Background: Cannabis is the illicit drug most widely used by young people in high-income countries. Allergy symptoms have only occasionally been reported as one of the adverse health effects of cannabis use. Objectives: To study IgE-mediated response to cannabis in drug users, atopic patients, and healthy controls. Methods: Asthmatic patients sensitised to pollen, and all patients sensitised to tobacco, tomato and latex, considered as cross-reacting allergens, were selected from a data base of 21,582 patients. Drug users attending a drug-rehabilitation clinic were also included. Controls were 200 non-atopic blood donors. Specific IgE determination, prick tests and specific challenge with cannabis extracts were performed in patients and controls. Results: Overall, 340 patients, mean age 26.9 ± 10.7 years, were included. Males (61.4%) were the most sensitised to cannabis (p < 0.001). All cannabis-sensitised patients were alcohol users. Eighteen (72%) of the patients allergic to tomato were sensitised to cannabis, but a positive specific challenge to cannabis was highest in patients sensitised to tobacco (13/21, 61.9%), (p < 0.001). Pollen allergy was not a risk factor for cannabis sensitisation. Prick tests and IgE for cannabis had a good sensitivity (92 and 88.1%, respectively) and specificity (87.1 and 96%) for cannabis sensitisation. Conclusions: Cannabis may be an important allergen in young people. Patients previously sensitised to tobacco or tomato are at risk. Cannabis prick tests and IgE were useful in detecting sensitisation.
Opiates may be significant allergens. Drug-abusers and people sensitised to tobacco are at risk. Both the prick and specific IgE tests efficiently detected sensitisation to opiates. The highest levels were related to more-severe clinical profiles.
Background: Wheat is a potent allergen source and is one of the causes of baker's asthma and food allergy. The best strategy for managing food hypersensitivity involves strict avoidance of the trigger. However, wheat is quite difficult to avoid. Several alternative strategies for the treatment of food allergy are under study. Spelt is a possible hypoallergenic crop that may be tried in patients with wheat allergy. Methods: We have evaluated the allergenic IgE hypersensitivity mediated by spelt in wheat allergic patients. Overall, 66 patients who suffered from baker's asthma or food allergy (45 males and 21 females, mean age 28.6 ± 12.9 years) were included. We have also compared its reactivity with standardized extracts from wheat and with purified non-specific lipid transfer proteins from wheat (Tri a 14) and from peach (Pru p 3). Immunodetection with spelt and common bread wheat extracts (Triticum aestivum, cultivar Astral) was performed. Fresh wheat and spelt grain extracts were used both for oral and bronchial challenge and skin tests. Specific IgE detection to different cereals was performed using the Immuno CAP System (Phadia, Uppsala, Sweden). The bronchial challenge was positive with wheat Astral in 44 (67%) patients, all of them suffered from asthma. Thirteen (29.54%) of these 44 patients had negative the challenge with spelt. The oral challenge with wheat Astral was positive in 22 (33%) patients with wheat food allergy, and the same test was positive in only in 6 of them with spelt (27.3%). The diagnostic yield (sensitivity, specificity and predictive values) of routine tests in determining spelt allergy by specific positive challenge responses was determined. Prick tests for spelt versus positive challenge tests had a good sensitivity (94%, 86.5 -99.4; 95% CI) and specificity (86%, 84 -90; 95% CI) for the diagnosis of spelt allergy. Immunodetection detected minor differences among different extracts. Conclusion: In summary, the prick test and bronchial and oral challenges both efficiently detected sensitization to spelt and their levels were related to more severe clinical profiles, but the wheal area was significantly lower with spelt (p < 0.001) and the percentage of positive challenge tests decreased. Our results suggest that spelt is an old crop that may be tried in patients with wheat allergy.
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