Tolerability and immunological effect of short up-dosing immunotherapy with 2 standardized native allergen extracts derived from the pollen of Salsola kali and Cupressus arizonica

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Extensive cross-reactivity between Salsola kali and Salsola imbricata

Background: There are no studies on cross-reactivity between Salsola kali and Salsola imbricata pollens. The main goals of the present study were to compare the degree of the cross-reactivity between S kali and S imbricata and to compare the various allergenic components shared by S kali and S imbricata. Methods: Serum samples were obtained from rhinitis patients with or without asthma living in Kuwait and presenting with a positive skin test result to S kali. SDS-PAGE/IgE Western blot and ELISA inhibition assay were performed. Results: The study population comprised 37 patients. The most frequent IgE proteins against S imbricata weighed around 12, 15, 18, 37, and 50+55 kDa. 2D electrophoresis revealed a correlation between S kali and S imbricata at 40, 60, and 75 kDa, with similar isoelectric points. ELISA inhibition revealed an Ag50 value of 1.7 μg/mL for S kali and 500.5 μg/mL for S imbricata when the solid phase was S kali and an Ag50 value of 1.4 μg/mL for S kali and 3.0 μg/mL for S imbricata when the solid phase was S imbricata. Conclusions: ELISA inhibition revealed strong cross-reactivity between S kali and S imbricata. This finding might be clinically relevant for the efficacy of allergen-specific immunotherapy. We report, for the first time, the allergenic profile of S imbricata and potentially allergenic proteins for S kali and S imbricata (AU)

Introducción: No existen estudios sobre la reactividad cruzada entre pólenes de Salsola kali y Salsola imbricata. El objetivo principal de este estudio es comparar el grado de reactividad cruzada entre Salsola kali y Salsola imbricata, y el objetivo secundario es comparar los diversos componentes alergénicos entre Salsola kali y Salsola imbricata. Métodos: Se obtuvo suero de pacientes con rinitis con o sin asma, que vivieran en Kuwait y tuvieran un test positivo a Salsola kali. Se realizaron SDS PAGE/IgE Western blot, ELISA inhibición, a los sueros de pacientes kuwaitíes. Resultados: Se incluyeron 37 pacientes kuwaitíes. Las proteínas que reaccionaron con más frecuencia contra Salsola imbricata se encontraron alrededor de 12, 15, 18, 37 y 50+55 kDa. La electroforesis 2D mostró una correlación entre Salsola kali y Salsola imbricata a 40, 60, 75 KDa con puntos isoeléctricos similares. El estudio de ELISA inhibición mostró un Ag50 de 1,7 μg/mL para Salsola kali y 500,5 μg/mL para Salsola imbricata cuando la fase sólida era Salsola kali, y un Ag50 de 1,4 μg/mL para Salsola kali y 3,0 μg/mL para Salsola imbricata cuando la fase sólida era Salsola imbricata. Conclusión: Salsola kali y Salsola imbricata presentan una fuerte reactividad cruzada como se observa en el ELISA inhibición y esto podría ser clínicamente relevante para la eficacia de la inmunoterapia específica contra alérgenos. Hemos descrito por primera vez el perfil alergénico para Salsola imbricata y los posibles alérgenos comunes entre Salsola kali y Salsola imbricata (AU)

Amaranthaceae pollens: review of an emerging allergy in the mediterranean area

The Amaranthaceae family is composed of about 180 genera and 2500 species. These common weeds have become increasingly relevant as triggers of allergy in the last few years, as they are able to rapidly colonize salty and arid soils in extensive desert areas. The genera Chenopodium, Salsola, and Amaranthus are the major sources of pollinosis from the Amaranthaceae family in southern Europe, western United States, and semidesert areas of Saudi Arabia, Kuwait, and Iran. In Spain, Salsola kali is one of the most relevant causes of pollinosis, together with olive and grasses. To date, 9 Amaranthaceae pollen allergens from Chenopodium album, Salsola kali, and Amaranthus retroflexus have been described and are listed in the International Union of Immunological Societies allergen nomenclature database. The major allergens of Amaranthaceae pollen belong to the pectin methylesterase, Ole e 1-like, and profilin panallergen families, whereas the minor allergens belong to the cobalaminindependent methionine synthase and polcalcin panallergen families. These relevant allergens have been characterized physicochemically, and immunologically at different levels. Recombinant forms, allergenic fusion recombinant proteins, and hypoallergenic derivatives of these allergens have been expressed in bacteria and yeast and compared with their natural proteins from pollen. In this review, we provide an extensive overview of Amaranthaceae pollen allergens, focusing on their physicochemical, and immunological properties and on their clinical significance in allergic patients. We also review studies where these recombinant allergens and their hypoallergenic derivatives have been used in clinical diagnosis and their potential use in personalized therapy (AU)

