Local differences of oral allergy syndrome with pollinosis--a comparison between Hanshinkan and Higashiharima in south Hyogo]

BACKGROUND: A number of cases of oral allergy syndrome (OAS) to fruits with birch pollinosis have been described. The antigen of Alnus sieboldiana (alder) trees which are massively planted on Rokko Mountain appeared to be highly similar to birch pollen. METHODS: We took the medical history of pollinosis and OAS, measured pollen-specific IgE (CAP-RAST) and performed prick tests of causative fruits to the outpatients of the two hospitals in different areas. RESULT: In Hanshinkan district, at the foot of Rokko Mountain, we experienced 9 cases of OAS among 377 outpatients. All 9 cases had alder specific-IgE. The prevalence rate of OAS was 11.0% in the alder specific-IgE-positive patients and 0% in the alder specific-IgE-negative patients in the area. On the other hand, in Higashiharima district where less alder trees exist and further from Rokko Mountain, 19 OAS patients were documented among 2000 outpatients. Six of the 19 patients with OAS did not have alder specific-IgE. The prevalence rate of OAS was 6.8% in the alder specific-IgE-positive patients and 11.8% in the mugwort specific-IgE-positive patients in the area. CONCLUSION: In Hanshinkan, alder pollinosis seems to be most important for the cross reactivity to the OAS. In Higashiharima, mugwort pollinosis may be more important than alder pollinosis for the cross reactivity to the OAS.     

Association between childhood oral allergy syndrome and sensitization against four major pollens (Japanese cedar, orchard grass, short ragweed, alder)]

BACKGROUND/AIM: Although OAS (oral allergy syndrome) during childhood is believed to be rare, it seems to be increasing these days. METHODS, SUBJECTS: We here report 16 cases of childhood OAS, which were diagnosed, in our division. In addition to these reports, we investigated the rate of sensitization against four major pollens (Japanese cedar, orchard grass, short ragweed, alder) among 1067 pediatric patients with allergic diseases (median age: 4 years old) in our division. The sensitization was examined by IgE CAPRAST and above class 2 was judged as positive sensitization. RESULTS: OAS in childhood differs from that in adulthood in some ways. One is that childhood OAS does not always accompany with pollinosis. The most frequent allergen in our study was kiwi fruits followed by tomato, orange and melon among these patients. The sensitization rate against alder was equivalent as that against orchard grass and short ragweed, but less than that against Japanese cedar. CONCLUSION: Childhood OAS may have different mechanisms from adulthood OAS which almost always accompanies with pollinosis or latex allergy.     

Oral allergy syndrome due to plant-derived foods: a clinical review of 63 patients over a period of 6 years]

BACKGROUND: The clinical features of many patients with oral allergy syndrome (OAS) due to plant-derived foods have rarely been reported in Japan. OBJECTIVES: We aimed to determine the causative foods of OAS due to plant-derived foods based on clinical features and skin prick tests (SPTs). Furthermore, we aimed to elucidate the association between causative foods and sensitized pollens in patients with OAS due to plant-derived foods. METHODS: SPTs and specific IgE measurements (CAP-FEIA: CAP) were performed in relation to foods and pollens in 118 patients with positive histories of OAS due to plant-derived foods. Patients with positive histories and with positive skin test responses were identified as having type I allergy to the causative foods. RESULTS: The mean age of 63 patients with positive histories and positive skin test responses was 29.2 years (range, 2-61 years), and there were twice as many females as male. The most frequent causative foods were found to be apple, peach, kiwi, and melon in 13, 12, 12, and 11 patients, respectively. CAP frequency was shown to be similar to that of SPT regarding apple, whereas it was less than that of SPT regarding melon, peach, and kiwi. A significant correlation between the frequencies of SPT and CAP was found regarding apple (r=0.39, p<0.05) but not peach, kiwi, and melon. Forty-one of 63 patients with OAS (66.1%) had pollinosis and/or allergic rhinitis. In patients with OAS due to apple, the positive ratio of CAP response against alder pollen was higher than that in patients with OAS due to melon. In patients with OAS due to melon, the positive ratio of CAP responses against ragweed pollen, grass pollen, and mugwort pollen was higher than that in patients with OAS due to apple. CONCLUSION: In this study, positive ratios of SPT and CAP tended to differ according to the causative food, showing a smaller potential for reaction than might be suggested by patient history. Therefore, for the time being it would be more accurate to use a skin test for the diagnosis of OAS due to plant-derived foods.     

