Comparison of IgE-binding components between 2 house dust mites in adult allergic patients

PURPOSE: This study investigated the differences in the profile of IgE-binding components between Dermatophagoides pteronyssinus (Dp) and Dermatophagoides farina (Df) in respiratory allergic patients sensitized to Dp/Df. METHODS: Eighteen patients with respiratory allergic diseases having higher levels of serum specific IgE to Df compared to those to Dp (>twice) were enrolled. IgE-immunoblot analysis using Dp and Df extracts were used to compare the IgE binding components. Study subjects were classified into 2 groups according to the results of IgE-immunoblot analysis: 6 subjects having IgE-binding components to group 1 and 2 allergens (group B) and 12 subjects not having them (group A). RESULTS: Group A subjects were older (47.92±8.51 vs. 35.50±11.10, P=0.039) and males were dominant (75% vs. 0% P=0.009). IgE-immunoblot analysis demonstrated that all the group B subjects had IgE bindings to 2 major components, 14 and 25 kDa, while group A subjects had IgE bindings to high-molecular weight components ranging from 60-98 kDa. The enzyme-linked immunosorbent assay inhibition test showed a significant inhibition with additions of Df, not with Dp in group B subjects. Serum specific IgE levels to Dp and Df were significantly higher in group B than in group A, while its ratio (Df to Dp) was significantly higher in group A. No differences were noted in clinical parameters, total IgE, or eosinophil cationic protein levels. CONCLUSION: Heterogeneity of IgE binding patterns to Dp and Df extracts was noted according to the ratio of serum specific IgE (Df/Dp).

Acute urticaria with angioedema following sea hare ingestion

Seafood is one of the common causes of food allergies to adults. The sea hare Aplysia kurodai is a marine mollusk which belongs to invertebrate gastropod that has been consumed as a food in Korea. Cases of acute toxic hepatitis after ingestion of sea hares have been reported, but few cases of allergic reactions to sea hare have been reported in the literature. A 33-year-old man was referred to our Emergency Department due to urticaria and periorbital/perioral swelling after eating sea hares. Approximately 10 years ago, he experienced similar allergic reactions to it. Skin prick and intradermal tests showed strong positive responses to crude sea hare allergen extract. He was diagnosed with food allergy to sea hares. We herein report the first case of sea hare allergy after ingestion.

Anaphylaxis following mushrooms ingestion

Various foods can induce anaphylaxis. However, mushrooms-induced anaphylaxis has not been reported in Korea. We report a patient with past anaphylactic episode caused by mushroom ingestion, confirmed by the skin test and specific IgE antibody to mushrooms. A 17-year-old girl with asthma was referred to our department due to itchy throat, dyspnea, and urticaria within 10 minutes after ingestion of a soup containing Oyster mushrooms. She presented an itching throat after ingestion of cooked mushrooms 3 years before the visit. She had an elevated serum IgE level (205 kU/L) and was sensitized to house dust mites. Skin prick tests with mushroom extracts showed a strong positive on Oyster and King Oyster mushrooms as well as Pyogo mushroom. The specific IgE antibody to each mushroom measured by enzyme-linked immunosorbent assay showed significant positive results to Oyster and Pyogo mushroom extracts, but was negative on King Oyster mushroom. We educated her to avoid eating Oyster and Pyogo mushrooms for preventing recurrence, whereas we couldn't perform oral challenge tests.

Paradoxical Increase of IgE Binding Components during Allergen-Specific Immunotherapy in Pollinosis Patients

Allergen-specific immunotherapy (SIT) reduces allergen specific IgE (sIgE) levels and achieves clinical and immunological tolerance by modulating innate and adaptive immunological responses. Increased temperature and CO2 concentrations caused by climate changes contribute to an increase of pollen count and allergenicity that influences clinical SIT outcomes. In this study, we investigated the changes of IgE binding components to tree and weed pollens in pollinosis patients who showed a paradoxical increase of serum sIgE level during pollen-SIT. We enrolled nine patients who showed an increasing pattern of serum sIgE level to alder, birch, ragweed and mugwort pollens by enzyme-linked immunosorbant assay. IgE immunoblot analysis confirmed the intensification or new generation of major IgE binding components that could be induced by climate change. The findings suggest that the regular monitoring of sIgE levels and symptom changes is required to improve the clinical outcomes of SIT in patients undergoing SIT for tree and weed pollens.

