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Component-resolved diagnosis of baker's allergy based on specific IgE to recombinant wheat flour proteins.
J Allergy Clin Immunol 2015; 135(6):1529-37JA

Abstract

BACKGROUND

Sensitization to wheat flour plays an important role in the development and diagnosis of baker's asthma.

OBJECTIVES

We evaluated wheat allergen components as sensitizers for bakers with work-related complaints, with consideration of cross-reactivity to grass pollen.

METHODS

Nineteen recombinant wheat flour proteins and 2 cross-reactive carbohydrate determinants were tested by using CAP-FEIA in sera of 101 bakers with wheat flour allergy (40 German, 37 Dutch, and 24 Spanish) and 29 pollen-sensitized control subjects with wheat-specific IgE but without occupational exposure. IgE binding to the single components was inhibited with wheat flour, rye flour, and grass pollen. The diagnostic efficiencies of IgE tests with single allergens and combinations were evaluated by assessing their ability to discriminate between patients with baker's allergy and control subjects based on receiver operating characteristic analyses.

RESULTS

Eighty percent of bakers had specific IgE levels of 0.35 kUA/L or greater and 91% had specific IgE levels of 0.1 kUA/L or greater to at least one of the 21 allergens. The highest frequencies of IgE binding were found for thiol reductase (Tri a 27) and the wheat dimeric α-amylase inhibitor 0.19 (Tri a 28). Cross-reactivity to grass pollen was proved for 9 components, and cross-reactivity to rye flour was proved for 18 components. A combination of IgE tests to 5 components, Tri a 27, Tri a 28, tetrameric α-amylase inhibitor CM2 (Tri a 29.02), serine protease inhibitor-like allergen (Tri a 39), and 1-cys-peroxiredoxin (Tri a 32), produced the maximal area under the curve (AUC = 0.84) in receiver operating characteristic analyses, but this was still lower than the AUC for wheat- or rye flour-specific IgE (AUC = 0.89 or 0.88, respectively).

CONCLUSIONS

Component-resolved diagnostics help to distinguish between sensitization caused by occupational flour exposure and wheat seropositivity based on cross-reactivity to grass pollen. For routine diagnosis of baker's allergy, however, allergen-specific IgE tests with whole wheat and rye flour extracts remain mandatory because of superior diagnostic sensitivity.

Authors+Show Affiliations

Institute for Prevention and Occupational Medicine, German Social Accident Insurance, Ruhr University Bochum (IPA), Bochum, Germany. Electronic address: Sander@ipa-dguv.de.Institute for Prevention and Occupational Medicine, German Social Accident Insurance, Ruhr University Bochum (IPA), Bochum, Germany.Institute for Risk Assessment Sciences (IRAS), Utrecht University, Utrecht, The Netherlands.Department of Allergy, Hospital La Paz Institute for Health Research (IdiPAZ) and CIBER of Respiratory Diseases (CIBERES), Madrid, Spain.Institute for Risk Assessment Sciences (IRAS), Utrecht University, Utrecht, The Netherlands.Institute for Prevention and Occupational Medicine, German Social Accident Insurance, Ruhr University Bochum (IPA), Bochum, Germany.Institute for Prevention and Occupational Medicine, German Social Accident Insurance, Ruhr University Bochum (IPA), Bochum, Germany.Institute for Prevention and Occupational Medicine, German Social Accident Insurance, Ruhr University Bochum (IPA), Bochum, Germany.Institute for Prevention and Occupational Medicine, German Social Accident Insurance, Ruhr University Bochum (IPA), Bochum, Germany.Institute for Prevention and Occupational Medicine, German Social Accident Insurance, Ruhr University Bochum (IPA), Bochum, Germany.Institute for Prevention and Occupational Medicine, German Social Accident Insurance, Ruhr University Bochum (IPA), Bochum, Germany.