Relationships between oral allergy syndrome and sensitization to pollen antigen, especially to mugwort]

BACKGROUND: In order to know the relationships between mugwort pollinosis and oral allergy syndrome (OAS), an etiological study was performed at Muroran City, where mugwort is the most frequent cause of pollinosis. METHODS: Allergic rhinitis patients positive to serum IgE to birch, mugwort or grass pollen visited to the outpatient-clinic of Otorhinolaryngology of Muroran City General Hospital from 1998 to 2002, were studied by a questionnaire concerning a past-history of OAS. RESULTS: The prevalence of OAS was significantly higher in patients positive to serum IgE antibody specific to birch pollen or mugwort pollen than those negative to each pollen-specific antibody (birch; 54.5 vs 23.5%, p<0.0001, mugwort; 41.0 vs 21.5%, p<0.01). The main causative foods were fruits of rose family in patients with only birch pollen-specific IgE antibody, and were those other than rose family, such as kiwi, melon, orange, celery and onion in those with only mugwort pollen-specific IgE antibody. The patients group with high Lumiward score to mugwort pollen tended to include severe OAS cases. CONCLUSION: A close relationship was suggested between mugwort pollen sensitization and OAS.     

Oral allergy syndrome among patients with birch pollinosis in Sapporo]

We evaluated the relationships between oral and pharyngeal hypersensitivity to fruits and vegetables (oral allergy syndrome) and birch pollinosis in 2003 in Sapporo. 1. Of 153 patients with birch pollinosis (seasonal nasal or ocular symptom and CAP positive [birch pollen CAP score 2 or more]), 65 patients (42%) have episode of oral allergy syndrome (OAS). And that rate in 2003 was higher than in 1992 and was equal to in 1998. 2. Among birch pollinosis patients, the higher the CAP score of birch pollen, the higher the prevalences of OAS were found to be. 3. Among birch pollinosis patients, female have OAS much more than male. 4. Among birch pollinosis patients in 1998, patients who visited to ENT clinic for medical consultation of birch pollinosis in March and April have OAS much more than patients who visited in May and June.     

Food hypersensitivity among Finnish university students: association with atopic diseases

BACKGROUND: Food hypersensitivity (FH) is commonly suspected, especially among adults with atopic diseases. Symptoms of FH vary from oral allergy syndrome (OAS) to gastrointestinal, respiratory and systemic reactions. More data are needed regarding patient groups at risk for FH, and symptoms and foods responsible for the reactions. METHODS: FH was studied in 286 Finnish university students. Four study groups were selected: subjects (i) with current atopic dermatitis (AD) with or without allergic rhinoconjunctivits (ARC) or asthma (n = 41); (ii) with past AD with or without ARC or asthma (n = 89); (iii) with ARC or asthma (n = 69); (iv) without clinically confirmed atopic disease (n = 87). A thorough clinical examination was performed with a questionnaire specifying adverse events to foods. In addition, IgE specific to five foods, and skin prick tests to four foods were determined. RESULTS: FH was reported by 172 subjects (60.1%), more often by females (66.3%) than by males (47.9%) (P = 0.003). FH was most frequent among subjects with AD, among those with current AD in 73.2%, with past AD in 66.3%, and with ARC or asthma in 63.8%; 44.8% of subjects without any atopic disease reported FH. Kiwi fruit caused symptoms most frequently (38.4%), followed by milk (32.6%), apple (29.1%), tomato (27.9%), citrus fruits (25.0%), tree nuts (23.3%), and peanut (17.4%). A total of 720 separate symptoms to 25 food items were reported. OAS was most common (51.2%), followed by gastrointestinal symptoms (23.5%), worsening of AD (11.4%), urticaria (4.2%), rhinitis or conjunctivitis (5.7%) and asthma (4.0%). Severe reactions occurred in 3.5% (25/720). Negative IgE and skin prick test to foods predicted well negative history, but the value of positive test results was limited. CONCLUSIONS: FH was reported most often by students with current AD and multiple atopic diseases. Severe reactions occurred especially in patients with ARC and asthma. After excluding lactose intolerance, milk hypersensitivity was frequently reported.     

