Chinese Bellflower Root Anaphylaxis: IgE-Binding Components and Cross-Reactivity With Mugwort and Birch

Kim, Sae‐Hoon; Lee, Sang‐Min; Park, Heung-Woo; Cho, Sang Heon; Min, Kyung-Up; Kim, You-Young; Chang, Yoon-Seok

doi:10.3904/kjim.2009.24.3.279

Cited by 6 publications

(3 citation statements)

References 9 publications

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“…Moreover, various Korean foods are reportedly implicated in diverse clinical manifestations of PFAS; e.g. , bronchospasm and urticaria caused by shiso leaf ( Perilla frutescens ), 21 anaphylaxis by Chinese bellflower root, 22 crown daisy-dependent exercise-induced anaphylaxis, 23 and PFAS caused by celery, lettuce, chicory, radish sprouts, ginseng, mango, kiwi, tomato, crown daisy and perilla leaf. 24 25 26 27 …”

Section: Discussionmentioning

confidence: 99%

Pollen-Food Allergy Syndrome in Korean Pollinosis Patients: A Nationwide Survey

Kim

Yang

et al. 2018

Allergy Asthma Immunol Res

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PurposePollen-food allergy syndrome (PFAS) is an immunoglobulin E (IgE)-mediated allergy in pollinosis patients caused by raw fruits and vegetables and is the most common food allergy in adults. However, there has been no nationwide study on PFAS in Korea. In this study, we investigated the prevalence and clinical characteristics of PFAS in Korea.MethodsTwenty-two investigators participated in this study, in which patients with allergic rhinoconjunctivitis and/or bronchial asthma with pollen allergy were enrolled. The questionnaires included demographic characteristics, a list of fruits and vegetables, and clinical manifestations of food allergy. Pollen allergy was diagnosed by skin prick test and/or measurement of the serum level of specific IgE.ResultsA total of 648 pollinosis patients were enrolled. The prevalence of PFAS was 41.7% (n = 270). PFAS patients exhibited cutaneous (43.0%), respiratory (20.0%), cardiovascular (3.7%) or neurologic symptoms (4.8%) in addition to oropharyngeal symptoms. Anaphylaxis was noted in 8.9% of the PFAS patients. Seventy types of foods were linked to PFAS; e.g., peach (48.5%), apple (46.7%), kiwi (30.4%), peanut (17.4%), plum (16.3%), chestnut (14.8%), pineapple (13.7%), walnut (14.1%), Korean melon (12.6%), tomato (11.9%), melon (11.5%) and apricot (10.7%). Korean foods such as taro/taro stem (8.9%), ginseong (8.2%), perilla leaf (4.4%), bellflower root (4.4%), crown daisy (3.0%), deodeok (3.3%), kudzu root (3.0%) and lotus root (2.6%) were also linked to PFAS.ConclusionsThis was the first nationwide study of PFAS in Korea. The prevalence of PFAS was 41.7%, and 8.9% of the PFAS patients had anaphylaxis. These results will provide clinically useful information to physicians.

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Section: Discussionmentioning

confidence: 99%

Pollen-Food Allergy Syndrome in Korean Pollinosis Patients: A Nationwide Survey

Kim

Yang

et al. 2018

Allergy Asthma Immunol Res

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“… 22 23 Studies have shown that immunoblotting with Chinese bellflower, birch, and mugwort revealed a common 40–55-kDa protein band that was very similar to the high-molecular-weight allergen responsible for the celery–birch–mugwort-spice syndrome. 22 23 Another possible protein that could cross-react with birch is an allergen of 14 kDa 22 ; however, further studies are needed to investigate this. In a study involving 80 Korean birch-positive patients, 45% reported OAS to ginseng, but the exact allergen that caused the cross-reactivity was not determined.…”

Section: Discussionmentioning

confidence: 99%

Oral Allergy Syndrome in Birch Pollen-Sensitized Patients from a Korean University Hospital

Kim

Park

et al. 2018

J Korean Med Sci

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BackgroundOral allergy syndrome (OAS) is a type of allergic reaction that mainly occurs on oral contact with raw fruit, vegetables, or nuts. The most common type of OAS is birch pollen-related food allergy. Although OAS is a common food allergy in adults, only few epidemiologic studies have been reported in Korea. Here we investigate the prevalence and triggers of birch pollen-related food allergy.MethodsWe conducted a retrospective chart review of 1,427 patients who underwent a skin prick test for inhalant allergens at the Asthma and Allergy Clinic in Seoul National University Bundang Hospital from January 2011 to December 2016.ResultsOf 1,427 patients, 125 (8.7%) were sensitized to birch pollen. Among them, 20.0% developed OAS, which was the most common food allergy (96.2%). The prevalence of OAS was higher in females, and was 18.2% in birch pollen-sensitized allergic rhinoconjunctivitis patients. Further, 72.0% OAS patients had rhinoconjunctivitis, 20.0% had asthma, and 12.0% had chronic urticaria. Apple (68.0%), peach (56.0%), nuts (36.0%), kiwi (20.0%), persimmon (20.0%), plum (16.0%), and cherry (16.0%) were frequent triggers; however, Chinese yam, kudzu vine, bellflower root, codonopsis, and ginseng were also revealed as triggers. Patients (60.0%) showed OAS with ≥ 3 foods at the same time. Only 3 patients showed mono-sensitivity to birch pollen, while others were multi-sensitized to trees, grasses, weed, or house dust mite allergens.ConclusionOAS was the most common food allergy in birch pollen-sensitized patients. This study revealed the unique triggers of OAS in Korea in addition to well-known triggers.

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“…Ginseng causes respiratory allergies in patients sensitized to birch pollen, and bellflower root shows crossreactivity with mugwort and birch pollen. 6,7 Arrowroot is a plant in the genus Pueraria, which is in the pea family Fabaceae. We performed IgE inhibition tests with arrowroot extract; mugwort pollen, to which the patient was already sensitized; and soybean, which belongs to the pea family.…”

Section: A Case Of Generalized Urticaria Caused By Arrowroot Ingestionmentioning

confidence: 99%