Journal Mobile Options
Table of Contents
Vol. 125, No. 1, 2001
Issue release date: May 2001
Int Arch Allergy Immunol 2001;125:57–65
(DOI:10.1159/000053797)

Multiple Pollen Sensitization: A Molecular Approach to the Diagnosis

Mari A.
Allergy Unit, National Health Service, Rome, Italy

Individual Users: Register with Karger Login Information

Please create your User ID & Password





Contact Information











I have read the Karger Terms and Conditions and agree.

To view the fulltext, please log in

To view the pdf, please log in

Abstract

Background: Sensitization to multiple pollen species is a frequent diagnostic event. Several allergenic molecules with a high level of homology have been identified in divergent pollen families and named panallergens. Methods: We sought to define the criteria to evaluate the prevalence of the multiple pollen sensitization, to identify specific markers of this condition, and to correlate them with the underlying allergic disease. Patients presenting an allergic respiratory disease underwent skin testing with 23 pollens. Patients fulfilling predefined selection criteria were grouped and classified as having multiple pollen sensitization. Patients in each subgroup were tested for IgE to rBet v 2, rJun o 2, rBet v 1, rPhl p 5 and bromelain. Demographical, allergological and clinical data were recorded in the subgroup of patients with multiple pollen sensitization. Results: Seventeen percent of the pollen-sensitized patients formed the multiple pollen-sensitized subgroup. These subjects were positive for most of the pollen species tested regardless of known exposure to them. None of the subjects sensitized to less than six pollen species were positive to panallergens, whereas 55% of the sera of the multiple pollen-sensitized group were positive to rBet v 2, and 15% to rJun o 2. IgE to rBet v 1 and rPhl p 5 were found positive in all the subgroups. Age, gender, bronchial asthma, oral allergy syndrome, skin test reactivity and previous specific immunotherapy differed significantly when these two subsets were considered. Conclusions: Allergy diagnosis based on allergenic molecules is crucial in the patient with multiple pollen sensitization. This condition appears to be determined by the sensitization to defined allergenic components (panallergens) rather than by pollen of multiple species as such. Detection of IgE to nonpanallergenic molecules allows to identify more relevant allergenic sources. Clinical aspects of the underlying allergic disease (e.g. asthma and oral allergy syndrome) seem to be differently related to IgE reactivity to panallergens.



Copyright / Drug Dosage

Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher or, in the case of photocopying, direct payment of a specified fee to the Copyright Clearance Center.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in goverment regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.

References

  1. Schafer T, Ring J: Epidemiology of allergic diseases. Allergy 1997;52(suppl 38):14–22.
  2. D’Amato G, Spieksma FTM, Bonini S: Allergenic Pollen and Pollinosis in Europe. Oxford, Blackwell Scientific, 1991.
  3. Solomon WR, Platts-Mills TAE: Aerobiology and inhalant allergens; in Middleton E Jr, Reed CE, Ellis EF, Adkinson NF, Yunginger JW, Busse WW (eds): Allergy – Principles and Practice, ed 5. St Louis, Mosby-Year Book, 1998, pp 367–403.
  4. Britton WJ, Woolcock AJ, Peat JK, Sedwick CJ, Lloyd DM, Leeder SR: Prevalence of bronchial hyperresponsiveness in children: The relationship between asthma and skin test reactivity to allergens in two communities. Int J Epidemiol 1986;15:202–209.
  5. Burrows B, Martinez FD, Halonen M, Barbee RA, Cline MG: Association of asthma with serum IgE levels and skin test reactivity to allergens. N Engl J Med 1989;320:271–277.
  6. Peat JK, Salome CM, Woolcock AJ: Factors associated with bronchial hyperresponsiveness in Australian adults and children. Eur Respir J 1992;5:921–929.
  7. Mari A, Di Felice G, Afferni C, Barletta B, Tinghino R, Sallusto F, Pini C: Assessment of skin prick test and serum specific IgE detection in the diagnosis of Cupressaceae pollinosis. J Allergy Clin Immunol 1996;98:21–31.
  8. Valenta R, Duchene M, Ebner C, Valent P, Sillaber C, Deviller P, Ferreira F, Tejkl M, Edelmann H, Kraft D, Scheiner O: Profilins constitute a novel family of functional plant pan-allergens. J Exp Med 1992;175:377–385.
  9. Valenta R, Hayek B, Seiberler S, Bugajska-Schretter A, Niederberger V, Twardosz A, Natter S, Vangelista L, Pastore A, Spitzauer S, Kraft D: Calcium-binding allergens: From plants to man. Int Arch Allergy Immunol 1998;117:160–166.
  10. Tinghino R, Barletta B, Palumbo S, Afferni C, Iacovacci P, Mari A, Di Felice G, Pini C: Molecular characterization of a cross-reactive Juniperus oxycedrus pollen allergen, Jun o 2, representing a novel calcium binding allergen. J Allergy Clin Immunol 1998;101:772–777.
  11. Liebers V, Sander I, van Kampen V, Raulf-Heimsoth M, Rozynek P, Baur X: Overview on denominated allergens. Clin Exp Allergy 1996;26:494–516.
  12. Stewart GA, Thompson PJ: The biochemistry of common aeroallergens. Clin Exp Allergy 1996;26:1020–1044.

