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1 : , IgE Oral Allergy Syndrome : OAS 13 Immuno- CAP ISAC Immuno Solidphase Allergen Chip 103 OAS OAS % Bet v 1 Cor a Aln g % PR - 10 Pathogenesis - Related Protein - 10 Mal d % Pru p % PR - 10 Bet v 2 3 Ole e 2 Mer a 1 Hev b 8 ImmunoCAP ISAC OAS PR - 10 ImmunoCAP ISAC pollen - food allergy syndrome : PFAS oral allergy syndrome : OAS OAS in vitro IgE CAP RAST : PR - 10 ImmunoCAP ISAC : TEL : FAX :
2 : CRD OAS 197 Radioallergosorbent Test OAS IgE Compornent resolved diagnostics CRD 3-9 OAS IgE I Bet v 1 Bet v 2 11 OAS IgE ImmunoCAP ISAC Immuno Solidphase Allergen Chip OAS % 1 7.7% % % OAS % % % 1 2 ImmunoCAP RAST Phadia, Upsala, Sweden : IgE IgE IgE Fluorescence - Enzyme Immunoassay : FEIA IgE IgE IgE IgE OAS IgE ImmunoCAP RAST 0.70 UA/ml class 2 ImmunoCAP ISAC Phadia, Upsala, Sweden 12 : IgE 1 nl μl 2 IgE IgE 20 μl IgE 2
3 IgE OAS 13 ImmunoCAP ISAC IgE 4 class ISU class 1 ImmunoCAP ISAC ImmunoCAP RAST ImmunoCAP ISAC ImmunoCAP RAST ImmunoCAP ISAC Positive Percent Agreement : PPA ImmunoCAP RAST ImmunoCAP ISAC Negative Percent Agreement : NPA Table 1 OAS % % % 2. ImmunoCAP RAST Fig. 1 IgE 0.70 UA/ml class 2 IgE 92.3% IgE 53.8% IgE 84.6% IgE 69.2% 3. Immuno- CAP ISAC Fig. 2 Bet v 1 IgE 92.3% Cor a % Table 1. Foods potentially causing OAS by interview Food Number % Apple Peach Kiwi Cherry Pear Banana Loquat Strawberry Melon Soybean curd Soy milk Chocolate Mango Carrot Orange Ficus Grapefruit Kumquat Potato Soybean Garlic Olive oil Rosaceae Aln g % IgE Mal d 1 IgE 92.3% Pru p % Ara h 8 Cor a IgE 69.2% PR - 10 Pathogenesis - Related Protein - 10 Bet v 2 IgE 23.1% Lipid Transfer Protein : LTP Art v 3 Pru p 3 Cor a 8 IgE Fig. 3 Bet v 1 OAS Bet v 1 PR - 10 PR - 10 No
4 : CRD OAS 199 pollen Fig. 1 Positive rates class 2 of ImmunoCAP specific IgE antibodies against crude antigens In plants, the positive rate of specific IgE antibodies against Betula platyphylla and the Alnus japonica were 100%. In foods, the positive rate of serum - specific IgE antibodies was highest for hazelnuts, the fruit of the common hazel, followed by peach, a fruit of the Rosaceae family. Fig. 2 Positive rates class 1 of ImmunoCAP ISAC using allergen components The positive rates of specific IgE antibodies against Bet v1 and Cor a , the main allergens of the Betulaceae families, were high. In foods, Mal d1 in apple and Pru p1 in peach, fruits of the Rosaceae families, and Cor a in hazel nuts and Ara h8 in peanuts, fruits of the non - Rosaceae families, were associated with high positive rates of specific IgE antibodies. PR - 10 Bet v 2 Bet v 2 Ole e 2 Hev v 8 No. 13 PR - 10 PR - 10 PR
