Kiwifruit allergy across Europe: Clinical manifestation and IgE recognition patterns to kiwifruit allergens

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• 作者：Thuy-My Le ; MD^a ; ^&lowast ; ; ^{t.t.m.le-2@umcutrecht.nl} ; Merima Bublin ; PhD^b ; ^&lowast ; ; Heimo Breiteneder ; PhD^b ; Montserrat Ferná ; ndez-Rivas ; MD ; PhD^c ; Riccardo Asero ; MD^d ; Barbara Ballmer-Weber ; MD^e ; Laura Barreales ; MD^c ; Peter Bures ; MD^e ; Simona Belohlavkova ; MD^f ; Fr&#233 ; d&#233 ; ric de Blay ; MD^g ; Michael Clausen ; MDⁱ ; ^j ; Ruta Dubakiene ; MD^h ; David Gislason ; MDⁱ ; ^j ; Els van Hoffen ; PhD^a ; Monika Jedrzejczak-Czechowicz ; MD ; PhD^k ; Marek L. Kowalski ; MD ; PhD^k ; Tanya Kralimarkova ; MD^l ; Jonas Lidholm ; PhD^m ; Å ; sa Marknell DeWitt ; PhD^m ; Clare E.N. Mills ; PhDⁿ ; Nikolaos G. Papadopoulos ; MD ; PhD^o ; Todor Popov ; MD ; PhD^l ; Ashok Purohit ; MD^g ; Ronald van Ree ; PhD^p ; Suranjith Seneviratne ; MD ; PhD^q ; Athanasios Sinaniotis ; MD^o ; Colin Summers ; MD^r ; Sonia Vá ; zquez-Cort&#233 ; s ; MD^c ; Stefan Vieths ; PhD^s ; Lothar Vogel ; PhD^s ; Karin Hoffmann-Sommergruber ; PhD^b ; Andr&#233 ; C. Knulst ; MD ; PhD^a
• 关键词：Actinidin ; allergens ; component resolved diagnosis ; diagnosis ; food allergy ; ImmunoCAP ; kiwifruit ; skin prick test
• 刊名：Journal of Allergy and Clinical Immunology
• 出版年：2013
• 出版时间：January, 2013
• 年：2013
• 卷：131
• 期：1
• 页码：164-171
• 全文大小：163 K

文摘

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Background

Kiwifruit is a common cause of food allergy. Symptoms range from mild to anaphylactic reactions.

Objective

We sought to elucidate geographic differences across Europe regarding clinical patterns and sensitization to kiwifruit allergens. Factors associated with the severity of kiwifruit allergy were identified, and the diagnostic performance of specific kiwifruit allergens was investigated.

Methods

This study was part of EuroPrevall, a multicenter European study investigating several aspects of food allergy. Three hundred eleven patients with kiwifruit allergy from 12 countries representing 4 climatic regions were included. Specific IgE to 6 allergens (Act d 1, Act d 2, Act d 5, Act d 8, Act d 9, and Act d 10) and kiwifruit extract were tested by using ImmunoCAP.

Results

Patients from Iceland were mainly sensitized to Act d 1 (32 % ), those from western/central and eastern Europe were mainly sensitized to Act d 8 (pathogenesis-related class 10 protein, 58 % and 44 % , respectively), and those from southern Europe were mainly sensitized to Act d 9 (profilin, 31 % ) and Act d 10 (nonspecific lipid transfer protein, 22 % ). Sensitization to Act d 1 and living in Iceland were independently and significantly associated with severe kiwifruit allergy (odds ratio, 3.98 [P?= .003] and 5.60 [P?< .001], respectively). Using a panel of 6 kiwifruit allergens in ImmunoCAP increased the diagnostic sensitivity to 65 % compared with 20 % for skin prick tests and 46 % ImmunoCAP using kiwi extract.

Conclusion

Kiwifruit allergen sensitization patterns differ across Europe. The use of specific kiwifruit allergens improved the diagnostic performance compared with kiwifruit extract. Sensitization to Act d 1 and living in Iceland are strong risk factors for severe kiwifruit allergy.