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Carrot allergy: double-blinded, placebo-controlled food challenge and identification of allergens.
J Allergy Clin Immunol 2001; 108(2):301-7JA

Abstract

BACKGROUND

Allergic reactions to carrot affect up to 25% of food-allergic subjects. Clinical manifestations of carrot allergy and IgE responses to carrot proteins, however, have never been studied in subjects with carrot allergy confirmed by means of double-blinded, placebo-controlled food challenge (DBPCFC).

OBJECTIVE

The purposes of this investigation were to confirm clinically relevant sensitizations to carrot by means of DBPCFC, to validate current diagnostic methods, and to identify IgE-reactive carrot proteins in patients with true allergy.

METHODS

DBPCFCs were performed in 26 subjects with histories of allergic reactions to carrot. Patients underwent skin prick tests with carrot extract, fresh carrot, and various pollen extracts. Specific IgE to carrot, celery, birch, and mugwort pollen and to rBet v 1, rBet v 2, and rBet v 6 were measured through use of the CAP method. Carrot allergens were identified by means of immunoblotting and blotting inhibition.

RESULTS

Twenty of 26 patients had positive DBPCFC results. The sensitivity of the determination of carrot-specific IgE antibodies through use of the CAP method (> or =0.7 kU/L) was 90%, the sensitivity for skin prick testing with commercial extracts was 26%, and the sensitivity for prick-to-prick tests with raw carrot was 100%. The Bet v 1--related major carrot allergen Dau c 1 was recognized by IgE from 85% of patients; 45% were sensitized to cross-reactive carbohydrate determinants and 20% to carrot profilin. In 1 subject, a Bet v 6--related carrot allergen was recognized. In 4 patients, IgE binding to Dau c 1 was not inhibited or was weakly inhibited by rBet v 1 or birch pollen extract.

CONCLUSION

This study confirmed the allergenicity of carrot by means of DBPCFC. DBPCFC-positive patients had exclusively specific IgE antibodies to birch pollen--related carrot allergens, Dau c 1 being the major allergen. The lack of inhibition of IgE binding to Dau c 1 by birch allergens in a subgroup of patients might indicate an secondary immune response to new epitopes on the food allergen that are not cross-reactive with Bet v 1.

Authors+Show Affiliations

Allergy Unit, Department of Dermatology, University Hospital, Zürich, Switzerland.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

11496252

Citation

Ballmer-Weber, B K., et al. "Carrot Allergy: Double-blinded, Placebo-controlled Food Challenge and Identification of Allergens." The Journal of Allergy and Clinical Immunology, vol. 108, no. 2, 2001, pp. 301-7.
Ballmer-Weber BK, Wüthrich B, Wangorsch A, et al. Carrot allergy: double-blinded, placebo-controlled food challenge and identification of allergens. J Allergy Clin Immunol. 2001;108(2):301-7.
Ballmer-Weber, B. K., Wüthrich, B., Wangorsch, A., Fötisch, K., Altmann, F., & Vieths, S. (2001). Carrot allergy: double-blinded, placebo-controlled food challenge and identification of allergens. The Journal of Allergy and Clinical Immunology, 108(2), pp. 301-7.
Ballmer-Weber BK, et al. Carrot Allergy: Double-blinded, Placebo-controlled Food Challenge and Identification of Allergens. J Allergy Clin Immunol. 2001;108(2):301-7. PubMed PMID: 11496252.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Carrot allergy: double-blinded, placebo-controlled food challenge and identification of allergens. AU - Ballmer-Weber,B K, AU - Wüthrich,B, AU - Wangorsch,A, AU - Fötisch,K, AU - Altmann,F, AU - Vieths,S, PY - 2001/8/10/pubmed PY - 2001/9/8/medline PY - 2001/8/10/entrez SP - 301 EP - 7 JF - The Journal of allergy and clinical immunology JO - J. Allergy Clin. Immunol. VL - 108 IS - 2 N2 - BACKGROUND: Allergic reactions to carrot affect up to 25% of food-allergic subjects. Clinical manifestations of carrot allergy and IgE responses to carrot proteins, however, have never been studied in subjects with carrot allergy confirmed by means of double-blinded, placebo-controlled food challenge (DBPCFC). OBJECTIVE: The purposes of this investigation were to confirm clinically relevant sensitizations to carrot by means of DBPCFC, to validate current diagnostic methods, and to identify IgE-reactive carrot proteins in patients with true allergy. METHODS: DBPCFCs were performed in 26 subjects with histories of allergic reactions to carrot. Patients underwent skin prick tests with carrot extract, fresh carrot, and various pollen extracts. Specific IgE to carrot, celery, birch, and mugwort pollen and to rBet v 1, rBet v 2, and rBet v 6 were measured through use of the CAP method. Carrot allergens were identified by means of immunoblotting and blotting inhibition. RESULTS: Twenty of 26 patients had positive DBPCFC results. The sensitivity of the determination of carrot-specific IgE antibodies through use of the CAP method (> or =0.7 kU/L) was 90%, the sensitivity for skin prick testing with commercial extracts was 26%, and the sensitivity for prick-to-prick tests with raw carrot was 100%. The Bet v 1--related major carrot allergen Dau c 1 was recognized by IgE from 85% of patients; 45% were sensitized to cross-reactive carbohydrate determinants and 20% to carrot profilin. In 1 subject, a Bet v 6--related carrot allergen was recognized. In 4 patients, IgE binding to Dau c 1 was not inhibited or was weakly inhibited by rBet v 1 or birch pollen extract. CONCLUSION: This study confirmed the allergenicity of carrot by means of DBPCFC. DBPCFC-positive patients had exclusively specific IgE antibodies to birch pollen--related carrot allergens, Dau c 1 being the major allergen. The lack of inhibition of IgE binding to Dau c 1 by birch allergens in a subgroup of patients might indicate an secondary immune response to new epitopes on the food allergen that are not cross-reactive with Bet v 1. SN - 0091-6749 UR - https://www.unboundmedicine.com/medline/citation/11496252/Carrot_allergy:_double_blinded_placebo_controlled_food_challenge_and_identification_of_allergens_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0091-6749(01)42126-9 DB - PRIME DP - Unbound Medicine ER -