Cross-reactivity between aeroallergens and food allergens

In patients with respiratory allergy,cross-reactivity between aeroallergens and foods may induce food allergy,symptoms ranging from oral allergy syndrome to severe anaphylaxis.Clinical entities due to Ig E sensitization to cross-reactive aeroallergen and food allergen components are described for many sources of plant origin(pollen-food syndromes and associations,such as birch-apple,cypress-peach and celery-mugwortspice syndromes,and mugwort-peach,mugwortchamomile,mugwort-mustard,ragweed-melon-banana,goosefoot-melon associations),fungal origin(Alternariaspinach syndrome),and invertebrate,mammalian or avian origin(mite-shrimp,cat-pork,and bird-egg syndromes).Clinical cases of allergic reactions to ingestion of food products containing pollen grains of specific plants,in patients with respiratory allergy to Asteraceae pollen,especially mugwort and ragweed,are also mentioned,for honey,royal jelly and bee polen dietary supplements,along with allergic reactions to foods contaminated with mites or fungi in patients with respiratory allergy to these aeroallergens.Medical history and diagnosis approach may be guided by the knowledge about the diverse cross-reacting allergens involved,and by the understanding of these clinical entities which may vary significantly or may be overlapping.The association between primary Ig E sensitization with respiratory symptoms to inhaled allergens and food allergy due to cross-reactive allergen components is important to assess in allergy practice.The use of molecular-based diagnosis improves the understanding of clinically relevant Ig E sensitization to cross-reactive allergen components from aeroallergen sources and foods.

Aeroallergens, air pollutants, and chronic rhinitis and rhinosinusitis

Chronic rhinitis and rhinosinusitis are among the most common conditions world-wide with significant morbidity and decreased quality of life. Although the pathogenesis of these conditions is multifactorial, there has been increasing evidence for the role of environmental factors such as aeroallergens and air pollutants as initiating or exacerbating factors. This review will outline the current literature focusing on the role of aeroallergens and air pollution in the pathogenesis of chronic sinonasal inflammatory conditions.

Analysis of Allergens in 5473 Patients with Allergic Diseases in Harbin, China

Objective To analyze the allergic status to common inhalant allergens and food allergens in clinical patients in Harbin in northeastern China and provide evidence to develop the prevention strategy of allergic disease. Methods The data were collected from 5 473 patients with clinical suspected allergic diseases seeking medical care in the Second Affiliated Hospital of Harbin Medical University. Among these patients, 2 530 （46.2%） were males aged 0-86 years, the youngest was only 1 month old and 2 579 （47.1%） were young children and teenagers. The serum specific Immunoglobulin E （slgE） to 14 kinds of common allergens and serum total IgE were detected by using AllergyScreen test （Mediwiss Analytic GmbH, Moers, Germany）. Results In 5 473 subjects the positive rate of slgE was 33.1% （n=1 813）. Cow milk （6.9%） and wheat （3.1%） were the most common food allergens, followed by house dust mite mix （12.5%） and mould mix （9.4%） and the age and gender specific differences in the positive rate were significant. For the children aged 〈7 years the positive rates to cow milk, beef-mutton, and egg white/egg yolk were high, but the positive rates to house dust mite mix, ragweed estragon, and mould mix were low （P〈0.05）. For the adults the positive rates to aeroallergens were high while the rates to food allergens were low. Conclusion The results from this study showed that the food allergens in Harbin had geographic characteristics, which support the viewpoint that the environment factors play an important role in the incidence of allergic diseases. Also, the detection of slgE and total IgE are essential to identify relevant allergens for the purpose of early diagnosis, management and prevention of allergic disease.

