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Kiwifruit allergy across Europe: clinical manifestation and IgE recognition patterns to kiwifruit allergens.
J Allergy Clin Immunol 2013; 131(1):164-71JA

Abstract

BACKGROUND

Kiwifruit is a common cause of food allergy. Symptoms range from mild to anaphylactic reactions.

OBJECTIVE

We sought to elucidate geographic differences across Europe regarding clinical patterns and sensitization to kiwifruit allergens. Factors associated with the severity of kiwifruit allergy were identified, and the diagnostic performance of specific kiwifruit allergens was investigated.

METHODS

This study was part of EuroPrevall, a multicenter European study investigating several aspects of food allergy. Three hundred eleven patients with kiwifruit allergy from 12 countries representing 4 climatic regions were included. Specific IgE to 6 allergens (Act d 1, Act d 2, Act d 5, Act d 8, Act d 9, and Act d 10) and kiwifruit extract were tested by using ImmunoCAP.

RESULTS

Patients from Iceland were mainly sensitized to Act d 1 (32%), those from western/central and eastern Europe were mainly sensitized to Act d 8 (pathogenesis-related class 10 protein, 58% and 44%, respectively), and those from southern Europe were mainly sensitized to Act d 9 (profilin, 31%) and Act d 10 (nonspecific lipid transfer protein, 22%). Sensitization to Act d 1 and living in Iceland were independently and significantly associated with severe kiwifruit allergy (odds ratio, 3.98 [P = .003] and 5.60 [P < .001], respectively). Using a panel of 6 kiwifruit allergens in ImmunoCAP increased the diagnostic sensitivity to 65% compared with 20% for skin prick tests and 46% ImmunoCAP using kiwi extract.

CONCLUSION

Kiwifruit allergen sensitization patterns differ across Europe. The use of specific kiwifruit allergens improved the diagnostic performance compared with kiwifruit extract. Sensitization to Act d 1 and living in Iceland are strong risk factors for severe kiwifruit allergy.

Authors+Show Affiliations

Department of Dermatology/Allergology, University Medical Center Utrecht, Utrecht, The Netherlands. t.t.m.le-2@umcutrecht.nlNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

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

Language

eng

PubMed ID

23141741

Citation

Le, Thuy-My, et al. "Kiwifruit Allergy Across Europe: Clinical Manifestation and IgE Recognition Patterns to Kiwifruit Allergens." The Journal of Allergy and Clinical Immunology, vol. 131, no. 1, 2013, pp. 164-71.
Le TM, Bublin M, Breiteneder H, et al. Kiwifruit allergy across Europe: clinical manifestation and IgE recognition patterns to kiwifruit allergens. J Allergy Clin Immunol. 2013;131(1):164-71.
Le, T. M., Bublin, M., Breiteneder, H., Fernández-Rivas, M., Asero, R., Ballmer-Weber, B., ... Knulst, A. C. (2013). Kiwifruit allergy across Europe: clinical manifestation and IgE recognition patterns to kiwifruit allergens. The Journal of Allergy and Clinical Immunology, 131(1), pp. 164-71. doi:10.1016/j.jaci.2012.09.009.
Le TM, et al. Kiwifruit Allergy Across Europe: Clinical Manifestation and IgE Recognition Patterns to Kiwifruit Allergens. J Allergy Clin Immunol. 2013;131(1):164-71. PubMed PMID: 23141741.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Kiwifruit allergy across Europe: clinical manifestation and IgE recognition patterns to kiwifruit allergens. AU - Le,Thuy-My, AU - Bublin,Merima, AU - Breiteneder,Heimo, AU - Fernández-Rivas,Montserrat, AU - Asero,Riccardo, AU - Ballmer-Weber,Barbara, AU - Barreales,Laura, AU - Bures,Peter, AU - Belohlavkova,Simona, AU - de Blay,Frédéric, AU - Clausen,Michael, AU - Dubakiene,Ruta, AU - Gislason,David, AU - van Hoffen,Els, AU - Jedrzejczak-Czechowicz,Monika, AU - Kowalski,Marek L, AU - Kralimarkova,Tanya, AU - Lidholm,Jonas, AU - DeWitt,Asa Marknell, AU - Mills,Clare E N, AU - Papadopoulos,Nikolaos G, AU - Popov,Todor, AU - Purohit,Ashok, AU - van Ree,Ronald, AU - Seneviratne,Suranjith, AU - Sinaniotis,Athanasios, AU - Summers,Colin, AU - Vázquez-Cortés,Sonia, AU - Vieths,Stefan, AU - Vogel,Lothar, AU - Hoffmann-Sommergruber,Karin, AU - Knulst,André C, Y1 - 2012/11/06/ PY - 2012/05/27/received PY - 2012/08/22/revised PY - 2012/09/06/accepted PY - 2012/11/13/entrez PY - 2012/11/13/pubmed PY - 2013/3/7/medline SP - 164 EP - 71 JF - The Journal of allergy and clinical immunology JO - J. Allergy Clin. Immunol. VL - 131 IS - 1 N2 - BACKGROUND: Kiwifruit is a common cause of food allergy. Symptoms range from mild to anaphylactic reactions. OBJECTIVE: We sought to elucidate geographic differences across Europe regarding clinical patterns and sensitization to kiwifruit allergens. Factors associated with the severity of kiwifruit allergy were identified, and the diagnostic performance of specific kiwifruit allergens was investigated. METHODS: This study was part of EuroPrevall, a multicenter European study investigating several aspects of food allergy. Three hundred eleven patients with kiwifruit allergy from 12 countries representing 4 climatic regions were included. Specific IgE to 6 allergens (Act d 1, Act d 2, Act d 5, Act d 8, Act d 9, and Act d 10) and kiwifruit extract were tested by using ImmunoCAP. RESULTS: Patients from Iceland were mainly sensitized to Act d 1 (32%), those from western/central and eastern Europe were mainly sensitized to Act d 8 (pathogenesis-related class 10 protein, 58% and 44%, respectively), and those from southern Europe were mainly sensitized to Act d 9 (profilin, 31%) and Act d 10 (nonspecific lipid transfer protein, 22%). Sensitization to Act d 1 and living in Iceland were independently and significantly associated with severe kiwifruit allergy (odds ratio, 3.98 [P = .003] and 5.60 [P < .001], respectively). Using a panel of 6 kiwifruit allergens in ImmunoCAP increased the diagnostic sensitivity to 65% compared with 20% for skin prick tests and 46% ImmunoCAP using kiwi extract. CONCLUSION: Kiwifruit allergen sensitization patterns differ across Europe. The use of specific kiwifruit allergens improved the diagnostic performance compared with kiwifruit extract. Sensitization to Act d 1 and living in Iceland are strong risk factors for severe kiwifruit allergy. SN - 1097-6825 UR - https://www.unboundmedicine.com/medline/citation/23141741/Kiwifruit_allergy_across_Europe:_clinical_manifestation_and_IgE_recognition_patterns_to_kiwifruit_allergens_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0091-6749(12)01503-5 DB - PRIME DP - Unbound Medicine ER -