Plant Food Allergy in Patients with Pollinosis from the Mediterranean Area

Background: Patients with pollinosis develop symptoms after intake of plant food more often than the general population. In order to study the prevalence of the presentation of allergic symptoms to plant foods in pollinosis, we selected a representative sample of the population from our Mediterranean area. Methods: All patients completed a questionnaire, provided a blood sample and underwent a battery of skin and other complementary tests (prick-prick, oral challenge test) when necessary. The pollen counts were obtained from the Elche pollen station. In addition, sera from a subgroup of patients were checked with an allergen molecule panel on an Advia Centaur XP platform. Results: Of the final sample (n = 233), 39.9% of the patients with pollinosis were sensitized and 30.9% had clinical allergy to at least one of the plant foods studied. Regression analysis showed that age and sensitization to the extracts of Platanus acerifolia and Artemisia vulgaris were the most important variables for discriminating between groups. Patients with pollinosis at a risk of allergy to plant foods had significantly higher Pru p 3 values [odds ratio (OR) 3.3; 95% confidence interval (95% CI) 2.3-4.8], and the value increased according to the number of plant food sensitizations. Conclusion: Plant food allergy is more common in patients with pollinosis than in the general population. The use of the London plain tree (P. acerifolia) and mugwort (A. vulgaris) in the skin tests may help identify such patients in our Mediterranean area, but determination of rPru p 3 could also be very useful in patients suspected of having plant food allergy.     

Effect of self-hypnosis on hay fever symptoms - a randomised controlled intervention study

BACKGROUND: Many people suffer from hay fever symptoms. Hypnosis has proved to be a useful adjunct in the treatment of conditions where allergic phenomena have an important role. METHODS: Randomised parallel group study over an observation period of two consecutive pollen seasons. Outcome data include nasal flow under hypnosis, pollinosis symptoms from diaries and retrospective assessments, restrictions in well-being and use of anti-allergic medication. We investigated 79 patients with a mean age of 34 years (range 19-54 years; 41 males), with moderate to severe allergic rhinitis to grass or birch pollen of at least 2 years duration and mild allergic asthma. The intervention consisted of teaching self-hypnosis during a mean of 2.4 sessions (SD 1.7; range 2-5 sessions) and continuation of standard anti-allergic pharmacological treatment. RESULTS: Of 79 randomised patients, 66 completed one, and 52 completed two seasons. Retrospective VAS scores yielded significant improvements in year 1 in patients who had learned self-hypnosis: pollinosis symptoms -29.2 (VAS score, range 0-100; SD 25.4; p < 0.001), restriction of well-being -26.2 (VAS score, range 0-100; SD 28.7; p < 0.001. In year 2, the control group improved significantly having learned self-hypnosis as well: pollinosis symptoms -24.8 (SD 29.1; p < 0.001), restriction of well-being -23.7 (SD 30.0; p < 0.001). Daily self-reports of subjects who learnt self-hypnosis do not show a significant improvement. The hazard ratio of reaching a critical flow of 70% in nasal provocation tests was 0.333 (95% CI 0.157-0.741) after having learnt and applied self-hypnosis.     

