Sensitization to PR-10 proteins is indicative of distinctive sensitization patterns in adults with a suspected food allergy

Abstract

BackgroundThe extent of co-sensitization within and between food protein families in an adult population is largely unknown. This study aimed to identify the most frequently recognized components in the PR-10 and storage protein family, as well as patterns in (co-)sensitization, in a birch-endemic area.MethodsResults of ImmunoCAP ISAC, performed during routine care in Dutch adult outpatients suspected of food allergy, were collected.ResultsA total of 305 patients were selected, aged 16–79 years (median 32 years). Sensitization to one or more PR-10 proteins was most frequent (74% of all subjects), followed by 35% to storage protein and 15% to nsLTPs. Within the PR-10 family, subjects were most often sensitized to Bet v 1 (73% of 305), Cor a 1.04 (72%) and Mal d 1 (68%). Sensitization to PR-10s from soy, celery and kiwi occurred distinctively less often (< 55% of Bet v 1 sensitized subjects) compared to other food PR-10s (all > 70%). Subjects sensitized to these ‘less common PR-10 proteins’ were sensitized to more food and inhalant components on the ISAC, compared to subjects sensitized to ‘common PR-10 proteins’ (median 22 vs 13 out of 112, p < 0.0001). Seven subjects demonstrated sensitization to food PR-10 proteins, without concomitant sensitization to pollen PR-10s. Within the storage proteins, sensitization to multiple peanut allergens was most common (on average 3 out of 4).ConclusionsSensitization to PR-10 food proteins could occur without concomitant sensitization to common PR-10 from pollen in a subset of subjects. Less commonly recognized PR-10 proteins appear to be an indication of polysensitization.Electronic supplementary materialThe online version of this article (10.1186/s13601-017-0177-4) contains supplementary material, which is available to authorized users.

Birch pollen allergy in Europe

“…The degree of birch pollen–related food cross‐reactivity is highly dependent on structural conformation and is determined by the epitope repertoire recognized by the specific IgE antibodies of individual patients . Some PR‐10 food proteins like apple and hazelnut are more frequently recognized than others like soy, celery, and kiwi, indicating differences in the degree of homology …”

High-Yield Production of the Major Birch Pollen Allergen Bet v 1 With Allergen Immunogenicity in Nicotiana benthamiana

“…More than 70% of birch pollen allergic patients reported an allergic reaction to at least 1 of 16 foods analyzed, and among them, apple was the food most commonly related to the induction of allergic symptoms (Geroldinger-Simic et al, 2011). Because the degree of IgE cross-reactivity highly depends on the structural conformation of the allergens, the amino acid similarity, and the epitopes repertoire, some PR-10 proteins including those produced by apple and hazelnut are more often recognized by these patients, as compared to others such as those derived from soybean and celery (Blankestijn et al, 2017). The PR-10 proteins of apple and hazelnut Mal d 1 and Cor a 1 show, respectively, 80 and 59% amino acid sequence similarity with Bet v 1, whereas those of soybean and celery, Gly m 4 and Api g 1, show only 14 and 16%, respectively (Blankestijn et al, 2017).…”

“…Because the degree of IgE cross-reactivity highly depends on the structural conformation of the allergens, the amino acid similarity, and the epitopes repertoire, some PR-10 proteins including those produced by apple and hazelnut are more often recognized by these patients, as compared to others such as those derived from soybean and celery (Blankestijn et al, 2017). The PR-10 proteins of apple and hazelnut Mal d 1 and Cor a 1 show, respectively, 80 and 59% amino acid sequence similarity with Bet v 1, whereas those of soybean and celery, Gly m 4 and Api g 1, show only 14 and 16%, respectively (Blankestijn et al, 2017). Birch pollen immunotherapy using a mouse model that mimics birch pollen-induced cross-reactivity to Mal d 1 significantly reduced the anaphylaxis induced by Mal d 1 (Utsch et al, 2016).…”

Highlights and recent developments in food and drug allergy, and anaphylaxis in EAACI Journals (2017)

“…16 Sensitization to PR-10 proteins is indicative of distinctive sensitization patterns in adults with a suspected food allergy. 17 Sensitization to PR-10 food proteins could occur without concomitant sensitization to common PR-10 from pollen in a subset of subjects. Less commonly recognized PR-10 proteins appear to be an indication of polysensitization.…”