Identification of IgE binding components of two major weed pollens, ragweed and mugwort

PURPOSE: Ragweed and mugwort pollens are the major weed allergens that cause pollinosis in Korea. The IgE-binding components to these 2 pollens and their cross-reactivity have not been reported in Korea, while several reports had been made in Western countries. We investigated IgE-binding components to ragweed and mugwort pollens and their allergenic relationship in patients sensitive to the 2 pollens. METHODS: We enrolled 33 allergic rhinitis patients with typical seasonal pollinosis symptoms in autumn and elevated serum specific IgE levels to ragweed and/or mugwort pollens (>10 kU/L by ImmunoCAP). The protein bands of the 2 pollen extracts were determined using sodium dodecyl sulphate-polyacrylamide gel electrophoresis, and IgE immunoblot analysis was performed to determine the IgE-binding components of each pollen extract. Enzyme-linked immunosorbent assay (ELISA) inhibition and immunoblot inhibition tests were performed to evaluate the cross-reactivity between ragweed and mugwort pollen extracts. RESULTS: Eight IgE-binding components (9, 10, 11, 12, 27, 30, 38, and 80 kDa) were found in ragweed pollen extracts, of which 4 (38, 11, 27, and 80 kDa) were major IgE-binding components. Eight IgE-binding components (10, 14, 16, 20-24, 26-30, 42, 60-66, and 80-90 kDa) were found in mugwort pollen extracts, of which 2 components (26-30 and 20-24 kDa) were major IgE-binding components. No significant inhibitions were noted between ragweed and mugwort pollen extracts by the ELISA inhibition test. No significant changes were noted in IgE immunoblot inhibition analysis. CONCLUSION: We identified 4 major IgE-binding components (38, 11, 35, 27, and 80 kDa) in ragweed pollens and 2 major IgE-binding components (26-30 and 20-24 kDa) in mugwort pollens. No cross-reactivity was found between ragweed and mugwort pollens.

Identification of immunoglobulin E binding components of two major tree pollens, birch and alder

PURPOSE: Pollinosis is one of the major allergic diseases caused by airborne pollens. Alder and birch pollens are the major sensitizing tree pollens in this country. The immunoglobulin E (IgE) reactivity to each pollen allergen is known to be variable according to the region. We determined the major IgE binding components of these tree pollens in sera of adult patients with allergic rhinitis. METHODS: Allergic rhinitis patients, of whom specific IgE level to birch and/or alder pollens (>10 kU/L by ImmunoCAP) were included. The protein bands of two pollen extracts were determined by sodium dodecyl sulphate-polyacrylamide gel electrophoresis, and their IgE-binding components were identified by IgE immunoblot analysis. The binding specificity and cross-reactivity between two pollens were evaluated by IgE enzyme linked immunosorbent assay (ELISA) inhibition test. RESULTS: Six IgE binding components were found in birch pollens in which two (14 kDa and 17 kDa) were major components. Two IgE binding components were found in alder pollens in which the 17 kDa was a major component. The IgE binding component to the major allergen component of 17 kDa was observed in 90.3% of the study subjects sensitive to alder pollens and 72.7% of them sensitive to birch pollens. The ELISA inhibition tests showed significant inhibitions with additions of birch/alder pollen extracts. CONCLUSION: We identified two major IgE binding components (17 kDa and 14 kDa) from birch pollens and one component (17 kDa) from alder pollens. Significant cross reactivity was noted between these two pollens.