Arnon Elizur1, Michael Y Appel2, Liat Nachshon3, Michael B Levy2, Naama Epstein-Rigbi2, Bo Pontoppidan4, Jonas Lidholm4, Michael R Goldberg2. 1. Institute of Allergy, Immunology and Pediatric Pulmonology and Department of Pediatrics, Yitzhak Shamir Medical Center, Zerifin, Israel; Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel. Electronic address: elizura@gmail.com. 2. Institute of Allergy, Immunology and Pediatric Pulmonology and Department of Pediatrics, Yitzhak Shamir Medical Center, Zerifin, Israel. 3. Institute of Allergy, Immunology and Pediatric Pulmonology and Department of Pediatrics, Yitzhak Shamir Medical Center, Zerifin, Israel; Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel. 4. Thermo Fisher Scientific, Uppsala, Sweden.
Abstract
BACKGROUND: Diagnostic methods for distinguishing walnut-allergic patients from walnut-sensitized but walnut-tolerant individuals are limited. Furthermore, characteristics of single walnut versus dual walnut-pecan allergy are lacking. OBJECTIVE: To provide clinical and molecular characteristics of walnut- and pecan-allergic patients. METHODS: A prospective cohort study of 76 walnut-sensitized patients was performed. Walnut skin prick test and serum measurements of specific IgE to walnut and its components were performed. Patients were challenged to walnut and pecan unless they regularly consumed walnut and pecan. RESULTS: Of the 76 patients studied, 61 were diagnosed as walnut-allergic and 15 as walnut-tolerant. IgE levels greater than or equal to 0.35 kUA/L to Jug r 1 or 4 provided the best diagnostic method for identifying walnut-allergic patients (accuracy, 0.93). Of the 61 walnut-allergic patients, 49 were pecan-allergic whereas 12 were pecan-tolerant. None of the walnut-tolerant patients was allergic to pecan. Dual allergic patients had significantly lower walnut reaction dose (median, 100 mg vs 1230 mg; P < .001). IgE levels greater than or equal to 0.35 kUA/L to Jug r 4, low-molecular-weight vicilins, or high-molecular-weight vicilins best segregated dual walnut-pecan-allergic patients from single walnut-allergic patients. Inhibition studies demonstrated that walnut pretreatment completely blocked IgE binding to pecan, whereas in some patients, pecan incubation only partially blocked IgE binding to walnut. CONCLUSIONS: Walnut components are helpful in diagnosing walnut allergy and in identifying patients with pecan coallergy. Competitive ELISA indicates that pecan comprises a subset of the allergenic determinants of walnut.
BACKGROUND: Diagnostic methods for distinguishing walnut-allergicpatients from walnut-sensitized but walnut-tolerant individuals are limited. Furthermore, characteristics of single walnut versus dual walnut-pecanallergy are lacking. OBJECTIVE: To provide clinical and molecular characteristics of walnut- and pecan-allergicpatients. METHODS: A prospective cohort study of 76 walnut-sensitized patients was performed. Walnut skin prick test and serum measurements of specific IgE to walnut and its components were performed. Patients were challenged to walnut and pecan unless they regularly consumed walnut and pecan. RESULTS: Of the 76 patients studied, 61 were diagnosed as walnut-allergic and 15 as walnut-tolerant. IgE levels greater than or equal to 0.35 kUA/L to Jug r 1 or 4 provided the best diagnostic method for identifying walnut-allergicpatients (accuracy, 0.93). Of the 61 walnut-allergicpatients, 49 were pecan-allergic whereas 12 were pecan-tolerant. None of the walnut-tolerant patients was allergic to pecan. Dual allergicpatients had significantly lower walnut reaction dose (median, 100 mg vs 1230 mg; P < .001). IgE levels greater than or equal to 0.35 kUA/L to Jug r 4, low-molecular-weight vicilins, or high-molecular-weight vicilins best segregated dual walnut-pecan-allergicpatients from single walnut-allergicpatients. Inhibition studies demonstrated that walnut pretreatment completely blocked IgE binding to pecan, whereas in some patients, pecan incubation only partially blocked IgE binding to walnut. CONCLUSIONS: Walnut components are helpful in diagnosing walnut allergy and in identifying patients with pecan coallergy. Competitive ELISA indicates that pecan comprises a subset of the allergenic determinants of walnut.
Authors: Stephen C Dreskin; Stef J Koppelman; Sandra Andorf; Kari C Nadeau; Anjeli Kalra; Werner Braun; Surendra S Negi; Xueni Chen; Catherine H Schein Journal: J Allergy Clin Immunol Date: 2020-11-18 Impact factor: 10.793
Authors: John T Lovell; Nolan B Bentley; Gaurab Bhattarai; Jerry W Jenkins; Avinash Sreedasyam; Yanina Alarcon; Clive Bock; Lori Beth Boston; Joseph Carlson; Kimberly Cervantes; Kristen Clermont; Sara Duke; Nick Krom; Keith Kubenka; Sujan Mamidi; Christopher P Mattison; Maria J Monteros; Cristina Pisani; Christopher Plott; Shanmugam Rajasekar; Hormat Shadgou Rhein; Charles Rohla; Mingzhou Song; Rolston St Hilaire; Shengqiang Shu; Lenny Wells; Jenell Webber; Richard J Heerema; Patricia E Klein; Patrick Conner; Xinwang Wang; L J Grauke; Jane Grimwood; Jeremy Schmutz; Jennifer J Randall Journal: Nat Commun Date: 2021-07-05 Impact factor: 14.919