Clinical Relevance of Profilin Sensitization Concerning Oral Allergy Syndrome in Birch Pollen Sensitized Patients

Abstract

Purpose Many plant food allergens contain homologs to the major birch allergen Bet v 1; therefore, the majority of patients with birch pollen allergy suffer from oral allergy syndrome. We studied the relevance of sensitization of Bet v 1 and co-sensitization with profilin concerning the clinical manifestations of an oral allergy syndrome. Patients and Methods A total of 1119 patients with a positive skin prick test to birch and diagnostic for specific IgE to the allergen components Bet v 1 and profilin were analyzed retrospectively regarding complaints in the upper and lower airways, with demographic data as well as oral and gastrointestinal allergy symptoms. Results Patients with simultaneous specific IgE to the allergen components Bet v 1 and profilin have to deal more often with an oral allergy syndrome and intestinal reactions. They also suffer more frequently and severely from rhinitis symptoms and show a higher tendency for asthma. No increased number of systemic reactions was seen. Conclusion Patients with birch allergy recognizing both allergens have more probabilities of suffering from an oral allergy syndrome, and allergologists should be aware of this in order to give better advice to their patients.

Identification of Allergenic Proteins in Velvet Mesquite (Prosopis velutina) Pollen: An Immunoproteomics Approach

“…Allergenic profilins are reported in various pollens, including olive, London planetree, amaranth, and sugar beet, among many others and are considered clinically relevant panallergens, showing extensive cross-reactivity between pollens and other foods of plant origin. Furthermore, the cross-reaction of pollen and fruit profilins can trigger oral allergy syndrome in allergic patients [43,44].…”

Enterosorbents in complex therapy of food allergies: a focus on digestive disorders and systemic toxicity in children

“…This syndrome is caused by cross-reactivity between certain types of food and pollen allergens. For example, a patient allergic to tree pollen may develop oral syndrome after eating apples, fresh carrots, peaches, cherries, and hazelnuts (9,86,87).…”

How Do Pollen Allergens Sensitize?

“…Recent data showed that ligand-binding played an important role in sensitization and manifestation of allergenic properties of Bet v 1 homologs and LTPs ( Fujimoto et al, 1998 ; Chruszcz et al, 2021 ). IgE antibodies to Bet v 1 cross-react with homologues allergens from pollen of such trees as alder (Aln g 1), hazel (Cor a 1), beech (Fag s 1), chestnut (Cas s 1) and others ( Grilo et al, 2021 ) as well as with Bet v 1-like proteins from nuts, fruits and vegetables, particularly, with the peanut Ara h 8 apple Mal d 1 ( Vanekkrebitz et al, 1995 ; Bohle et al, 2003 ), carrot Dau c 1 ( Zulehner et al, 2017 ), causing oral allergy syndrome (OAS) ( Costa et al, 2022 ) in 70% of birch allergic patients ( Högerle et al, 2022 ). Symptoms of OAS usually appear immediately after plant food consumption and mainly affect oropharyngeal area, but such severe reactions as anaphylaxis also may take place ( Högerle et al, 2022 ).…”

“…IgE antibodies to Bet v 1 cross-react with homologues allergens from pollen of such trees as alder (Aln g 1), hazel (Cor a 1), beech (Fag s 1), chestnut (Cas s 1) and others ( Grilo et al, 2021 ) as well as with Bet v 1-like proteins from nuts, fruits and vegetables, particularly, with the peanut Ara h 8 apple Mal d 1 ( Vanekkrebitz et al, 1995 ; Bohle et al, 2003 ), carrot Dau c 1 ( Zulehner et al, 2017 ), causing oral allergy syndrome (OAS) ( Costa et al, 2022 ) in 70% of birch allergic patients ( Högerle et al, 2022 ). Symptoms of OAS usually appear immediately after plant food consumption and mainly affect oropharyngeal area, but such severe reactions as anaphylaxis also may take place ( Högerle et al, 2022 ). The spatial structures of Bet v 1-like allergens are similar to each other and consist of both β-sheets and α-helixes forming together Y-shaped hydrophobic cavity ( van Loon and van Kammen, 1970 ; Fujimoto et al, 1998 ; Pasternak et al, 2006 ).…”