5 PR-10 Profilin LTP Csse Birch Alder Hazel Apple Peach Kiwi Celery Carrot Soybean Peanut Hazelnut Birch Timothy Olive Euphobia Latex Artemisia Parietaria Peach Hazelnut Food as cause of OAS Bet v 1 Aln g 1 Cor a 1.01 Mal d 1 Pru p 1 Act d 8 Api g 1 Dau c 1 Gly m 4 Ara h 8 Cor a 1.04 Bet v 2 Phl p 12 Ole e 2 Mer a 1 Hev b 8 Art v 3 Par j 2 Pru p 3 Cor a 8 Tokyo Idai 02 1 Apple, Peach, Kiwi, Soybean, Pear, Cherry, Strawberry Tokyo Idai 04 2 Apple, Peach, Soybean Tokyo Idai 05 3 Apple, Peach, Kiwi, Pear, Cherry, Strawberry, Melon, Orange, Grape, Almond Tokyo Idai 09 4 Apple, Peach, Kiwi, Pear, Cherry, Strawberry Tokyo Idai 10 5 Apple Tokyo Idai 13 6 Apple, Peach, Kiwi, Pear, Banana Tokyo Idai 20 7 Apple, Peach Tokyo Idai 23 8 Apple, Kiwi, Melon, Mango, Banana Tokyo Idai-26 9 Apple, Peach, Carrot, Banana Tokyo Idai Apple, Pear, Cherry, Melon, Watermelon Tokyo Idai Kiwi, Strawberry, Banana Tokyo Idai Apple, Peach, Kiwi, Pear, Cherry, Melon Tokyo Idai Apple, Strawberry, Banana Fig. 3. Comparison of the Results of ImmunoCAP ISAC According to Patient Patients with OAS who were positive for Bet v1 were also positive for plants and foods that contain PR - 10 proteins, which are highly homologous with Bet v1. Similarly, patients with OAS who were positive for Bet v2 were also positive for profilins. As for the relation to causative food substances, symptoms seen in such patients were consistent with those caused by foods containing PR - 10 proteins and foods containing profilins. is PR - 10 is Profilin PR - 10 ImmunoCAP ISAC Table 2 PR - 10 ImmunoCAP RAST PPA 70% 100% LTP NPA 100% Immuno- CAP RAST Bet v 1 Bet v 2 Pru p 1 Ara h 8 Cor a 1 PR - 10 PPA 75% 100% NPA 100% Bet v 2 PPA 100% NPA 100% 1987 Amlot 14 Ortolani 15 OAS OAS 1 OAS OAS Bet v Bet v 1 1 PR Bet v OAS LTP LTP OAS OAS Immuno- CAP ISAC 5
6 : CRD OAS 201 Table 2. Positive percent agreement PPA and negative percent agreement NPA of ImmunoCAP ISAC and ImmunoCAP RAST using crude antigens and allergen components Crude ImmunoCAP RAST vs ImmunoCAPISAC Component ImmunoCAP RAST vs ImmunoCAPISAC PPA % NPA % PPA % NPA % Birch Bet v Birch Bet v Birch Bet v Apple Mal d Peach Pru p Peach Pru p Hazelnut Cor a Hazelnut Cor a Hazelnut Cor a 9 0 Peanut Ara h Peanut Ara h Peanut Ara h Peanut Ara h Kiwi Act d Kiwi Act d Kiwi Act d Kiwi Act d Celery Api g Soybean Gly m Soybean Gly m Soybean Gly m IgE ImmunoCAP RAST OAS OAS Bet v 1 Aln g 1 Cor a IgE PR PR - 10 Bet v 1 Bet v 2 IgE 92.3% 23.1% Bet v 1 Shirasaki CAP 0.35 Bet v %, Bet v % CAP 0.35 Bet v 1 98% Bet v 2 12% Bet v 1 100% Bet v 2 2% Bet v 2 Ole e 2 Mer a 1 Hev b OAS OAS OAS
7 OAS Case No. 13 Bet v 1 Bet v 1 Mal d 1 Pru p 1 IgE Bet v 1 Mal d 1 Pru p 1 PR - 10 Bet v 1 OAS Cor a N - Cor a 1 72% PR - 10 Bet v 1 PR - 10 OAS Bet v 2 3 Case No. 3,10,13 Ole e 1 Mer a 1 Hev b 8 OAS LTP LTP Pru p 3 Art v 3 27 LTP OAS OAS No. 13 OAS ImmunoCAP ISAC ImmunoCAP RAST ImmunoCAP ISAC PPA NPA 13 PR - 10 PPA NPA ImmunoCAP ISAC ImmunoCAP RAST PPA ImmunoCAP ISAC 1 28 ImmunoCAP ISAC OAS Bet v 1 PR - 10 OAS Bet v 2 OAS ImmunoCAP ISAC OAS ImmunoCAP ISAC OAS Bet v 1 PR - 10 PR - 10 OAS OAS ImmunoCAP ISAC ImmunoCAP RAST 7
