Birch pollen–related food allergy: Clinical aspects and the role of allergen-specific IgE and IgG4 antibodies - 10/08/11
Reprint requests: Barbara Bohle, PhD, Medical University of Vienna, Department of Pathophysiology and Allergy Research, Waehringer Guertel 18-20, AKH-3Q, A-1090 Wien, Austria.Abstract |
Background |
Patients with birch pollen allergy often develop allergic reactions to plant foods.
Objective |
To evaluate the prevalence, main symptoms, and triggers of birch pollen–related food allergy and the role of food-specific IgG4 antibodies in food tolerance.
Methods |
Food-induced symptoms were evaluated in 225 individuals with birch pollen allergy by using a standardized questionnaire. IgE and IgG4 levels specific for the major birch pollen allergen Bet v 1 and birch profilin Bet v 2 and the Bet v 1 homologs in apple (Mal d 1) and hazelnut (Cor a 1) were quantified by ImmunoCAP. Mock-treated and IgG-depleted sera from patients tolerating hazelnuts in food challenges were compared for their inhibitory activity for binding of Cor a 1–IgE complexes to B cells.
Results |
In total, 73% of the study population experienced food allergy, which was perennial in 86% of the affected individuals. The oral allergy syndrome was the main clinical manifestation. However, more than 58% of the patients also experienced food-induced rhinoconjunctivitis. Apples and hazelnuts were identified as the most frequent triggers. Food allergy correlated with IgE reactivity to Bet v 1 but not to Bet v 2. Mal d 1–specific and Cor a 1–specific IgG4/IgE ratios were significantly higher in food-tolerant individuals than individuals with food allergy. Sera from IgG4-positive food-tolerant patients possessed IgG-dependent IgE-inhibitory activity.
Conclusion |
Birch pollen–related food allergy is highly prevalent and often perennial. High food allergen–specific IgG4/IgE ratios seem associated with food tolerance, potentially because specific IgG4 blocks IgE binding to food allergens. Thus, the presence of food allergen–specific IgG4 antibodies is no diagnostic marker for birch pollen–related food allergy.
Le texte complet de cet article est disponible en PDF.Key words : Birch pollen allergy, food allergy, oral allergy syndrome, Bet v 1, IgE, blocking antibodies
Abbreviations used : FAB, r, SIT
Plan
| Supported by the Austrian Science Fund, project SFB-F1807-B13, the Christian Doppler Research Association, and Biomay AG, Vienna, Austria. |
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| Disclosure of potential conflict of interest: B. Bohle receives research support from the Austrian Science Fund and the Christian Doppler Laboratory. S. Vieths is an associate for the Institute for Product Quality; has received honoraria for scientific presentations from Phadia; has received honoraria as an expert reviewer from the Food Allergy Resource and Research Program; has received research support from the European Union, the German Research Foundation, the German Federal Ministry of Education and Research, the Research Fund for the German Food Industry, Monsanto Co, Pioneer Hi-Bred International, Inc, the Food Allergy Resource and Research Program, and the European Directorate for the Quality of Medicines and Health Care; is chairman of the Food Allergy Interest Group and a member of the Executive Committee for EAACI; is chairman of the Allergen Standardization Subcommittee and secretary of the Allergen Nomenclature Subcommittee for the International Union of Immunological Studies; is a Registered Expert for the European Agency for the Evaluation of Medicinal Products and European Pharmacopoeia Commission; is chairman of Technical Committee 275 Working Group 12 “Food Allergens” for the European Committee for Standardization; and is a member of the Food Allergy Working Group for the German Society for Allergy and Clinical Immunology. The rest of the authors have declared that they have no conflict of interest. |
Vol 127 - N° 3
P. 616 - mars 2011 Retour au numéro
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