Allergy Asthma Immunol Res.  2019 Jan;11(1):116-128. 10.4168/aair.2019.11.1.116.

Mugwort Pollen-Related Food Allergy: Lipid Transfer Protein Sensitization and Correlation With the Severity of Allergic Reactions in a Chinese Population

• Deng S
• Yin J

• KMID: 2426790
• DOI: http://doi.org/10.4168/aair.2019.11.1.116

Abstract

PURPOSE
Little is known about the importance of lipid transfer protein (LTP) sensitization in China. In this study, we investigated the relationship between LTP sensitization and the severity of clinical symptoms in a population of patients with mugwort pollen-related food allergy.
METHODS
Food-induced symptoms were evaluated in 148 patients with mugwort pollen allergy by a standardized questionnaire. Specific immunoglobulin E (IgE) to Art v 1, Art v 3, Pru p 3, Ara h 9 and Cor a 8 were quantified by ImmunoCAP. Immunoblotting of peach extracts were performed with sera from peach-allergic patients.
RESULTS
In total, 72% (107/148) of the study population experienced food allergy. Forty-eight percent (51/107) of patients with mugwort pollen-related food allergy experienced at least 1 episode of food-induced anaphylaxis. Food allergy correlated with IgE reactivity to Art v 3, but not to Art v 1. Sensitization to Pru p 3, Ara h 9 or Cor a 8 was prevalent (80%, 69 or 63%, respectively) among individuals with food allergy. Food allergic patients with systemic reactions (SR) had higher values for Pru p 3, Ara h 9 and Cor a 8 than patients with oral allergy syndrome (OAS). Furthermore, the strong IgE reactivity detected in immunoblots of peach extracts indicated that Pru p 3 was the major allergen and was more prevalent in patients with SR than in patients with OAS (100% vs. 55%).
CONCLUSIONS
LTPs are major food allergens for mugwort pollen-related food allergy in China, and may contribute to SR.

Keyword

Lipid transfer protein; mugwort pollen allergy; food allergy

MeSH Terms

Allergens
Anaphylaxis
Artemisia*
Asian Continental Ancestry Group*
China
Food Hypersensitivity*
Humans
Hypersensitivity*
Immunoblotting
Immunoglobulin E
Immunoglobulins
Prunus persica
Rhinitis, Allergic, Seasonal
Allergens
Immunoglobulin E
Immunoglobulins

Figure

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  Fig. 1 Food sensitization in 107 individuals with mugwort pollen-related food allergy.

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  Fig. 2 Levels of total IgE and specific IgE to mugwort pollen, Art v 1 and Art v 3 were compared in FA (filled triangles, n = 107) and NFA (open circles, n = 41) patients. IgE, immunoglobulin E; FA, food-allergic; NFA, non-food-allergic.

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  Fig. 3 Comparison of levels of total IgE and specific IgE to mugwort pollen, Art v 1 and Art v 3 in predicting mugwort pollen-related food allergy. Art v 3-specific IgE had the largest area under ROC curve (AUC, 0.757; 95% CI, 0.662–0.852; P < 0.001) with reference to total IgE (AUC, 0.479; 95% CI, 0.379–0.578; P = 0.689), specific IgE to mugwort pollen (AUC, 0.705; 95% CI, 0.620–0.789; P < 0.001) and Art v 1 (AUC, 0.495; 95% CI, 0.397–0.593; P = 0.925). IgE, immunoglobulin E; ROC, receiver operating characteristic; AUC, area under the curve; CI, confidence interval.

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  Fig. 4 IgE levels of LTP (Pru p 3, Ara h 9 and Cor a 8) were compared among food (peach, peanut and hazelnut, respectively)-allergic patients with systemic reactions and oral allergy syndrome. IgE, immunoglobulin E; LTP, lipid transfer protein.

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  Fig. 5 ROC curve analysis for specific IgE to mugwort pollen, Art v 3, peach and its allergenic components in predicting systemic reactions to peach. Pru p 3-specific IgE had the largest area under ROC curve (AUC, 0.77; 95% CI, 0.676–0.872; P < 0.001) with reference to specific IgE to mugwort pollen (AUC, 0.57; 95% CI, 0.448–0.693; P = 0.271), Art v 3 (AUC, 0.55; 95% CI, 0.420–0.670; P = 0.483), peach (AUC, 0.73; 95% CI, 0.627–0.837; P < 0.001), Pru p 1 (AUC, 0.48; 95% CI, 0.347–0.604; P = 0.701), and Pru p 4 (AUC, 0.58; 95% CI, 0.457–0.708; P = 0.199). ROC, receiver operating characteristic; IgE, immunoglobulin E; AUC, area under the curve; CI, confidence interval.

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  Fig. 6 Representative results of immunoblotting of peach extracts with sera from patients with mugwort pollen-related peach allergy. lane 1–6: serum from patients with systemic reactions to peach; lane 7–9: serum from patients with oral allergy syndrome; lane 10: serum from patients with mugwort pollinosis without food allergy.

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