8 : CRD OAS : 56 : , Yagami K : Allergy to cross - reactive plant proteins. Int Arch Allergy 128 : , Ebo DG, Bridts CH, Verweij MM, De Knop KJ, Hagendorens MM, De Clerck LS, Stevens WJ : Sensitization profiles in birch pollen - allergic patients with and without oral allergy syndrome to apple : lessons from multiplexed component - resolved allergy diagnosis. Clin Exp Allergy 40 : , Bohle B : The impact of pollen - related food allergens on pollen allergy. Allergy 62 : 3-10, Gamboa PM, Sanz ML, Lombardero M, Barber D, Sanchez - Monje R, Goikoetxea ML, Antepara I, Ferrer M, Salcedo G : Compornent - resolved in vitro diagnosis in Peach - allergic patients. J investing allergol Cline immunol 19 : 13-20, Lin J, Bardina L, Shreffler WG, Andreae DA, Ge Y, Wang J, Bruni FM, Fu Z, Han Y, Sampson HA : Development of a novel microarray for large - scale epitope mapping of food allergens. J Allergy Clin Immunol 124 : , Steckelbroeck S, Ballmaer - Weber BK, Vieths S : Potential, pitfalls, and prospects of food allergens or synthetic sequential epitopes. J Allergy Clin Immunol 121 : , Vrtala S : From allergen genes to new forms of allergy diagnosis. Allergy 63 : , Vrtala S, Sperr WR, Reimitzer I, van Ree R, Laffer S, Muller WD, Valent P, Lechner K, Rumpold H, Kraft D : C - DNA cloning of a major allergen from timothy grass pollen ; characterization of the recombinant Ph1 pv allergen. J Immunol 151 : , Ebner C, Birkner T, Valenta R, Rumpold H, Breitenbach M, Scheiner O, Kraft D : Common epitopes of birch pollen and apples - studies by western and northern blot. J Allergy Clin Immunol 88 : , : OAS 209 : , Jahn - Schmid B, Harwangg C, Hiller R, Bohle B, Ebner C, Scheiner O, Mueller MW : Allergen microarray : comparison of microarray using recombinant allergens with conventional diagnostic methods to detect allergen - specific serum immunoglobulin E. Clin Exp Allergy 33 : , Giovanni M, Floriano B, Sergio B, Enrico M, Michele M, Gianni P, Enzo RR, Angelo V, Walter C, and on behalf of the Utalian Board for ISAC : The Immuno- CAP ISAC molecular allergology approach in adult multi - sensitized Italian patients with respiratory symptom. Clinical Biochemistry 44 : , Amlot PL, Kemeny DM, Zachary C, Parkesp P, Lessof MH : Oral allergy syndrome : symptoms of IgE mediated hypersensitivity to foods. Clin Allergy 17 : 33-42, Ortolani C, Ispano M, Pastorella EA, Ansaloni R, Magri GC : Comparison of results of skin prick test wuth fresh foods and commercial food extracts and RAST in 100 patients with oral allergy syndrome. J Allergy Clin Immunol 83 : , Hoffmann SK, Susani M, Ferreira F, Jertschin P, Ahorn H, Steiner R, Kraft D, Scheiner O : High level expression and purification of the major birch pollen allergen, Bet v 1. Protein Expr purify 9 : 33-42, : OAS 209 : , : 55 : , Wensing M, Akkerdass JH, van Leeuwen WA, Stapel SO, bruijnzeel - koomen CA.F.M, Aalberse RC, Bast BJ.E.G, Knuist AC, van Ree R : IgE to Bet v 1 and profiling : Cross reactivity patterns and clinical relevance. J Allergy Clin Immunol 110 : , : 8 : , Lombardero M, Garcia - Selles FJ, Polo F, Jimeno L, Chamorro