Do <b><i>Plantago lanceolata</i></b> Skin Prick Test-Positive Patients Display IgE to Genuine Plantain Pollen Allergens? Investigation of Pollen Allergic Patients from the North-East of France

Abstract

Background: English plantain (Plantago lanceolata) is an important weed pollen allergen source triggering allergic symptoms during summer. To elucidate genuine versus cross-reactive sensitization, we investigated IgE reactivity patterns and inhibition capacities of plantain-sensitized patients. Methods: Sera of 35 rhinoconjunctivitis patients from the north-east of France with positive skin prick tests (SPT) to Plantago lanceolata pollen were tested with clinically relevant allergen sources using ELISA, ImmunoCAP, and immunoblot inhibition. Results: The patients were multisensitized with additional reactivity to grass (94.3%), ash (74.3%), birch (71.4%), and mugwort (55.2%) pollen in SPT. Sensitization prevalence to allergen molecules was 34.3% (Pla l 1), 94.3% (Phl p 1/5), 60.0% (Ole e 1), 65.7% (Bet v 1), 37.1% (profilin), and 40.0% (CCD). In immunoblot, IgE reactivity to plantain pollen was inhibited with relevant pollen extracts and purified rPla l 1. Two sera did not reveal any IgE cross-reactivity, while reactivity to plantain was efficiently inhibited by grass pollen in the sera of 10 patients. The sera from 17 different patients could be inhibited by grass, birch, or ash pollen to varying degrees. Thus, only 37.1% of our patients demonstrated true plantain pollen sensitization, while 62.9% were solely positive due to IgE cross-reactive molecules from other clinically relevant pollen. Conclusions: Plantain pollen-sensitized patients are multi-reactors demonstrating varying and complex IgE-reactivity profiles. In vivo and in vitro tests using extracts are typically blurred due to the presence of homologous allergens or CCD in grass, birch, or ash pollen. So far, Pla l 1 represents the only indicative marker allergen for the diagnosis of genuine plantain pollen sensitization.

The Incidence of Allergy to Common Allergens Based on a Retrospective Analysis

“…they are sensitive to two or more allergens. This is consistent with the data from the US, where the exposure to numerous allergens simultaneously is also quite common, but with differences observed in scope of the dominant allergens in various households [63][64][65][66]. The study revealed that allergies as a result of exposure to environmental allergens are a major public health problem [67].…”

Frequent IgE recognition of Blomia tropicalis allergen molecules in asthmatic children and young adults in equatorial Africa

“…SPT were performed on the forearm, in the absence of antihistamine intake for at least one week (Alk-Abello, Horsholm, Denmark). The test was considered positive if the greatest diameter of the wheal was >3 mm or >50% of the greatest diameter of the positive control (histamine solution at 1/1000) ( 29 ). Each positive test was recorded in mm, by measuring the greatest diameter of the wheal ( Table 1 ).…”

EAACIMolecular Allergology User's Guide 2.0

“…In the general adolescent population in Austria, sensitization to the genuine and major allergen Pla l 1 was as high as 10.4% 666 . While an association with grass pollen or pan‐allergen sensitization is frequently observed, genuine Pla l 1‐related plantain allergy represents a true co‐sensitization 358,678,679 …”

“…666 While an association with grass pollen or panallergen sensitization is frequently observed, genuine Pla l 1-related plantain allergy represents a true co-sensitization. 358,678,679 High levels of reactivity to Mercurialis annua pollen ranging from 28-56% were observed in several areas of Spain. 680 Due to use of Chenopodium album in greening programs, the weed gained relevance in countries with desert and semi-desert areas accounting for up to 70.7% sensitization in asthmatic patients.…”