    External Resources

  13. Laffer S, Valenta R, Vrtala S, Susani M, van Ree R, Kraft D, Schreiner O, Duchene M: Complementary DNA cloning of the major allergen Phl p I from timothy grass (Phleum pratense); recombinant Phl p I inhibits IgE binding to group I allergens from eight different grass species. J Allergy Clin Immunol 1994;94:689–698.
  14. Niederberger V, Laffer S, Froschl R, Kraft D, Rumpold H, Kapiotis S, Valenta R, Spitzauer S: IgE antibodies to recombinant pollen allergens (Phl p 1, Phl p 2, Phl p 5, and Bet v 2) account for a high percentage of grass pollen-specific IgE. J Allergy Clin Immunol 1998;101:258–264.
  15. van Ree R, van Leeuwen WA, Aalberse RC: How far can we simplify in vitro diagnostics for grass pollen allergy?: A study with 17 whole pollen extracts and purified natural and recombinant major allergens. J Allergy Clin Immunol 1998;102:184–190.
  16. van Ree R, van Leeuwen WA, Akkerdaas JH, Aalberse RC: How far can we simplify in vitro diagnostics for Fagales tree pollen allergy? A study with three whole pollen extracts and purified natural and recombinant allergens. Clin Exp Allergy 1999;29:848–855.
  17. Aalberse RC, van Ree R: Crossreactive carbohydrate determinants. Clin Rev Allergy Immunol 1997;15:375–387.
  18. Mari A, Iacovacci P, Afferni C, Barletta B, Tinghino R, Di Felice G, Pini C: Specific IgE to cross-reactive carbohydrate determinants strongly affect the in vitro diagnosis of allergic diseases. J Allergy Clin Immunol 1999;103:1005–1011.
  19. van der Veen MJ, van Ree R, Aalberse RC, Akkerdaas J, Koppelman SJ, Jansen HM, van der Zee JS: Poor biologic activity of cross-reactive IgE directed to carbohydrate determinants of glycoproteins. J Allergy Clin Immunol 1997;100:327–334.
  20. Niederberger V, Pauli G, Gronlund H, Froschl R, Rumpold H, Kraft D, Valenta R, Spitzauer S: Recombinant birch pollen allergens (rBet v 1 and rBet v 2) contain most of the IgE epitopes present in birch, alder, hornbeam, hazel, and oak pollen: A quantitative IgE inhibition study with sera from different populations. J Allergy Clin Immunol 1998;102:579–591.
  21. Hoffmann-Sommergruber K, O’Riordain G, Ahorn H, Ebner C, Da Camara Machado ML, Puhringer H, Scheiner O, Breiteneder H: Molecular characterization of Dau c 1, the Bet v 1 homologous protein from carrot and its cross-reactivity with Bet v 1 and Api g 1. Clin Exp Allergy 1999;29:840–847.
  22. Fritsch R, Ebner C, Kraft D: Allergenic crossreactivities. Pollens and vegetable foods. Clin Rev Allergy Immunol 1997;15:397–404.
  23. Valenta R, Duchene M, Pettenburger K, Sillaber C, Valent P, Bettelheim P, Breitenbach M, Rumpold H, Kraft D, Scheiner O: Identification of profilin as a novel pollen allergen: IgE autoreactivity in sensitized individuals. Science 1991;253:557–560.
  24. Tutin TG, Heywood VH, Burges NA, Moore DM, Valentine DH, Walters SM, Webb DA: Flora europea. Cambridge, Cambridge University Press, 1980.
  25. Pignatti S: Flora d’Italia, ed 1. Bologna, Edagricole, 1982.
  26. Varela S, Subiza J, Subiza JL, Rodriguez R, Garcia B, Jerez M, Jiemenez JA, Panzani R: Platanus pollen as an important cause of pollinosis. J Allergy Clin Immunol 1997;100:748–754.
  27. Hirschwehr R, Heppner C, Spitzauer S, Sperr WR, Valent P, Berger U, Horak F, Jager S, Kraft D, Valenta R: Identification of common allergenic structures in mugwort and ragweed pollen. J Allergy Clin Immunol 1998;101:196–206.
  28. National Institutes of Health, National Heart, Lung and Blood Institute: Global Initiative for Asthma: Global Strategy for Asthma Management and Prevention. NHLBI/WHO Workshop Report 1993, January 1995, No 95-3659.
  29. Pastorello EA, Ortolani C: Oral allergy syndrome; in Metcalfe DD, Sampson HA, Simon RA (eds): Food Allergy: Adverse Reactions to Foods and Food Additives, ed 2. Cambridge, Blackwell Science, 1997, pp 137–150.
  30. Malling HJ: Methods of skin testing. Allergy 1993;48(suppl):55–62.
  31. Barletta B, Tinghino R, Iacovacci P, Afferni C, Butteroni C, Di Felice G, Pini C, Mari A: Profilins, calcium-binding proteins, and carbohydrate crossreacting determinants in 23 different pollen species. J Allergy Clin Immunol 2000;105/2:S36.
  32. Elfman L, Svensson M, Lidholm J, Pauli G, Valenta R: Different profiles in specific IgE to rBet v 1 and rBet v 2 in patients allergic to birch pollen from six countries. Int Arch Allergy Immunol 1997;113:249–251.