Platanus acerifolia pollinosis and food allergy

BACKGROUND: In Mediterranean areas, oral allergy syndrome (OAS) occurs independently of an associated birch pollinosis; moreover, on occasions it presents with no other associated pollinosis. The aim of this study was to assess the possible association of OAS with Platanus acerifolia pollinosis. METHODS: We evaluated consecutive patients seen for pollinosis in an allergy department. Seven hundred and twenty patients were selected on the basis of seasonal or perennial rhinitis, or asthma, or both. Respiratory and food allergies were studied in all patients. Clinical history was recorded and examinations and skin prick tests were performed with a battery of available common inhalant allergens and plant-derived food allergens. Specific IgE levels to P. acerifolia pollen extract and food allergens tested were measured. Molecular masses of the IgE-binding proteins and cross-reactivity among the P. acerifolia pollen and different food extracts were also determined. RESULTS: Of the 720 patients evaluated, 61 (8.48%) were sensitized to P. acerifolia pollen. Food allergy was observed in 32 (52.45%) of the 61 patients sensitized to P. acerifolia pollen. Food allergens most frequently implicated were hazelnuts, peach, apple, peanuts, maize, chickpea and lettuce. Enzyme allergosorbent (EAST)-inhibition showed high inhibition values when P. acerifolia pollen extract was used as free phase. On the contrary low inhibition was observed when plant-derived food allergens were used as free phase and P. acerifolia pollen extract as solid phase. CONCLUSIONS: Cross-reactivity was observed among P. acerifolia pollen and plant-derived foods. OAS in these patients may have been caused by primary respiratory sensitization.     

Correlation of oral allergy syndrome due to plant-derived foods with alder pollen, rbet v 1 and rbet v 2 sensitization in Yokohama region]

BACKGROUND.AIM: Oral allergy syndrome (OAS) to plant foods is often caused by cross-reactivity to pollen. We investigated whether there was any significant correlation between sensitization to the pollen of alder and Japanese cedar flying off in spring and prevalence of OAS in Yokohama region. METHODS: We measured specific IgE antibodies (CAP-FEIA: CAP) against alder and Japanese cedar in 337 outpatients with skin allergy in 2005 (M:F=167:170, 33.4 years of age, on the average). In the patients who showed positive response to CAP against alder and Japanese cedar, we also tested response to CAP against rBet v 1 and rBet v 2. In addition, we statistically analyzed whether there was any correlation between prevalence of OAS and sensitization to the pollen. RESULTS: Ratio of positive response to CAP against alder was 23.4% (79 cases) while that to CAP against Japanese cedar was 73.7% (244 cases). Response to CAP against rBet v 1 and rBet v 2 was tested in 55 cases, and the ratio of positive response to CAP against rBet v 1 was 43.6% (24 cases) while that to CAP against rBet v 2 was 27.3% (15 cases). Prevalence of OAS showed a significant positive correlation (p<0.001) with sensitization to alder, but no correlation with sensitization to Japanese cedar. CONCLUSION: It was suggested that sensitization to alder pollen would be involved in prevalence of OAS in Yokohama region.     

Fennel, cucumber, and melon allergy successfully treated with pollen-specific injection immunotherapy.

BACKGROUND: In subjects with both pollinosis and vegetable food allergy, most allergenic epitopes of fruits and vegetables are present in pollen. A recent study showed a marked reduction or a total disappearance of apple-induced oral allergy syndrome in patients receiving injection immunotherapy with birch pollen extracts. OBJECTIVE: To assess whether vegetable food allergy following other kinds of primary pollinosis may be successfully treated with pollen-specific immunotherapy. METHODS: A 34-year-old woman with long-standing pollinosis and typical oral allergy syndrome (OAS) with the ingestion of both fennel and cucumber and whose OAS was associated with immediate laryngeal edema after the ingestion of melon, was treated with two commercial depot aluminum hydroxide-adsorbed extracts of 1 grass pollen and 2 mugwort pollen 50% + ragweed pollen 50%. RESULTS: After 36 months of injection specific immunotherapy, the patient was able to tolerate both fresh fennel and cucumber without consequence on open oral challenge tests. After 43 months of immunotherapy, the patient tolerated fresh melon as well on open oral challenge. She has re-introduced these vegetables in her normal diet. Skin tests showed no reactivity to fresh fennel and there was a reduction of the wheal induced by fresh cucumber. CONCLUSION: Vegetable food allergy following primary sensitization to pollens, other than birch, may also be effectively reduced by pollen-specific injection immunotherapy.     

Anaphylaxis to raw potato.

