Riccardo Asero1, Renato Ariano2, Arianna Aruanno3, Claudio Barzaghi4, Paolo Borrelli5, Moira Busa6,7, Giorgio Celi8, Massimo Cinquini9, Gabriele Cortellini10, Francesca D'Auria11, Marco De Carli12, Camilla Di Paolo9, Giulia Garzi13, Fabio Lodi Rizzini14, Monica Magnani15, Giuseppina Manzotti16, Alessandro Marra4, Stefano Miceli Sopo17, Francesco Murzilli18, Eleonora Nucera3, Elena Pinter13, Valerio Pravettoni19, Federica Rivolta19, Angela Rizzi3, Nicoletta Saporiti20, Enrico Scala21, Danilo Villalta22, Mona-Rita Yacoub20, Giuliana Zisa23. 1. Ambulatorio di Allergologia, Clinica san Carlo, Paderno Dugnano (MI), Italia. 2. Private Practice, Liguria, Italy. 3. Fondazione Policlinico Universitario A. Gemelli- IRCCS Università Cattolica del Sacro Cuore, Roma, Italy. 4. Ambulatorio di Allergologia, UOC Medicina, ASST Rhodenese, P.O Rho, Rho, Italia. 5. SSD Dermatologia e Allergologia - Ospedale Beauregard, Aosta, Italia. 6. Ambulatorio di Allergologia U.O.S. Dermatologia Ospedale di Mirano (VE), Mirano, Italia. 7. Ambulatorio di Allergologia Ospedale di Bassano del Grappa (VI), Bassano del Grappa, Italia. 8. Clinica Villa Pia, Roma, Italy. 9. SSVD Allergologia, Spedali Civili Brescia, Italia. 10. UOD Allergologia, Az Sanitaria della Romagna, Rimini, Italia. 11. ASST Bergamo Ovest, Bergamo, Italia. 12. S.O.C Medicina 2, Presidio Ospedaliero "Santa Maria della Misericordia", Udine, Italy. 13. Ambulatorio di Allergologia, UOC Medicina Interna ed Immunologia Clinica, Policlinico Umberto I, Roma, Italia. 14. Dipartimento Scienze Cliniche e Sperimentali, Università Studi Brescia / SSVD Allergologia, Spedali Civili Brescia, Italy. 15. Allergologia U.O.C.P.S. AUSL Bologna, Bologna, Italia. 16. Ambulatorio di Allergologia, Casa di Cura Beato Palazzolo, Bergamo, Italia. 17. Pediatric Allergy Unit, Pediatrics Area, Department of Life Sciences and Public Health, Policlinico Gemelli Fondazione Universitaria IRCCS, Università Cattolica del Sacro Cuore, Roma, Italia. 18. U.O.S.D. di Allergologia, Ospedale S.S. Filippo e Nicola, Avezzano (AQ), Italy. 19. UOC General Medicine Immunology and Allergology - IRCCS Foudation Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy. 20. Unit of Immunology, Rheumatology, Allergy and Rare Diseases, IRCCS Ospedale San Raffaele, Milano, Italy. 21. Istituto Dermopatico dell'Immacolata, Rome, Italy. 22. Immunologia e Allergologia, Ospedale S. Maria degli Angeli, Pordenone, Italia. 23. S.S. Allergologia e Immunologia Clinica, S.C.D.U. Medicina Interna I - A.O.U. Maggiore della Carità di Novara, Novara, Italy.
Abstract
BACKGROUND: Heat-and-pepsin-sensitive plant food allergens (PR-10 and profilin) sometimes cause systemic reaction. OBJECTIVE: To detect the risk factors for systemic reactions induced by labile food allergens. METHODS: A retrospective multicenter study was performed on patients with a documented history of systemic allergic reaction to labile plant food allergens and on age-matched controls with a history of oral allergy syndrome (OAS) induced by the same foods. Offending foods, their amount, and state (solid or liquid), and potential cofactors (nonsteroidal anti-inflammatory drugs, protonic pump inhibitors, exercise, alcohol, and fasting) were considered. RESULTS: We studied 89 patients and 81 controls. Sensitization to PR-10 or profilin, IgE to Bet v 1 and/or Bet v 2, and foods causing OAS were similar in the two groups. Twenty patients experienced >1 systemic allergic reaction. Tree nuts, Rosaceae, Apiaceae, and soymilk were the main offending foods. Seventeen (19%) patients were taking a PPI when the systemic reaction occurred (vs 5% in controls; P < .025). The ingestion of the offending food in liquid form (soymilk) was frequent among patients (15%) but unusual among controls (2%; P < .025). Soy milk-induced systemic reactions were independent of PPI treatment. Fasting and excess of allergen, but not NSAID and exercise, were other relevant cofactors for systemic reactions. Systemic reactions occurred without any identifiable cofactor in 39 (44%) cases. CONCLUSION: PR-10- and profilin-induced systemic reactions are facilitated by PPI, ingestion of large amounts of unprocessed foods, and fasting. Soybean beverages represent a risk for PR-10 hypersensitive patients and should be avoided.
BACKGROUND: Heat-and-pepsin-sensitive plant food allergens (PR-10 and profilin) sometimes cause systemic reaction. OBJECTIVE: To detect the risk factors for systemic reactions induced by labile food allergens. METHODS: A retrospective multicenter study was performed on patients with a documented history of systemic allergic reaction to labile plant food allergens and on age-matched controls with a history of oral allergy syndrome (OAS) induced by the same foods. Offending foods, their amount, and state (solid or liquid), and potential cofactors (nonsteroidal anti-inflammatory drugs, protonic pump inhibitors, exercise, alcohol, and fasting) were considered. RESULTS: We studied 89 patients and 81 controls. Sensitization to PR-10 or profilin, IgE to Bet v 1 and/or Bet v 2, and foods causing OAS were similar in the two groups. Twenty patients experienced >1 systemic allergic reaction. Tree nuts, Rosaceae, Apiaceae, and soymilk were the main offending foods. Seventeen (19%) patients were taking a PPI when the systemic reaction occurred (vs 5% in controls; P < .025). The ingestion of the offending food in liquid form (soymilk) was frequent among patients (15%) but unusual among controls (2%; P < .025). Soy milk-induced systemic reactions were independent of PPI treatment. Fasting and excess of allergen, but not NSAID and exercise, were other relevant cofactors for systemic reactions. Systemic reactions occurred without any identifiable cofactor in 39 (44%) cases. CONCLUSION:PR-10- and profilin-induced systemic reactions are facilitated by PPI, ingestion of large amounts of unprocessed foods, and fasting. Soybean beverages represent a risk for PR-10hypersensitivepatients and should be avoided.
Authors: Natália F Mendes; Carlos P Jara; Eli Mansour; Eliana P Araújo; Licio A Velloso Journal: Allergy Asthma Clin Immunol Date: 2021-01-06 Impact factor: 3.406
Authors: Aleksandra Siekierzynska; Dorota Piasecka-Kwiatkowska; Aleksander Myszka; Marta Burzynska; Barbara Sozanska; Tomasz Sozanski Journal: Clin Transl Allergy Date: 2021-06-02 Impact factor: 5.871