Katarzyna Napiórkowska

Celery--cause of severe anaphylactic shock.

BACKGROUND We present a case of anaphylactic shock induced by celery ingestion in a 28-year old woman with pollinosis during allergen (50% birch, 50% grass) immunotherapy. CASE REPORT A female patient, aged 28 was admitted to the clinic due to a serious anaphylactic reaction. The event took place 15 min after ingesting fresh celery. She recovered after routine treatment with adrenaline, corticosteroids and antazoline. CONCLUSIONS Our case shows the possibility of simultaneous occurrence of hypersensitivity to inhaled allergens and food. In such cases, it is considered part of cross-reactivity We discuss the importance of cross- reactivity associated with sensitization to pollen and vegetable foods.

Role of E-selectin and platelet endothelial cell adhesion molecule 1 in gastritis in food allergy patients

Introduction The prevalence of food allergies and other allergic reactions is increasing worldwide, particularly in highly-urbanized populations. Cell adhesion molecules are expressed in response to various pro-inflammatory cytokines. The expression of intercellular adhesion molecule 1 – ICAM-1 (CD54), ICAM-1 (CD106), P-selectin (CD62P), and E-selectin (CD62E) on vascular endothelial cells is induced by such pro-inflammatory cytokines as tumor necrosis factor α (TNF-α) and interleukin-1 (IL-1). Aim To analyze concentrations of E-selectin and platelet endothelial cell adhesion molecule-1 (PECAM-1) in patients with an allergic type of food sensitivity co-existing with gastritis and to compare them to the values determined in individuals with dyspeptic symptoms not associated with allergic disorders. Material and methods The study included 80 patients, among them 50 individuals with food sensitivity confirmed based on compulsory standards, and 30 subjects with dyspeptic symptoms not accompanied by allergic conditions. Venous blood samples were taken from each patient and concentrations of E-selectin and PECAM-1 were determined by means of ELISA. Results Mean concentrations of sE-selectin and sPECAM-1 in patients with food allergy amounted to 54.0 ±21.6 ng/ml and 132.8 ±31.4 ng/ml, respectively. In individuals without food allergy, mean concentrations of sE-selectin and sPECAM-1 were 57.7 ±17.9 ng/ml and 139.6 ±31.1 ng/ml, respectively. Patients with food allergy and individuals with dyspeptic symptoms not associated with food allergy did not differ significantly in terms of sE-selectin concentrations (Mann-Whitney U-test, p = 0.453028). Similarly, no significant intergroup differences were observed with regard to sPECAM-1 concentrations (Mann-Whitney U-test, p = 0.231054). Conclusions Adhesion molecules play an important role in the development of inflammation. This study did not find significant differences in the concentrations of such molecules as sE-selectin and sPECAM-1 between patients with food allergy and gastritis, and subjects in whom gastritis was not accompanied by atopic disorders. A positive correlation between the concentrations of sPECAM-1 and E-selectin was observed in food allergy patients. Consequently, it can be concluded that these molecules participate in the pathogenesis of the inflammatory process independently of the etiopathogenesis of gastritis.

Determination of ECP Concentration in Patients with Allergic Type of Food Hypersensitivity and in Patients with Dyspeptic Symptoms not Associated with Food Allergy

Introduction. The results of many studies suggest that the tendency towards the prevalence of food allergies is increasing [1, 2, 3]. It is estimated that approximately 20% of population modifies their diet due to adverse reactions observed after ingestion of certain foods [2]. Still, the exact prevalence rate of food allergies in pediatric and adult populations cannot be satisfactorily estimated [4]. The aim of this study was to determine serum concentrations of eosinophil cationic protein (ECP) in patients with allergic type of food sensitivity and to compare them to data obtained from patients with dyspeptic disorders without a concomitant allergic condition. Material and methods. This study included a group of 80 patients; among them 50 individuals with diagnosed food sensitivity based on existing standards, and 30 subjects with dyspeptic symptoms without an associated allergic condition. Venous blood was collected from each participant and ECP concentration was determined by means of fluoro-immunoenzyme assay (FIA) with UniCAP ECP test (Pharmacia Diagnostics). Results. The arithmetic mean serum ECP concentration in patients with food allergy was found to be 24.604 ± 40.36 μg/l. In all individuals, serum ECP concentrations were within the detection limit of the applied method. The average concentration of ECP in a group of subjects without food allergy was determined to be 29.9±64.76 μg/l and did not exceed the lower or the upper detection limit of the applied method. Conclusions. Patients with food allergy did not differ significantly from those with dyspeptic symptoms without a concomitant allergy in terms of ECP concentration (Mann-Whitney U test, p=0.754218).

