Allergy Asthma Immunol Res.  2016 Nov;8(6):505-511. 10.4168/aair.2016.8.6.505.

Clinical Significance of Component Allergens in Fagales Pollen-Sensitized Peanut Allergy in Korea

• Park KH
• Son YW
• Lee SC
• Jeong K
• Sim DW
• Park HJ
• Lee S
• Lee JH
• Park JW

• KMID: 2349990
• DOI: http://doi.org/10.4168/aair.2016.8.6.505

Abstract

PURPOSE
Clinical features of peanut allergy can range from localized to systemic reactions. Because peanut and birch pollen have cross-reactivity, peanut can lead to localized allergic reaction in Fagales pollen-sensitized oral allergy syndrome (OAS) patients without peanut sensitization per se. The purpose of this study was to discriminate true peanut food allergy from cross-reactive hypersensitivity in birch-sensitized peanut allergy.
METHODS
Birch-sensitized (n=81) and peanut anaphylaxis patients (n=12) were enrolled. Peanut-related allergic reactions and sensitization profiles were examined. Specific IgE to Fagales tree pollens (birch, oak), peanut, and their component allergens (Bet v 1, Bet v 2, Ara h 1, Ara h 2, Ara h 3, Ara h 8, and Ara h 9) were evaluated. Based on these specific IgEs and clinical features, the patients were classified into 4 groups: group 1 (Fagales pollen allergy without OAS), group 2 (Fagales pollen allergy with OAS), group 3 (OAS with peanut anaphylaxis), and group 4 (peanut anaphylaxis).
RESULTS
After peanut consumption, one-third of OAS patients experienced oral symptoms not associated with peanut sensitization. Ara h 1 or Ara h 2 was positive in peanut anaphylaxis patients, whereas Ara h 8 was positive in OAS patients. There were 4 patients with both peanut anaphylaxis and OAS (group 3). Both Ara h 2 and Ara h 8 were positive in these patients. Foods associated with OAS in Korea showed unique patterns compared to Westernized countries.
CONCLUSIONS
Ara h 2 and Ara h 8 may be important component allergens for discriminating peanut allergy.

Keyword

Allergens; IgE; peanut hypersensitivity; pollen; trees

MeSH Terms

Allergens*
Anaphylaxis
Arachis*
Betula
Food Hypersensitivity
Humans
Hypersensitivity
Immunoglobulin E
Korea*
Peanut Hypersensitivity*
Pollen
Rhinitis, Allergic, Seasonal
Trees
Allergens
Immunoglobulin E

Figure

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  Fig. 1 Classification of participating patients into 4 groups. OAS, oral allergy syndrome.

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  Fig. 2 Sensitization profiles of peanut allergens. (A) Positive rates, (B) Specific (IgE titers to total and component peanut allergens. *P value<0.05; **P value<0.005.

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  Fig. 3 Sensitization profiles of peanut allergens in peanut allergic patients. (A) Positive rates, (B) Specific IgE titers to total and component peanut allergens in patients with peanut allergy. *P value<0.05; **P value<0.005.

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  Fig. 4 Specific IgE titers to total and component tree pollen allergens in patients with and without oral allergy syndrome (OAS). *P value<0.05; **P value<0.005.

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  Fig. 5 Receiver operating characteristic (ROC) curve of specific sIgE titers for prediction of oral allergy syndrome (OAS). AUC, area under the curve; CI, confidence interval.

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