La familia Amaranthaceae se compone de alrededor de 180 géneros y 2500 especies vegetales. En los últimos años, el polen de estas malezas está adquiriendo una relevancia cada vez mayor como inductor de alergia, ya que estas plantas son capaces de colonizar rápidamente los suelos salinos y áridos de zonas desertificadas. El polen de los géneros Chenopodium, Salsola y Amaranthus es el causante del mayor número de casos de polinosis asociados a la familia Amaranthaceae en países del sur de Europa, oeste de Estados Unidos, y en las zonas semi-desérticas de Arabia Saudí, Kuwait o Irán. En España, el polen de Salsola kali es una de las causas más relevantes de polinosis junto con los pólenes de olivo y gramíneas. Hasta la fecha, se han descrito un total de nueve alérgenos del polen de Chenopodium album, Salsola kali y Amaranthus retroflexus, los cuales se han depositado en la base de datos de nomenclatura de alérgenos IUIS. Los alérgenos principales del polen de la familia Amaranthaceae pertenecen a las familias pectin metilesterasa, Ole e 1, o a la familia de panalérgenos -profilina-, mientras que los alérgenos secundarios descritos pertenecen a la familia de panálergenos -polcalcina-, o bien, corresponden a la metionina sintasa independiente de cobalamina. Estos relevantes alérgenos se han caracterizado fisicoquímica e inmunológicamente en mayor o menor profundidad. Las formas recombinantes, y sus variantes recombinantes o derivados hipoalergénicos fusionados a un tag, se han expresado en bacteria o levadura y se ha comparado su funcionalidad con sus correspondientes homólogos naturales presentes en el polen. En esta revisión, ofrecemos una extensa descripción de los alérgenos del polen de la familia Amaranthaceae, centrándonos en sus propiedades físico-químicas e inmunológicas, y en su importancia clínica en los pacientes alérgicos. Por otra parte, también hemos revisado aquellos estudios en donde se han utilizado estos alérgenos recombinantes y sus derivados hipoalergénicos en el diagnóstico clínico, o bien, en donde se describe su potencial uso en la terapia personalizada (AU)

Double-blind, placebo-controlled study with a modified therapeutic vaccine of Salsola kali (Russian thistle) administered through use of a cluster schedule.

BACKGROUND: The inhalation of Salsola kali pollen is a common cause of respiratory diseases in Europe and North America. OBJECTIVE: To evaluate the efficacy and safety of a depigmented and glutaraldehyde-polymerized therapeutic vaccine of S kali. METHODS: The trial was randomized, double-blind, and placebo-controlled using a rush protocol in the build-up phase. Sixty patients with rhinoconjunctivitis (19 also had mild asthma) were randomly allocated to receive either active treatment (polymerized extract) or placebo. The final distribution was 41 patients in the active and 19 in the placebo group. Side effects were registered. Symptom and medication scores and the number of days free of symptoms during the pollen season were assessed to evaluate the clinical efficacy. A Rhinoconjunctivitis Quality of Life Questionnaire was completed in the previous pollen season (before treatment) and during the pollen season 1 year later (in the trial). Dose-response skin tests were performed at baseline and at the end of the trial. RESULTS: There was a significant difference (P < .05) in symptom and medication scores between both groups during the pollen season, with the active group the one that had fewer symptoms and lower intake of medication. The number of days without symptoms was higher in the active group (P < .05). This group also had a significant improvement in the Rhinoconjunctivitis Quality of Life Questionnaire and a reduction in skin sensitivity. No moderate or severe systemic reactions were registered. CONCLUSION: Immunotherapy with this modified vaccine of S kali pollen is safe and efficacious to treat patients clinically sensitive to this pollen. CLINICAL IMPLICATIONS: Patients allergic to S kali (Russian thistle) can be successfully treated with immunotherapy to improve symptoms of allergic rhinitis and asthma, reduce medication use, and improve quality of life parameters.