Pub Type(s)

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

Language

eng

PubMed ID

25576081

Citation

Sander, Ingrid, et al. "Component-resolved Diagnosis of Baker's Allergy Based On Specific IgE to Recombinant Wheat Flour Proteins." The Journal of Allergy and Clinical Immunology, vol. 135, no. 6, 2015, pp. 1529-37.
Sander I, Rihs HP, Doekes G, et al. Component-resolved diagnosis of baker's allergy based on specific IgE to recombinant wheat flour proteins. J Allergy Clin Immunol. 2015;135(6):1529-37.
Sander, I., Rihs, H. P., Doekes, G., Quirce, S., Krop, E., Rozynek, P., ... Raulf, M. (2015). Component-resolved diagnosis of baker's allergy based on specific IgE to recombinant wheat flour proteins. The Journal of Allergy and Clinical Immunology, 135(6), pp. 1529-37. doi:10.1016/j.jaci.2014.11.021.
Sander I, et al. Component-resolved Diagnosis of Baker's Allergy Based On Specific IgE to Recombinant Wheat Flour Proteins. J Allergy Clin Immunol. 2015;135(6):1529-37. PubMed PMID: 25576081.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Component-resolved diagnosis of baker's allergy based on specific IgE to recombinant wheat flour proteins. AU - Sander,Ingrid, AU - Rihs,Hans-Peter, AU - Doekes,Gert, AU - Quirce,Santiago, AU - Krop,Esmeralda, AU - Rozynek,Peter, AU - van Kampen,Vera, AU - Merget,Rolf, AU - Meurer,Ursula, AU - Brüning,Thomas, AU - Raulf,Monika, Y1 - 2015/01/07/ PY - 2014/06/05/received PY - 2014/11/07/revised PY - 2014/11/12/accepted PY - 2015/1/11/entrez PY - 2015/1/13/pubmed PY - 2015/8/13/medline KW - Baker's asthma KW - Triticum aestivum KW - alpha-amylase inhibitor KW - component-resolved diagnosis KW - cross-reactivity KW - grass pollen KW - recombinant allergens KW - rye flour KW - specific IgE KW - wheat allergy SP - 1529 EP - 37 JF - The Journal of allergy and clinical immunology JO - J. Allergy Clin. Immunol. VL - 135 IS - 6 N2 - BACKGROUND: Sensitization to wheat flour plays an important role in the development and diagnosis of baker's asthma. OBJECTIVES: We evaluated wheat allergen components as sensitizers for bakers with work-related complaints, with consideration of cross-reactivity to grass pollen. METHODS: Nineteen recombinant wheat flour proteins and 2 cross-reactive carbohydrate determinants were tested by using CAP-FEIA in sera of 101 bakers with wheat flour allergy (40 German, 37 Dutch, and 24 Spanish) and 29 pollen-sensitized control subjects with wheat-specific IgE but without occupational exposure. IgE binding to the single components was inhibited with wheat flour, rye flour, and grass pollen. The diagnostic efficiencies of IgE tests with single allergens and combinations were evaluated by assessing their ability to discriminate between patients with baker's allergy and control subjects based on receiver operating characteristic analyses. RESULTS: Eighty percent of bakers had specific IgE levels of 0.35 kUA/L or greater and 91% had specific IgE levels of 0.1 kUA/L or greater to at least one of the 21 allergens. The highest frequencies of IgE binding were found for thiol reductase (Tri a 27) and the wheat dimeric α-amylase inhibitor 0.19 (Tri a 28). Cross-reactivity to grass pollen was proved for 9 components, and cross-reactivity to rye flour was proved for 18 components. A combination of IgE tests to 5 components, Tri a 27, Tri a 28, tetrameric α-amylase inhibitor CM2 (Tri a 29.02), serine protease inhibitor-like allergen (Tri a 39), and 1-cys-peroxiredoxin (Tri a 32), produced the maximal area under the curve (AUC = 0.84) in receiver operating characteristic analyses, but this was still lower than the AUC for wheat- or rye flour-specific IgE (AUC = 0.89 or 0.88, respectively). CONCLUSIONS: Component-resolved diagnostics help to distinguish between sensitization caused by occupational flour exposure and wheat seropositivity based on cross-reactivity to grass pollen. For routine diagnosis of baker's allergy, however, allergen-specific IgE tests with whole wheat and rye flour extracts remain mandatory because of superior diagnostic sensitivity. SN - 1097-6825 UR - https://www.unboundmedicine.com/medline/citation/25576081/Component_resolved_diagnosis_of_baker's_allergy_based_on_specific_IgE_to_recombinant_wheat_flour_proteins_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0091-6749(14)01675-3 DB - PRIME DP - Unbound Medicine ER -