Allergènes alimentaires croisant avec les allergènes des pollens

The range of pollen-food cross-reactions has increased over the past decade, the clinical pictures are more clear with respect to the allergens concerned, and the molecular basis for some of them have been determined. Diagnostic methods include skin tests, assays for specific IgE, and open and double blind oral provocation tests. Investigation of allergic cross-reactions, first based solely on immunological inhibition techniques using natural allergen extracts, have benefited from molecular biology. Many allergens homologous with pollen allergens have been sequenced and the three dimensional structure of Pru av 1 has been determined, allowing studies on a sub-molecular scale. Allergen cross-reactions between pollen and food, for which the clinical relevance is well established, involve allergens of the Bet v 1 and Bet v 2 families. These allergens are present in numerous edible fruits and vegetables. Identity with the Bet v 1 sequence varies from 38 to 67%, being closest for the profilins (70-80%). Cross sensitization with Bet v 1 and profilins, although particularly frequent, may be silent clinically. Other candidate molecules involved in cross-reactions between pollen and food allergens are Bet v 6, a minor birch allergen, the lipotransferases found in some of the compositae, and the 1,3-β-glucanases corresponding to a major olive allergen. The significance of the detection of specific IgE directed against carbohydrate determinants remains to be investigated. A major problem for the clinician is the absence of clinical significance of cross-reactivity that has been demonstrated in vitro and in vivo.