MJ, Garcia - Casado G, Sanchez - Monge R, Daiaz - Perales A, Salcedo G, Barber D ; Prevalence of sensitization to Artemisia allergens Art v 1, Art v 3 and Art v 60kDa Cross - reactivity among Art v 3 and other relevant lipid - transfer protein allergens. Clin Exp Allergy 34 : , Moverare R, Westritschnig K, Svensson M, Hayek B, Bende M, Pauli G, Sorva R, Haahtela T, Valenta R, Elfman L : Different IgE reactivity profiles in birch pollen - sensitive patients from six European populations revealed by recombinant allergens : an imprint of local sensitization. Int Arch Allergy immunol 128 : , Shirasaki H, Yamamoto T, Koyanagi Y : Detection of specific IgE antibodies in sera of Japanese birch - allergyc patients using recombinant allergens Bet v 1, Bet v 2 and Bet v 4. Allergol Int 57 : 93-96, : 108 : ,
9 : 21 : 66-67, : 13 : , : IgE 58 : , : ImmunoCAP ISAC 30 : 54-58, 2010 Allergen Analysis by Component - resolved Diagnostics CRD in Patients with Oral Allergy Syndrome Hiroko ABE, Masae NUKAGA, Tomoyuki NIITSUMA, Masato ODAWARA Third Department of Internal Medicine, Tokyo Medical University Abstract Allergy testing with the use of crude antigens extracted from food is now commonly performed to evaluate patients for food allergies, but has the drawback of high sensitivity and low specificity. The measurement of specific immunoglobulin E antibodies against allergy components has enabled us to understand the sensitization status and clinicohistopathological characteristics of patients with allergic diseases. We used ImmunoCAP ISAC an immunological solid - phase allergen chip to analyze 103 components and sensitization patterns in 13 patients with oral allergy syndrome OAS, a type of food allergy. Of the 13 patients with OAS, % tested positive for Bet v1 the primary allergen of Betula platyphylla and Cor a in Japanese white birch, and % tested positive for Aln g1 in Alnus japonica. These substances are classified as pathogenesis - related protein 10 PR - 10 proteins. As for foods, 12 patients 92.3% tested positive for Mal d 1 in apple a fruit of the Rosaceae family, and % tested positive for Pru p 1 in peach. These substances are also classified as PR - 10 proteins. All 3 patients with positive results for Bet v2 of Betula platyphylla were positive for Ole e2 in olive, Mer a1 in the Euphorbiaceae family, and Hev b8 in latex. All of these substances are profilins. The results of ImmunoCAP ISAC showed that patients with OAS can be broadly divided into 2 groups : those sensitized to PR - 10 proteins and those sensitized to profilins. ImmunoCAP ISAC, which enables allergens to be comprehensively detected at component levels on a single examination, can evaluate sensitization patterns associated with common types of antigenicity and is also useful for appropriate food avoidance therapy. Key words : Oral allergy syndrome, PR - 10 protein, Cross reaction, ImmunoCAP ISAC 9
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