C. Metz-Favre

Identification of enolases and aldolases as important fish allergens in cod, salmon and tuna: component resolved diagnosis using parvalbumin and the new allergens.

The majority of fish‐allergic patients are sensitized to parvalbumin, known to be the cause of important IgE cross‐reactivity among fish species. Little is known about the importance of fish allergens other than parvalbumin.

Pneumopathie d’hypersensibilité à Penicillium chrysogenum et Streptomyces mésophile : intérêt de l’enquête environnementale à domicile

Hypersensitivity pneumonitis (HP) occurred after organic antigens inhalation at home is rare and the diagnosis is very often difficult. We report the case of a 55-year male patient with allergic asthma since childhood, well controlled with inhaled corticosteroids, twice hospitalized for respiratory distresses. The patient presented fever (39°C), dry cough, rapidly progressive dyspnea, chest pain and crackles. Blood gas analysis found a hypoxemia of 52 mmHg, and CT-scan showed ground glass images in the upper lobes. Respiratory function tests showed severe obstructive syndrome and a decrease of diffusion test. HP was suspected because the symptoms were triggered by domestic environmental. The Medical Indoor Environment Councelor (MIEC) visited the patients house and camper and performed air and dust samples. Moldy walnuts were found in the camper. The identification of microorganisms present in the air and on the surfaces in the camper was used for serum precipitins research by double diffusion (DD) and electrosyneresis (E) methods. From the 14 antigens tested, serological tests were considered significant for mesophilic Streptomyces (five arcs DD, six arcs E) and Penicillium chrysogenum (one arc DD, four arcs E). After removal from the camper of the objects suspected to be contaminated, the patients symptoms regressed. This is a typical case of domestic HP to mesophilic Streptomyces and P. chrysogenum. The MIECs intervention was useful in both diagnosis and treatment.

Les marqueurs d’exposition au tabagisme passif

Resume Introduction La fumee de tabac est l’un des polluants atmospheriques les plus repandus dans l’environnement interieur. Le tabagisme passif est defini comme l’inhalation involontaire de la fumee de tabac presente dans l’air. Le but de cet article est d’exposer les interets et les limites des methodes de dosage du tabagisme passif. Etat des connaissances Le tabagisme passif peut s’apprecier par des mesures directes des polluants de la fumee de tabac dans l’air et par le dosage des biomarqueurs, reflet indirect de l’exposition. Conclusion Les dosages atmospheriques de la nicotine et du 3-Ethenylpyridine semblent plus adaptes en raison de leur specificite. Parmi les quatre marqueurs biologiques (la nicotine, la cotinine, les thiocyanates, les adduits de proteines ou d’ADN) seul le dosage de la cotinine urinaire peut etre retenu comme marqueur fiable de l’exposition tabagique. Il est utilise comme reference dans la plupart des etudes epidemiologiques, mais ne reflete que l’exposition tabagique des 48 dernieres heures. Le dosage de la nicotine ou de la cotinine dans les phaneres (cheveux ou ongles) reflete l’exposition du tabagisme des trois derniers mois et pourrait devenir un marqueur de reference dans les etudes epidemiologiques et toxicologiques. Cependant d’autres etudes devraient etre realisees pour confirmer l’interet de ces marqueurs.

Do Plantago lanceolata Skin Prick Test-Positive Patients Display IgE to Genuine Plantain Pollen Allergens? Investigation of Pollen Allergic Patients from the North-East of France

Background: English plantain (Plantago lanceolata) is an important weed pollen allergen source triggering allergic symptoms during summer. To elucidate genuine versus cross-reactive sensitization, we investigated IgE reactivity patterns and inhibition capacities of plantain-sensitized patients. Methods: Sera of 35 rhinoconjunctivitis patients from the north-east of France with positive skin prick tests (SPT) to Plantago lanceolata pollen were tested with clinically relevant allergen sources using ELISA, ImmunoCAP, and immunoblot inhibition. Results: The patients were multisensitized with additional reactivity to grass (94.3%), ash (74.3%), birch (71.4%), and mugwort (55.2%) pollen in SPT. Sensitization prevalence to allergen molecules was 34.3% (Pla l 1), 94.3% (Phl p 1/5), 60.0% (Ole e 1), 65.7% (Bet v 1), 37.1% (profilin), and 40.0% (CCD). In immunoblot, IgE reactivity to plantain pollen was inhibited with relevant pollen extracts and purified rPla l 1. Two sera did not reveal any IgE cross-reactivity, while reactivity to plantain was efficiently inhibited by grass pollen in the sera of 10 patients. The sera from 17 different patients could be inhibited by grass, birch, or ash pollen to varying degrees. Thus, only 37.1% of our patients demonstrated true plantain pollen sensitization, while 62.9% were solely positive due to IgE cross-reactive molecules from other clinically relevant pollen. Conclusions: Plantain pollen-sensitized patients are multi-reactors demonstrating varying and complex IgE-reactivity profiles. In vivo and in vitro tests using extracts are typically blurred due to the presence of homologous allergens or CCD in grass, birch, or ash pollen. So far, Pla l 1 represents the only indicative marker allergen for the diagnosis of genuine plantain pollen sensitization.