Allergy Asthma Respir Dis.  2014 Sep;2(4):306-309. 10.4168/aard.2014.2.4.306.

Oral allergy syndrome caused by crown daisy and sesame leaf

• Hong GN
• Kim MA
• Yoon MK
• Lee SH
• Park HS

• KMID: 2262402
• DOI: http://doi.org/10.4168/aard.2014.2.4.306

Abstract

Oral allergy syndrome (OAS) is a subtype of food allergy composing of itching sense and edema in the oral cavity, lips, throat, pharynx, and larynx following ingestion of some fresh fruits or vegetables. Although the major pathogenic mechanism of OAS is known to be IgE-mediated response, here we experienced a case of OAS due to crown daisy (CD) and sesame leaf (SL) mediated by a non-IgE antibody mediated mechanism. A 33-year-old female visited our clinic to evaluate numbness of the tongue and gingiva after eating fresh CD and SL for 2 years. The patient had suffered from allergic rhinitis and atopic dermatitis for 20 years and took medications intermittently. There had been a history of food allergy to crab and shrimp. The serum total IgE level was elevated (404 kU/mL). The skin prick test showed strong positive reactions to tree and weed pollens, but not to CD and SL extracts. Enzyme-linked immunosorbant assay for detecting serum specific IgE to crude extracts of CD and SL showed negative results. The basophil activation test performed with crude extracts of CD or SL showed significant up-regulation of CD63-positive basophils by both CD and SL. In conclusion, we report a case of OAS due to CD and SL, not associated with pollen allergy, which is shown to be mediated by a non-IgE mediated mechanism.

Keyword

Food hypersensitivity; Pathogenesis; Basophils; Crown daisy; Sesame leaf

MeSH Terms

Adult
Basophils
Complex Mixtures
Crowns*
Dermatitis, Atopic
Eating
Edema
Female
Food Hypersensitivity
Fruit
Gingiva
Humans
Hypersensitivity*
Hypesthesia
Immunoglobulin E
Larynx
Lip
Mouth
Pharynx
Pollen
Pruritus
Rhinitis
Rhinitis, Allergic, Seasonal
Sesamum*
Skin
Tongue
Up-Regulation
Vegetables
Complex Mixtures
Immunoglobulin E

Figure

• 

  Fig. 1 Four to 20% sodium dodecyl sulphate-polyacrylamide gel electrophoresis (SDS-PAGE) finding of crown daisy and sesame leaf extracts. Protein bands ranged from 9 kDa to 175 kDa were detected by SDS-PAGE.

• 

  Fig. 2 Absorbance values of specific IgE to crown daisy (A) and sesame leaf (B) extracts by enzyme-linked immunosorbent assay in sera from the patient (•) with the oral allergy syndrome and normal controls (○). The horizontal lines indicate the cutoff level of positive results.

• 

  Fig. 3 Expression of CD63 in basophils induced by crown daisy (A) and sesame leaf (B) extracts in the patients with oral allergy syndrome. Up-regulation of CD63 positive basophils was noted with additions of crown daisy (A) and sesame leaf (B) extracts in dose dependent manners. Calcium ion (Ca++) is tested as a positive control.

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