BACKGROUND: Potato allergy has been described rarely, generally in relation to the Oral Allergy Syndrome (OAS). Adults with seasonal allergic rhinitis have been reported in whom peeling of raw potatoes causes oculonasal symptoms, wheezing, and contact urticaria. Skin testing with fresh fruits and vegetables has been recommended in cases of OAS, although the sensitivity of commercial potato extract is reportedly equal to that of fresh potato. CASE REPORT: This report describes a 4-year-old with raw potato-induced anaphylaxis. He rapidly developed urticaria, angioedema, respiratory distress, vomiting and diarrhea after biting into a raw potato that was being used for painting in preschool. Review of systems is significant for viral-induced wheezing, but no symptoms suggestive of seasonal allergic rhinitis were evident. His mother has a history of seasonal allergic rhinitis and contact urticaria with raw potato. Skin testing to commercial potato extract was negative and skin testing to fresh potato by the prick + prick method was markedly positive. Skin testing to birch tree was negative. An open challenge to a small amount of cooked potato was negative. Food challenge to raw potato was not considered indicated in this case of immediate anaphylaxis to a single food. CONCLUSIONS: This patient had clinical and skin test reactivity to raw and uncooked potato in the absence of OAS. The patient will be followed for the development of seasonal allergic rhinitis.     

Allergy to foods in patients monosensitized to Artemisia pollen

It is known that patients with pollinosis may display clinical characteristics caused by allergy to certain fruits and vegetables, but subjects allergic to Artemisia seem to show particularly peculiar characteristics. The clinical features of 84 patients with rhinitis, asthma, urticaria, and/or anaphylaxis whose inhalant allergy was exclusively to Artemisia vulgaris were studied and compared with a control group of 50 patients monosensitized to grass pollen. The mean age for the beginning of symptoms was 30.2 years, and this was higher than in the control group ( P <0.05). We found the main incidence to be in women (70.2%). Some 42.3% had family history of atopia, lower than in the control group ( P <0.05), while the prevalence of asthma and urticaria was significantly higher ( P <0.05). Food hypersensitivity was reported by 23 patients (27.3%) allergic to Artemisia. The foods responsible (with respective numbers of cases) were honey (14), sunflower seeds (11), camomile (four), pistachio (three), hazelnut (two), lettuce (two), pollen (two), beer (two), almond (one), peanut (one), other nuts (one), carrot (one), and apple (one). None of the patients monosensitized to grass had food allergy. CAP inhibition experiments were carried out on a single patient. Results showed the existence of common antigenic epitopes in pistachio and Artemisia pollen for this patient. We concluded that mugwort hay fever can be associated with the Compositae family of foods, but that it is not normally associated with other foods.     

A study on the nasal and eye symptoms of pollinosis in hakodate]

We have investigated the nasal and eye symptoms of pollinosis in Hakodate. There were elevated levels of dispersion of Cryptomeria japonica pollen in Hakodate in 1995 and 1998. In 1995 and 2001, there were also elevated levels of dispersion of Betula platyphylia var. japonica pollen. From March to June and September from July 1999 to May 2002, there was an increased incidence of pollinosis in Hakodate. In 641 patients with allergic rhinitis, the specific IgE positive rates for house dust and mite, Artemisia (Art), Gramineae (Gra), Betulaplatyphylia var. japonica (BJ), and Cryptomeria Japonica (CJ) were 73.5, 28.5, 25.7, 14.2 and 21.2%, respectively. The subjects with pollinosis in 2001 and 2002 (n=95) were divided into four groups as follows: Cryptomeria japonica (n=49), Betula platyphylia var. japonica (n=11), Gramineae (n=18) and Artemisia (n=17) pollinosis. The general severity of rhinitis and conjunctivitis were divided into four grades ( (-), (+), (++) and (+++) ), respectively. The combined (++) and (+++) rates observed for the general severity of rhinitis for all these subjects (n=95) was 86.4% and there was no significant difference in the general severity of rhinitis between any of the four groups. The combined (++) and (+++) rates for the general severity of conjunctivitis for all subjects (n=95) was 56.9% and the general severity of conjunctivitis for BJ and Gra pollinosis were significantly (P<0.01) higher than those observed for CJ pollinosis. In conclusion, the present data shows that the general severity of rhinitis in subjects with pollinosis in Hakodate was more severe than that of conjunctivitis and also that the general severity of conjunctivitis was dependent on the specific pollen (s) responsible for the pollinosis.     