Precision medicine allergy immunoassay methods for assessing immunoglobulin E sensitization to aeroallergen molecules

Molecular-based allergy diagnosis for the in vitro assessment of a patient immunoglobulin E(IgE) sensitization profile at the molecular level uses allergen molecules(also referred to as allergen components), which may be well-defined, highly purified, natural allergen components or recombinant allergens. Modern immunoassay methods used for the detection of specific Ig E against aeroallergen components are either singleplex(such as the fluorescence enzyme immunoassay with capsulated cellulose polymer solid-phase coupled allergens, the enzyme-enhanced chemiluminescence immunoassay and the reversed enzyme allergosorbent test, with liquid-phase allergens), multiparameter(such as the line blot immunoassay for defined partial allergen diagnostics with allergen components coating membrane strips) or multiplex(such as the microarraybased immunoassay on immuno solid-phase allergen chip, and the two new multiplex nanotechnology-based immunoassays: the patient-friendly allergen nanobead array, and the macroarray nanotechnology-based immunoassay used as a molecular allergy explorer). The precision medicine diagnostic work-up may be organized as an integrated "U-shape" approach, with a "top-down" approach(from symptoms to molecules) and a "bottomup" approach(from molecules to clinical implications), as needed in selected patients. The comprehensive and accurate Ig E sensitization molecular profiling, with identification of the relevant allergens, is indicated within the framework of a detailed patient's clinical history to distinguish genuine Ig E sensitization from sensitization due to cross-reactivity(especially in polysensitized patients), to assess unclear symptoms and unsatisfactory response to treatment, to reveal unexpected sensitizations, and to improve assessment of severity and risk aspects in some patients. Practical approaches, such as anamnesis molecular thinking, laboratory molecular thinking and postmolecular anamnesis, are sometimes applied. The component-resolved diagnosis of the specific IgE repertoire has a key impact on optimal decisions making for prophylactic and specific immunotherapeutic strategies tailored for the individual patient.

Allergic rhinitis facts from an Irish pediatric population

Objective:Assessing the main allergens in the pediatric population from the largest urban area in the country.Methods:Clinical letters of patients referred with possible allergic rhinitis(AR)were retrospectively reviewed over the past 5 years.Results:Five hundred and fifty‐five patients were included.Males suffer twice as often with AR than females and have high titers of allergens.House dust mites(44.7%)and grass pollen(29%)were the main allergens in our area,with 48%of patients sensitized to both allergens.Half of the patients had the diagnosis of AR confirmed with positive allergen‐specific tests.For the other half,the diagnosis was based on a clinical assessment performed by a pediatric otolaryngologist.Conclusions:Half of suspected AR children have environmental allergen sensitivity confirmed by testing,and a large number had a clinical diagnosis of AR after an otolaryngology consultation.Our findings can help clinicians to initiate AR treatment considering the most problematic allergens in the area.

Climate change,air pollution,and allergic respiratory diseases:a call to action for health professionals

Rising emissions of greenhouse gases in the atmosphere have warmed the planet substantially and are also accompanied by poor air quality.The increased prevalence of allergic airway disease worldwide can be partially attributed to those global environmental changes.Climate change and air pollution pose adverse impacts on respiratory allergies,and that the mechanisms are complex and interactive.Adverse weather conditions,such as extreme temperatures,can act directly on the respiratory tract to induce allergic respiratory illnesses.Thunderstorms and floods can alter the production and distribution of aeroallergens while wildfires and dust storms increase air pollution,and therefore indirectly enhance health risks.Concentrations of particulate matter and ozone in the air have been projected to increase with climate warming and air stagnation,and the rising temperatures and CO2 increase pollen,molds,and spores,which escalate the risk of allergic respiratory diseases.The synergistic effects of extreme heat and aeroallergens intensify the toxic effect of air pollutants,which in turn augment the allergenicity of aeroallergens.With the Earth’s climate change,migration of humans and plants shift the living environments and allergens of susceptible people.Urban residents are exposed to multiple factors while children are sensitive to environmental exposure.Since climate change may pose many unexpected and persistent effects on allergic respiratory diseases,health professionals should advocate for effective mitigation and adaptation strategies to minimize its respiratory health effects.