Does SIT to Der p protect from snail sensitization?

Meglio, Paolo; Plantamura, M.; Arabito, E.; Falagiani, P.; Torre, Amy B De La; Rossi, Paolo

doi:10.1034/j.1398-9995.2002.23575_12.x

Cited by 17 publications

(8 citation statements)

References 7 publications

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“…There are reports that subjects already clinically allergic to foods containing tropomyosin may worsen their food allergy symptoms following mite immunotherapy [14,15], but this is a different issue. Indeed, in a study on two groups of children, respectively treated or not by mite immunotherapy for a mean duration of 19 months, the only new sensitization to snail was found among children not treated with immunotherapy [16]. Of course, the eating habit is an important factor: in the study by Meglio et al less than 20% of children had previously eaten snails [16], but in the study by Asero et al all the included patients ate crustaceans and molluscs of any kind with no clinical reaction [9].…”

Section: Discussionmentioning

confidence: 99%

“…Indeed, in a study on two groups of children, respectively treated or not by mite immunotherapy for a mean duration of 19 months, the only new sensitization to snail was found among children not treated with immunotherapy [16]. Of course, the eating habit is an important factor: in the study by Meglio et al less than 20% of children had previously eaten snails [16], but in the study by Asero et al all the included patients ate crustaceans and molluscs of any kind with no clinical reaction [9]. It is also true that a sensitisation to shrimp's tropomyosin can be found in subjects allergic to mites who never ate shrimps or shellfish [17].…”

Section: Discussionmentioning

confidence: 99%

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Lack of neo-sensitization to Pen a 1 in patients treated with mite sublingual immunotherapy

Rossi¹,

Monasterolo²,

Incorvaia³

et al. 2010

Clin Mol Allergy

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BackgroundSome studies reported the possible induction of food allergy, caused by neo-sensitization to cross-reacting allergens, during immunotherapy with aeroallergens, while other studies ruled out such possibility.ObjectivesThe aim of this study was to evaluate the development of neo-sensitization to Pen a 1 (tropomyosin) as well as the appearance of reactions after ingestion of foods containing tropomyosin as a consequence of sublingual mite immunization.Materials and methodsSpecific IgE to Tropomyosin (rPen a 1) before and after mite sublingual immunotherapy in 134 subjects were measured. IgE-specific antibodies for mite extract and recombinant allergen Pen a 1 were evaluated using the immunoenzymatic CAP system (Phadia Diagnostics, Milan, Italy).ResultsAll patients had rPen a 1 IgE negative results before and after mite SLIT and did not show positive shrimp extract skin reactivity and serological rPen a 1 IgE conversion after treatment. More important, no patient showed systemic reactions to crustacean ingestion.ConclusionsPatients did not show neo-sensitization to tropomyosin, a component of the extract (namely mite group 10) administered. An assessment of a patient's possible pre-existing sensitisation to tropomyosin by skin test and/or specific IgE prior to start mite extract immunotherapy is recommended.Trial RegistrationThis trial is registered in EudraCT, with the ID number of 2010-02035531.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Lack of neo-sensitization to Pen a 1 in patients treated with mite sublingual immunotherapy

Rossi¹,

Monasterolo²,

Incorvaia³

et al. 2010

Clin Mol Allergy

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“…However, a recent study shows that mite immunotherapy does not seem to induce de novo tropomyosin sensitization in miteallergic patients [59]. Concerning mollusks, reports have suggested that mite immunotherapy should be avoided in patients with combined mite-snail allergy [60], although other authors have suggested contradictory results [61].…”

Section: Crossreactivity and Special Considerations For Immunotherapymentioning

confidence: 97%

Mite immunotherapy

Fernández-Caldas¹,

Iraola²,

Boquete³

et al. 2006

Curr Allergy Asthma Rep

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Dermatophagoides pteronyssinus and D. farinae are the most common house dust mites and are among the most common sources of indoor allergens worldwide. These species are very common in humid regions, where most allergic individuals are sensitized to house dust mites. Specific immunotherapy with mite extracts has demonstrated clinical benefits in several double-blind, placebo-controlled trials that are included in recent reviews of subcutaneous immunotherapy, including pediatric and adult patients with rhinoconjunctivitis and or asthma. Most successful studies of mite immunotherapy have used native allergen extracts adsorbed onto aluminum hydroxide, or chemically modified mite-allergen extracts. Several studies have also shown efficacy using sublingual immunotherapy in pediatric and adult patients with asthma and/or rhinitis. Additionally, the efficacy of subcutaneous immunotherapy has been demonstrated in patients with atopic dermatitis, although more double-blind, placebo-controlled studies are needed. Based on several studies, it cannot be concluded that mite immunotherapy is more dangerous or safer than immunotherapy with grasses, epithelia, or animal epithelia. Because the delivery of high doses of allergen carries with it the risk for immunoglobulin E (IgE)-mediated events, several methods have been developed to reduce specific IgE binding to mite-allergen extracts. An important challenge for future mite immunotherapy modalities is the delivery of relatively high doses without a significant risk for severe reactions.

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“…One paper reported success with mugwort/ragweed SIT in a patient with associated OAS to fennel, cucumber and melon (196). The SIT with house dust mite has been associated with the induction (98, 197, 198) or deterioration (199) of snail allergy – suggesting to avoid SIT to house dust mites in patients with snail allergy – as well as protection against possible sensitization to snails (200).…”

Section: Therapeutic Optionsmentioning

confidence: 99%

Allergic cross‐reactivity: from gene to the clinic

Ferreira

Hawranek

Gruber

et al. 2004

Allergy

228

163

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A large number of allergenic proteins have now their complete cDNA sequences determined and in some cases also the 3D structures. It turned out that most allergens could be grouped into a small number of structural protein families, regardless of their biological source. Structural similarity among proteins from diverse sources is the molecular basis of allergic cross‐reactivity. The clinical relevance of immunoglobulin E (IgE) cross‐reactivity seems to be influenced by a number of factors including the immune response against the allergen, exposure and the allergen. As individuals are exposed to a variable number of allergenic sources bearing homologous molecules, the exact nature of the antigenic structure inducing the primary IgE immune response cannot be easily defined. In general, the ‘cross‐reactivity’ term should be limited to defined clinical manifestations showing reactivity to a source without previous exposure. ‘Co‐recognition’, including by definition ‘cross‐reactivity’, could be used to describe the large majority of the IgE reactivity where co‐exposure to a number of sources bearing homologous molecules do not allow unequivocal identification of the sensitizing molecule. The analysis of reactivity clusters in diagnosis allows the interpretation of the patient's reactivity profile as a result of the sensitization process, which often begins with exposure to a single allergenic molecule.

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Does SIT to Der p protect from snail sensitization?

Cited by 17 publications

References 7 publications

Lack of neo-sensitization to Pen a 1 in patients treated with mite sublingual immunotherapy

Lack of neo-sensitization to Pen a 1 in patients treated with mite sublingual immunotherapy

Mite immunotherapy

Allergic cross‐reactivity: from gene to the clinic

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