Prevalence and food avoidance behaviors for gustatory rhinitis.

BACKGROUND: Gustatory rhinitis is a type of nonallergic rhinitis that is usually associated with ingestion of hot or spicy foods. Characteristics of this condition and its impact on food choices have not been studied. OBJECTIVE: To survey individuals regarding causative foods, association with atopic conditions, and food avoidance behaviors for gustatory rhinitis. METHODS: An original, self-administered questionnaire was distributed to children and adults who were seen in a busy outpatient dermatology clinic. Atopic history, frequency of rhinorrhea after food ingestion, intake of foods associated with gustatory rhinitis, symptom severity, and food avoidance were evaluated. RESULTS: Of the 571 participants who completed the survey, 396 (69%) indicated at least 1 food resulted in gustatory rhinitis symptoms. Patients with allergic rhinitis (P < .001) and a history of smoking (P = .049) were more likely to have experienced gustatory rhinitis. Bread (6%) and hot chili peppers (49%) represented the least and most common foods identified, respectively. A total of 65% of patients who experienced gustatory rhinitis never avoided the causative food, whereas 46% were never bothered by their symptoms. Patients who reported more causative foods were also more likely to use medications before eating to lessen their symptoms (P = .03). CONCLUSION: The results presented herein suggest that almost all foods can be implicated, both children and adults develop this condition, and patients with a history of allergic rhinitis or smoking are more likely to report gustatory rhinitis symptoms. Most patients though do not avoid the causative food(s) and are not significantly bothered by symptoms.     

The natural course of allergic rhinitis during 12 years of follow-up

As symptoms of allergic rhinitis are generally thought to disappear with increasing age, we decided to follow up our allergic rhinitis patients to ascertain whether their disease had regressed or progressed, and whether they had developed respiratory symptoms. At our department, between 1979 and 1982, allergic rhinitis was diagnosed in 108 patients. In 1993, 82 of the patients (40 women, 42 men; mean age 36 years), none of whom had received immunotherapy, answered a questionnaire concerning the status of their allergic rhinitis, and any development of the disease during the interim. Of the 82 patients, one was free of allergic symptoms and 39% had become better; symptoms were unchanged in 39% of cases, and worse in 21%. Six percent had suffered from asthma at presentation, 6% had developed asthma in the interim, and 34% reported other lower airways symptoms. Neither sex nor age at diagnosis was a determinant of the course of allergic rhinitis. Thus, in contrast to findings in other studies, the severity of allergic rhinitis seems to have increased among our patients.     

Allergic sensitization and clinical reactions to latex, food and pollen in adult patients

BACKGROUND: Many latex-allergic patients are sensitized to one or more foods. Patients allergic to tree and/or grass pollens are also often sensitized to plant-derived foods. Atopy, defined in most studies as sensitivity to an aeroallergen, is a risk factor for latex allergy. The relative importance of pollen sensitivity, a sign of atopy, as a risk factor for food allergy in latex-allergic patients has not, however, been examined. OBJECTIVE: To investigate the relationship between pollen sensitivity and sensitivity to food in latex-allergic patients. METHODS: Forty-four latex-allergic patients (Groups 1 and 2), 24 of whom were also allergic to tree and/or grass pollen (Group 1) and 25 pollinosis patients who were not allergic to latex (Group 3) were studied. We obtained a history of reactions to food and skin tested them with 12 fresh-frozen fruits. RESULTS: All 12 foods induced a skin test reaction in at least one patient in each of the three Groups. There were, however, twice as many positive skin test reactions to food in patients with pollinosis, whether or not they were allergic to latex, as there were in patients allergic to latex but not to pollen. Latex-allergic patients were most likely to have a positive skin test and a history of a reaction to avocado or banana whereas patients with pollinosis only were most likely to have a positive skin test and a history of a reaction to apple, peach or celery. CONCLUSIONS: These results suggest that concomitant allergy to pollen is an important risk factor in determining which plant-derived foods sensitize latex-allergic patients.     

