Nora Nilsson1,2, Caroline Nilsson3, Helena Ekoff4, Sandra Wieser-Pahr5,6, Magnus P Borres4,7, Rudolf Valenta5,6, Gunilla Hedlin1,2, Sigrid Sjölander4. 1. Lung/Allergy Department, Karolinska Institutet and Karolinska University Hospital, Astrid Lindgren Children's Hospital, Stockholm, Sweden. 2. Centre for Allergy Research, Karolinska Institutet, Stockholm, Sweden. 3. Department of Clinical Science and Education, Södersjukhuset, Karolinska Institutet and Sachs Children's Hospital, Stockholm, Sweden. 4. Thermo Fisher Scientific, ImmunoDiagnostics, Uppsala, Sweden. 5. Division of Immunopathology, Department of Pathophysiology and Allergy Research, Center of Pathophysiology, Infectiology and Immunology, Medical University of Vienna, Vienna, Austria. 6. Christian Doppler Laboratory for the Development of Allergen Chips, Medical University of Vienna, Vienna, Austria. 7. Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden.
Abstract
BACKGROUND: Specific immunoglobulin E (IgE) sensitization to wheat is more common than a doctor's confirmed wheat allergy and is also frequently observed in grass pollen-allergic patients (pollinosis patients). Thus, the objective of this study was to investigate the level and feature of serological IgE cross-reactivity between grass pollen and wheat in a cohort of pollinosis subjects with no diagnosis of wheat allergy. METHODS: Seventy-two children, aged 5-17 years, with a doctor's diagnosis of pollinosis, IgE towards grass pollen, and currently eating wheat were recruited. Serum samples were analyzed for IgE against wheat, timothy grass/wheat-specific allergen components, Pru p 3, and cross-reactive carbohydrate determinants (CCD) and specific IgE-binding inhibition experiments were performed. RESULTS: Sixty percent of the grass pollen subjects were sensitized to wheat with a median of 0.5 kUA/L. Wheat-sensitized subjects were more often sensitized to the two allergens, Phl p 12 and CCD, known to be cross-reactive between grass and wheat. Sensitizations to seven wheat-specific allergens derived from the gluten fraction were, with the exception of one individual, only found in wheat-sensitized subjects. These subjects also more often reported current and past history of allergy to staple foods (milk, egg, wheat, soy, and fish). CONCLUSION: Wheat sensitization caused by cross-reactivity but also by sensitization to wheat-specific allergens was common in the grass-allergic children and also associated with allergy to staple foods other than wheat. The results indicate the presence of a subgroup of pollinosis patients with simultaneous sensitization to wheat and food allergy not only caused by cross-reactions.
BACKGROUND: Specific immunoglobulin E (IgE) sensitization to wheat is more common than a doctor's confirmed wheatallergy and is also frequently observed in grass pollen-allergicpatients (pollinosispatients). Thus, the objective of this study was to investigate the level and feature of serological IgE cross-reactivity between grass pollen and wheat in a cohort of pollinosis subjects with no diagnosis of wheatallergy. METHODS: Seventy-two children, aged 5-17 years, with a doctor's diagnosis of pollinosis, IgE towards grass pollen, and currently eating wheat were recruited. Serum samples were analyzed for IgE against wheat, timothy grass/wheat-specific allergen components, Pru p 3, and cross-reactive carbohydrate determinants (CCD) and specific IgE-binding inhibition experiments were performed. RESULTS: Sixty percent of the grass pollen subjects were sensitized to wheat with a median of 0.5 kUA/L. Wheat-sensitized subjects were more often sensitized to the two allergens, Phl p 12 and CCD, known to be cross-reactive between grass and wheat. Sensitizations to seven wheat-specific allergens derived from the gluten fraction were, with the exception of one individual, only found in wheat-sensitized subjects. These subjects also more often reported current and past history of allergy to staple foods (milk, egg, wheat, soy, and fish). CONCLUSION:Wheat sensitization caused by cross-reactivity but also by sensitization to wheat-specific allergens was common in the grass-allergicchildren and also associated with allergy to staple foods other than wheat. The results indicate the presence of a subgroup of pollinosispatients with simultaneous sensitization to wheat and food allergy not only caused by cross-reactions.