    External Resources

  33. Heiss S, Fischer S, Muller WD, Weber B, Hirschwehr R, Spitzauer S: Identification of a 60 kD cross-reactive allergen in pollen and plant-derived food. J Allergy Clin Immunol 1996;98:938–947.

    External Resources

  34. Karamloo F, Schmitz N, Scheurer S, Foetisch K, Hoffmann A, Haustein D, Vieths S: Molecular cloning and characterization of a birch pollen minor allergen, Bet v 5, belonging to a family of isoflavone reductase-related proteins. J Allergy Clin Immunol 1999;104:991–999.
  35. van Ree R, Antonicelli L, Akkerdaas JH, Garritani MS, Aalberse RC, Bonifazi F: Possible induction and food allergy during mite immunotherapy. Allergy 1996;51:108–113.
  36. Batanero E, Crespo JF, Monsalve RI, Martin-Esteban M, Villalba M, Rodriguez R: IgE-binding and histamine-release capabilities of the main carbohydrate component isolated from the major allergen of olive tree pollen, Ole e 1. J Allergy Clin Immunol 1999;103:147–153.
  37. Valenta R, Lidholm J, Niederberger V, Hayek B, Kraft D, Gronlund H: The recombinant allergen-based concept of component-resolved diagnostics and immunotherapy (CRD and CRIT). Clin Exp Allergy 1999;29:896–904.


Pay-per-View Options
Direct payment This item at the regular price: USD 38.00
Payment from account With a Karger Pay-per-View account (down payment USD 150) you profit from a special rate for this and other single items.
This item at the discounted price: USD 26.50