The pollen survey and dynamic statistics of patients with allergic rhinitis in Hakodate]

We have investigated the pollen survey (1994-1998) and dynamic statistics of patients with allergic rhinitis (1999-2000) in Hakodate, which is located southern part of Hokkaido. We have noted the pollen dispersion of Cryptomeria japonica, Cupressaceae, white birch, Gramineae and Artemisia. Especially, a lot of dispersion of Cryptomeria japonica has been noted in April. Concerning the dynamic statistics of patients with allergic rhinitis, we have investigated the 192 patients with allergic rhinitis in Hakodate municipal hospital. There has been a lot of pollinosis in March, April, May and September. Frequency of positive reaction to the specific IgE have been 38.0% of house dust, 16.9% of Artemisia, 13.2% of Gramineae, 10.3% of white birch, 9.0% of Cryptomeria japonica and 6.9% of cat in 379 subjects. In conclusion, we have noted that Cryptomeria japonica and white birch in addition to Gramineae and Artemisia are becoming more important antigen in patients with pollinosis in Hakodate, south part of Hokkaido.     

Allergy to Rosaceae fruits without related pollinosis

Background: Rosaceae fruit allergy is frequently associated with birch pollinosis in Central and Northern Europe and with grass pollen allergy in Central Spain. The main cross-reactive structures involved for birch pollinosis are Bet v 1 and profilin, and for grass pollinosis they are profilin and carbohydrate determinants. Rosaceae fruit allergy can occasionally be observed in patients without pollinosis. Objective: We investigated the clinical presentation and the allergens involved in allergy to Rosaceae fruit without pollinosis. Methods: Eleven patients from Central Spain allergic to apples, peaches, and/or pears but not to pollens were compared with 22 control subjects with combined grass pollen and fruit allergy. Skin prick tests and RASTs to apple, peach, and pear were performed. Cross-allergenicity was studied by RAST inhibition. Bet v 1 was tested with an indirect RAST, and profilin was tested in skin prick tests, histamine release, and RAST. Results: Rosaceae fruit allergy without pollinosis is severe with 82% of patients reporting systemic symptoms, mainly anaphylaxis (73%), whereas oral symptoms are less frequent (64%). Anaphylactic shock was observed in 36% of patients. The fruit allergens involved showed cross-reactivity among Rosaceae species but were not related to profilin or Bet v 1. Ninety-one percent of patients with combined grass pollinosis and fruit allergy reported oral allergy, 45% reported systemic symptoms, 18% reported anaphylaxis, and 9% reported anaphylactic shock. Conclusion: Allergy to Rosaceae fruits in patients without a related pollen allergy is a severe clinical entity. Profilin- and Bet v 1-related structures are not involved in Rosaceae fruit allergy without pollinosis.(J Allergy Clin Immunol 97;100;728-33)     

High levels of Olea europaea pollen and relation with clinical findings.

BACKGROUND: Olea europaea pollen is an important cause of seasonal allergic rhinitis and bronchial asthma in southern Spain. For patients allergic to grass pol- len the critical concentration of airborn pollen is 50 grains/m3, but in the case of Olea pollinosis no data is available. METHODS: Fifty-six seasonal allergic rhinitis patients (29 in 1994 and 27 in 1995) were included in this study, all of whom lived in Jaen. Daily symptom card were filled in and pollen counts during May and June were performed in both years. A linear regression model was used for analysis of the airborne pollen concentration and the symptom score. RESULTS: Significant correlations among daily counts of Olea pollen and rhinitis symptoms were obtained. Most of our monosensitized patients needed a high Olea pollen concentration in the atmosphere (around 400 grains/m3) to suffer at least from mild allergic rhinitis symptoms. CONCLUSION: Local conditions with a wide area dedicated to olive tree cultivars result in a high concentration of this pollen in the atmosphere. Monosensitized Olea patients in our area seem to need exceptionally high levels to suffer from allergic symptoms.