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. 2016 Nov;8(6):505-11.
doi: 10.4168/aair.2016.8.6.505.

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

Kyung Hee Park  1   2 , Young Woong Son  1 , Sang Chul Lee  1 , Kyunguk Jeong  3 , Da Woon Sim  1   2 , Hye Jung Park  1   2 , Sooyoung Lee  3 , Jae Hyun Lee  1   2 , Jung Won Park  1   4
Affiliations

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

Kyung Hee Park et al. Allergy Asthma Immunol Res. 2016 Nov.

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.

Keywords: Allergens; IgE; peanut hypersensitivity; pollen; trees.

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Conflict of interest statement

There are no financial or other issues that might lead to conflict of interest.

Figures

Fig. 1
Fig. 1. Classification of participating patients into 4 groups. OAS, oral allergy syndrome.
Fig. 2
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.
Fig. 3
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.
Fig. 4
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.
Fig. 5
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.
See this image and copyright information in PMC

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