive.

The article presents a case study of a woman suffering from rhinoconjunctivitis that responded to antihistamines. It states that she was having tomato hypersensitivity and respiratory allergens was for the tomatoes with branches. It also states that the patient's serum showed strong Immunoglobulin E reactivity to tomato fuzz and stem extract but not to tomato fruit.

The article presents the case study of a 41 year old man with a history of seasonal rhino-conjunctivitis and asthma and allergy to goat and sheep milk. One gram of milk reportedly caused him asthma, diffuse urticaria, and angioedema of the face. He underwent several skin tests which revealed that his monosensitization to grass pollen and serum showed reaction to sheep milk. The article discusses association of serum albumin to several allergies related to dairy products.

The article focuses on a study related to the detection of Hev b8-specific immunoglobulin E (sIgE) as a reliable marker of natural rubber latex (NRL) allergy and asymptomatic sensitization. In the study, seven patients were considered and all of them suffered from rhinitis or asthma apart from being sensitized to several allergens.

Describes a case of life-threatening cross reactivity between latex and jujube in a 25-year-old nurse. Performance of an immunological study on serum of patient after extracting Jujube fruits and latex sap; IgE-reactivity of the serum against jujube and latex extracts; Presence of a 20 kD prohevein-like protein in both extracts confirming the existence of latex-jujube cross-reactivity.

Reports on the contradictions of a study related to allergy to minor allergens of Brazil nut (Bertholletia excelsa). Medical history of the patient on whom the study was conducted; Conclusions drawn after the skin prick test on the patient; Measurement of patient's Immunoglobulin E reactivity to Brazil nut and birch pollen.

Describes a case of a patient with history of pellitory allergy which experienced an anaphylactic episode after the ingestion of a piece of bread baked with five cereals. Cross-reactivity between the major allergen of sunflower seed and mustard; Immunoblot analysis of sunflower seed extracts; Two albumin fractions in sunflower seed; Immunoglobulin E reactivity of serum to three distinct proteins.

Describes a case of exercise-induced anaphylaxis due to ingestion of grapes. Single blind-challenge metabisulfite; Electrophoresis of the grape extract; Assessment of immunoglobulin E reactivity; Increase in serum tryptase levels; Skin prick and prick-to-prick responses.

Presents a case of string-bean induced anaphylaxis. Medical history of the patient; Administration of skin prick test; Sensitivity to distinct vegetable food allergens.

Describes the unusual immunoglobulin E-mediated egg allergy in adults. Reactivity of the skin to egg white and egg yolk; Physical manifestations of the disease; Sensitivity of allergens to enzymatic digestion.

Examines the clinical reactivity of allergic patients to several fishes. Conduction of skin prick test for the investigation; Role of parvalbumin as the major cod allergen; Characteristics of parvalbumin.

Examines a case involving a sesame seed-induced anaphylaxis. Chemical components of sesame seeds; Signs and symptoms of sesame-seed anaphylaxis; Treatment and patient prognosis.

Examines the apple extracts for skin prick test. Comparison between the allergenic activity of the Lofarma extracts; Incubation of the biotinylated apple extracts; Modification in extraction procedures.

Discusses a case of cross-reactivity between latex and sweet pepper due to prohevein. Results of the skin prick tests conducted on the patient; Electrophoretic profile of latex extract; Main latex allergens recognized by the immunoglobulin E of the patient.

Evaluates the incidence of sensitization to pistachio nut in patients with Parietaria pollinosis allergy. Evidence of cutaneous sensitization in patients from the Parietaria-sensitized group; Absence of any evidence of serologic sensitization in patients allergic to other allergens or in skin prick test-(SPT) negative subjects; Negative SPT to other dried fruits by patients sensitized to both Parietaria and pistachio nut.

Background: Since the 1980s, there has been increased use of latex gloves by health care workers and a concomitant increase of irritant and allergic reactions. The total protein content and the latex allergenic protein content in different types of medical gloves commonly used in our hospital were evaluated to acquire information useful for preventing latex allergy in our hospital personnel., Methods: The total protein content and the allergic latex protein contents were evaluated with Lowry modified method and RAST inhibition assay in samples and extracts of 29 different types of medical gloves., Results: The highest concentrations of total proteins and allergenic latex proteins were found in examination powdered latex gloves and in surgical powdered latex gloves; a significant amount of latex proteins was found in some brands of nitrile gloves., Conclusions: The clear association between the total protein levels and the allergenic latex protein levels suggests that the gloves with highest total protein content have the greatest allergenic potential. Therefore, it is recommended that manufacturing companies should provide package inserts including the total protein contents and possibly allergenic latex protein levels. They should declare whether they have added latex to their nitrile glove formulation. RAST-inhibition assays directly on glove samples instead of glove extract seems to be a good reliable and faster alternative for the evaluation of the allergenic potential of latex gloves., (Copyright 2003 Wiley-Liss, Inc.)

Local intranasal immunotherapy relieves the allergic symptoms of rhinitic patients but little is known about the absorption and distribution of inhaled allergens in the body. The aim of this study was to establish whether allergenic proteins are able to reach the bloodstream by penetrating through the nasal mucosa when aqueous P. judaica extract was administered into the nostrils of normal rabbits. Optimal conditions for a sensitive modified RAST (immunocapture RAST) were set up and the method was used to detect clinically relevant allergenic activity in the systemic circulation. The kinetic profile after intranasal treatment was compared with the profile after intravenous injection of the allergenic extract. The findings are discussed in relation to the mechanism by which local immunotherapy acts.