Oral allergy syndrome to grapes

Giannoccaro, F.; Munno, G.; Riva, G; Pugliese, Steven C.; Paradiso, M. T.; Ferrannini, A.

doi:10.1111/j.1398-9995.1998.tb03923.x

Cited by 21 publications

(9 citation statements)

References 4 publications

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“…Although IgE-mediated hypersensitivity to grapes has been considered an uncommon problem [3], often associated with oral allergy syndrome reactions [26,27,28], we describe a group of 37 children and young adults, who had faced one or more severe reactions after the consumption of grapes. This cohort suggests that grape allergy may not be a trivial problem requiring epidemiological evaluation as well as elucidation of the mechanisms involved in terms of primary sensitisation, occurring symptoms, molecular structure and cross-reactions as well as clinical relevance of allergens involved in allergic reactions.…”

Section: Discussionmentioning

confidence: 99%

Severe Immediate Allergic Reactions to Grapes: Part of a Lipid Transfer Protein-Associated Clinical Syndrome

Vassilopoulou

Zuidmeer

Akkerdaas

et al. 2007

Int Arch Allergy Immunol

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Background: Grape allergy is considered rare; grape lipid transfer protein (LTP; Vit v 1), an endochitinase and a thaumatin-like protein (TLP) have been reported as grape allergens. A considerable number of patients have referred to our department for severe reactions to grapes, and several IgE binding proteins were detected. Objectives: The aim of this study was to identify and characterise the allergens involved in severe allergic reactions to grapes and describe the population in which they occur. Methods: Patients with reported severe allergic reactions to grapes (n = 37) are described. Grape allergens were purified/fractionated by a combination of chromatographic techniques, identified by proteomic analysis and biochemically characterised. Immunoreactivity was assessed by blot (inhibitions) and RAST (inhibitions), and skin prick tests were performed with the isolated allergens. Results: All subjects were polyallergic, sensitised and reactive to several additional foods and pollen. All patients were sensitised to grape LTP. A 28-kDa expansin, a 37.5-kDa polygalacturonase-inhibiting protein, a 39-kDa β-1,3-glucanase and a 60-kDa protein were identified as minor grape allergens. Endochitinase and TLP did not play a role. Inhibition experiments revealed the possible cross-reactive role of LTP for clinical sensitivities to other LTP-containing plant foods, but also the involvement of cross-reactive carbohydrate determinants of minor allergens in IgE cross-reactivity. Conclusions: LTP is the major grape allergen, while additional minor allergens may contribute to clinical reactivity. Severe grape allergy presents in atopic patients who frequently react to other LTP-containing, plant-derived foods. The ‘LTP syndrome’ is the appropriate term to describe this condition.

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Section: Discussionmentioning

confidence: 99%

Severe Immediate Allergic Reactions to Grapes: Part of a Lipid Transfer Protein-Associated Clinical Syndrome

Vassilopoulou

Zuidmeer

Akkerdaas

et al. 2007

Int Arch Allergy Immunol

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“…Most patients reported with grape allergy did not tolerate any grape species, wine or raisins [3,4,5,6,7,8]. Only 1 patient seems to have a grape allergy specific to a certain Americana blue grape but tolerance to other grapes [3].…”

Section: Discussionmentioning

confidence: 99%

“…Grapes grown in temperate and subtropical areas on all continents are widely consumed as fresh fruit, juice and wine. However, allergy to grapes has been rarely reported [3,4,5,6,7,8]. In a recent study, endochitinase 4, LTP Vit v 1 (accession No.…”

Section: Introductionmentioning

confidence: 99%

Wine Anaphylaxis in a German Patient: IgE-Mediated Allergy against a Lipid Transfer Protein of Grapes

Schäd

Trcka

Vieths

et al. 2005

Int Arch Allergy Immunol

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Background: IgE-mediated allergy to grapes has very rarely been reported in patients from the Mediterranean area. Recently, endochitinase 4 and a lipid transfer protein (LTP) have been identified as major allergens in grape-allergic patients who do not have an associated pollinosis. The purpose of this case study was to identify the allergens responsible for severe anaphylactic reactions after consumption of wine, fresh grapes and raisins in a German patient. Methods: Prick-to-prick tests and the basophil activation test (BAT) were performed to confirm allergy. Specific IgE was further analyzed by immunoblotting and inhibition tests for the determination of crossreactivity. The IgE-binding protein was subjected to N-terminal microsequencing. Results: Prick-to-prick tests were positive to fresh and cooked white and blue grapes, to raisins, to white and red wine, and to grape extract. Specific IgE against grapes (f259) was 2.43 kU/l (class 2). The BAT showed specific IgE-mediated activation of basophils after stimulation with grape extract. IgE binding to a 15-kDa protein was completely inhibited by pre-incubation with recombinant cherry LTP Pru av 3. N-terminal sequencing identified this 15-kDa protein as grape LTP Vit v 1. Conclusion: Our data show that sensitization to LTP can occur outside the Mediterranean area causing severe fruit allergy without association to pollinosis.

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“…Recent studies have shown a possible relation between allergic reactions to grapes and other fruits. 2 Sensitisation to apple, peach, cherry, and banana was also investigated using prick-to-prick tests. Investigation of atopy using skin prick tests with 10 commercial allergens was not possible on all employees due to the production schedule of the winery.…”

Section: Methodsmentioning

confidence: 99%

Asymptomatic sensitisation to grapes in a sample of workers in the wine industry: Table 1

Kalogeromitros

Rigopoulos²,

Gregoriou³

et al. 2004

Occup Environ Med

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Aims: To assess the prevalence of sensitisation to grapes (Vitis vinifera var. agiorghitiko) in a population with repeated exposure to grape allergens through direct cutaneous contact as well as through the gastrointestinal tract. Methods: One hundred and twenty subjects were enrolled in each of four groups: grape harvesters, winery workers in selection of grapes, winery workers operating de-stemming/ crushing/pressing machines, and administrative personnel. Sensitisation to grapes was examined by skin prick-to-prick tests with fresh fruit and juice. Results: Eight harvesters and five workers in grape selection had positive reaction to the grapes tested. No machine operators or administrative personnel had positive tests. The likelihood of sensitisation was estimated at 3.7% per year of occupation by logistic regression analysis. None of the employees reported symptoms associated with sensitisation to grapes. Conclusion: Asymptomatic sensitisation to grapes was detected only in workers handling the fruit, suggesting that sensitisation is more likely to occur through cutaneous exposure and/or minor wounding than through the gastrointestinal tract. Prevalence rates were high and the clinical impact needs to be further investigated.

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Oral allergy syndrome to grapes

Abstract: ACKNOWLEDGMENTWe thank the agronomist Dr Carlo Colella for his valuable technical assistance.

Cited by 21 publications

References 4 publications

Severe Immediate Allergic Reactions to Grapes: Part of a Lipid Transfer Protein-Associated Clinical Syndrome

Severe Immediate Allergic Reactions to Grapes: Part of a Lipid Transfer Protein-Associated Clinical Syndrome

Wine Anaphylaxis in a German Patient: IgE-Mediated Allergy against a Lipid Transfer Protein of Grapes

Asymptomatic sensitisation to grapes in a sample of workers in the wine industry: Table 1

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