![]() ![]() Storage proteins and nsLTPs on the other hand, are considered resistant to thermal processing, and pH changes, and are associated with moderate to severe symptoms upon ingestion. PR-10 proteins and profilins are considered labile proteins, and sensitization to these proteins is usually associated with mild symptoms, mostly limited to the oral cavity. In plant food allergy, important protein families include the pathogenesis related protein family 10 (PR-10) proteins, profilins, seed storage proteins and non-specific lipid transfer proteins (nsLTP). The current ISAC model holds 112 components, which are a selection of known food and inhalant allergens, as well as allergens from others sources such as latex (see Additional file 1: Table 1).Ĭomponents can be grouped into protein families based on their biological function and structural homology. Studies have demonstrated a good concordance between the ImmunoCAP and ImmunoCAP ISAC in assessing sensitization to components. The ImmunoCAP Immuno-Solid phase Allergen Chip (ISAC Thermo Fisher Scientific, Uppsala, Sweden) is a multiplex technology to assess the presence of specific IgE to a large number of components at the same time. A consensus document by the WAO-ARIA-GA2LEN Task Force elaborates the role of CRD in three major aspects of allergy diagnostics: distinguishing between genuine versus cross-reactive sensitization, assessing the possible risk of a severe allergic reaction upon exposure in selected patients and identifying allergens for specific immunotherapy. In food allergy diagnostics, component-resolved diagnostics (CRD) allows the clinician to assess the presence of specific IgE (sIgE) to allergenic proteins (components), instead of crude extracts. Less commonly recognized PR-10 proteins appear to be an indication of polysensitization. Sensitization to PR-10 food proteins could occur without concomitant sensitization to common PR-10 from pollen in a subset of subjects. Within the storage proteins, sensitization to multiple peanut allergens was most common (on average 3 out of 4). Seven subjects demonstrated sensitization to food PR-10 proteins, without concomitant sensitization to pollen PR-10s. Subjects sensitized to these ‘less common PR-10 proteins’ were sensitized to more food and inhalant components on the ISAC, compared to subjects sensitized to ‘common PR-10 proteins’ (median 22 vs 13 out of 112, p < 0.0001). Sensitization to PR-10s from soy, celery and kiwi occurred distinctively less often ( 70%). Within the PR-10 family, subjects were most often sensitized to Bet v 1 (73% of 305), Cor a 1.04 (72%) and Mal d 1 (68%). Sensitization to one or more PR-10 proteins was most frequent (74% of all subjects), followed by 35% to storage protein and 15% to nsLTPs. ResultsĪ total of 305 patients were selected, aged 16–79 years (median 32 years). Results of ImmunoCAP ISAC, performed during routine care in Dutch adult outpatients suspected of food allergy, were collected. This study aimed to identify the most frequently recognized components in the PR-10 and storage protein family, as well as patterns in (co-)sensitization, in a birch-endemic area. The extent of co-sensitization within and between food protein families in an adult population is largely unknown.
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