Cor a 14: Missing Link in the Molecular Diagnosis of Hazelnut Allergy?

Abstract

Background: Hazelnut allergy shows distinct clinical patterns that can be predicted through component-resolved diagnosis. However, identification of sensitization profiles remains incomplete. Methods: Sera of 75 patients allergic to hazelnuts, 14 infants with atopic dermatitis (AD) sensitized to hazelnuts, 15 hazelnut-tolerant individuals with specific IgE (sIgE) to hazelnuts and 15 healthy control individuals were tested for sIgE reactivity to rCor a 1.04, rCor a 8, nCor a 9, nCor a 11, rCor a 14, rBet v 1, rBet v 2 and cross-reactive carbohydrate determinants (CCDs). Results: Sensitization to Cor a 14 was observed in 18 out of 20 preschool children, 8 out of 10 school-aged children and 2 out of 7 adults with generalized reactions and in 3 out of 14 infants with AD. Only 2 out of 38 patients with an oral allergy syndrome (OAS) were sensitized to Cor a 14. No sensitization to Cor a 14 was observed in the group of hazelnut-tolerant and healthy control individuals. Sensitization to Cor a 1.04 was seen in 36 out of 38 OAS patients and in 14 out of 37 patients with generalized reactions. However, only 3 patients with generalized reactions were monosensitized to Cor a 1.04. Sensitization to Cor a 9 was observed in 26 out of 37 patients with generalized reactions and in 4 out of 14 infants with AD. Sensitization to Cor a 11, Cor a 8, rBet v 2 and CCDs was rare. Conclusions: Sensitization to Cor a 14 can have early onset and shows age-related variations. Together with Cor a 9, Cor a 14 enables us to correctly identify almost 90% of children with generalized reactions to hazelnut.

Is Microarray Analysis Really Useful and Sufficient to Diagnose Nut Allergy in the Mediterranean Area?

“…It is important to highlight that this study did not include children. This exclusion criterion may explain why only a few of the individuals analyzed were sensitized to common major allergens (storage proteins), since sensitization profiles have been reported to differ according to age [18][19][20]. The differential profile we observed sensitized to Ara h 6 according to ELISA.…”

Utility of Component-Resolved Diagnostics in Food Allergy

“…Patients with objective symptoms had significantly higher Cor a 9 and Cor a 14 compared to those who are not clinically reactive (median sIgE to Cor a 9:5.31 vs. 0.18 kU A /L; median sIgE to Cor a 14:2.18 vs. <0.10 kU A /L). Cor a 14 is age dependent and detected more frequently in preschoolers [60,61]. There was no difference between the sIgE to Cor a 1 (median 2.26 vs. 3.91 kU A /L), SPT, and sIgE to hazelnut extract between those with and without clinical reactivity.…”

Molecular allergy diagnosis: Status anno 2015

“…These so-called "gatekeeper" tests allow an improved discrimination between genuine allergy and merely sensitization [5,[12][13][14] and furthermore enables us to establish personalized sensitization patterns (with constituent components of a particular allergen that are recognized by the individual patient) [12,[14][15][16][17][18][19][20][21][22][23]. Determining the sensitization profile of an individual patient creates the opportunity to assess the individual risk of severity of an allergic reaction and to predict the natural course (outgrow vs. persistence).…”

“…Determining the sensitization profile of an individual patient creates the opportunity to assess the individual risk of severity of an allergic reaction and to predict the natural course (outgrow vs. persistence). Moreover, in this context CRD has unveiled that these sensitization profiles might show geographical and age-related differences with clear distinct clinical outcomes [13,[23][24][25][26]. Finally, CRD might facilitate selection of patients for allergen-specific immunotherapy and contribute to the monitoring of the immunological effects of therapy [27][28][29].…”

“…Sensitization to these components is unrelated to birch pollen allergy and is predominantly associated with more severe symptoms on consumption of raw or processed nuts [13,23,39]. Moreover, sensitization to these components was demonstrated already to occur in infants suffering from atopic dermatitis [23,40]. In contrast, adults generally suffer from a secondary hazelnut allergy and display local discomfort of the oropharyngeal cavity, i.e.…”