Assessment of cross-reactivity in patients allergic to birch pollen by immunoblotting

Cross-reactivity related to birch pollynosis and ingestion of certain food poses a severe clinical and diagnostic problem. Sera were taken from 21 adult patients allergic to birch pollen with symptoms after ingestion of apples, carrots and celeries, and seven control subjects allergic to birch pollen only. Concentrations of allergen-specific IgE against allergens of birch pollen, apple, carrot and celery were measured with enzyme immunoassay, fluorimetric enzyme-linked immunoassay and immunoblotting. Immunoblotting technique may serve as a valuable diagnostic tool for birch pollen associated cross-reactivity.

The role of skin prick test in diagnosis of food allergy in patients with birch pollinosis

Introduction. The incidence of food allergy is constantly growing. Particularly high percentage of patients is allergic to pollens - even 70 % of patients with a pollen allergy suffer from undesirable symptoms that appear after eating plant foods. It is connected mainly with crossreactivity between allergens. The fact that manifestations of food allergy concern different systems and organs is a problem and it causes diagnosing food allergy difficult and often underestimated. The aim of this study was to determine the role of skin prick tests in the diagnosis of food allergy in patients with birch pollinosis. Matherial and methods. 35 patients with birch pollinosis suffering after eating apple, celery, carrot, tomato, banana, peach, peanut and hazelnut were included to the study. The skin prick tests with applying extracts of allergens mentioned above were determined for all individuals. Results. The analysis of the results of positive skin prick tests in patients reporting manifestations was as follows: celery 100 %, hazelnut 65.4 %, peanut 40 %, carrot 30.8 %, peach 20 %, tomato 14.3 %, apple 3.7 % and banana 0 %. In the skin prick tests, negative results were also achieved, although patients reported appearance of symptoms of sensitivity to given allergens: apple (74.3 % of persons), peach (34.3 % of persons), the hazelnut and the carrot (25.5 % for each of allergens), the tomato and the peanut (17.1 % for each of allergens) and banana (11.4 %). It is interesting that some of the patients had positive test results for the celery (22.8 %), although they did not report symptoms of oversensitivity to this kind of food. Conclusions. Although skin prick tests are a universally used diagnostic method but in case of food allergy, the negative result cannot be a criterion which results in excluding this diagnosis .

An assessment of cross reactivity with patients allergic to birch pollen using the immunoblotting.

The aim Evaluation of the applicability of immunoblotting for diagnosing cross reactivity between homologous proteins present in various sources. Method and material: Group of 21 patients with birch pollen allergy aged 41,7±5,2 revealing symptoms after eating cross-reacting food and positive skin tests, or prick by prick tests with native food allergens. Control group 7 persons aged 39,8±4,7, allergic to birch pollen without any symptoms after having eaten the above mentioned food. Concentration of asIgE for birch pollen, apple, carrot and celery allergens has been measured with EIA method. Concentration of asIgE against recombinant allergens of birch pollen Bet v1, Bet v2 and celery Api g1 has been evaluated with FEIA-UniCAP 100. As plant material served specially prepared extracts of apples’, separately peel and pulp, as well as of carrot and celery. The detection of proteins following the immunobloting was conducted by incubating in the darkness the nitrocellulose membrane in a buffer solution and peroxidase substrate.

Evaluation of sE-selectin and sPECAM-1 levels in patients diagnosed with food allergy

Results The average sE-selectin levels in the food allergy patient population were 54.0 +/- 21.6 ng/mL, while in the allergy-free population, the average sE-selectin levels were 57.7 +/-17.9 ng/mL. No statistically significant difference between sE-selectin levels was found between food allergy patients and patients with dyspeptic symptoms without concomitant food allergy (Mann-Whitney U-test, p =0.453028). In the food allergy patient population, average sPECAM-1 levels were 132.8 +/-31.4 ng/ ml, while in the allergy-free population average sPECAM-1 levels were 139.6 +/- 31.1 ng/ml. The analysis of the obtained results revealed no statistically significant difference between sPECAM-1 levels in food allergy patients and patients with dyspeptic symptoms without concomitant food allergy. Conclusions The results of examinations conducted in this study showed no statistically significant differences in serum PECAM-1 and E-selecine levels between the study groups.

Diagnosis of cross-reactivity in patients with birth pollinosis

Material and Methods The clinical history and the positive SPT with the birch extract were the condition for qualifications. 23 patients included in the first group were only birch allergic. 35 patients in the other group had birch pollen allergy and they reported symptoms after eating apple, celery, carrot, tomato, banana, peach, peanut and hazelnut. The skin tests were performed and serum IgE concentration (total and specific) were determined for all individuals. The immunoblotting was performed for the patients with the positive value of birch, apple, celery and/or carrot specific IgE.

Evaluation of peripheral blood eosinophilia, serum ECP levels of eosinophils in inflammatory infiltrates of gastric mucosa in food allergy patients

Eosinophilic infiltration may be found in all segments of the gastrointestinal tract. The goal of this study was to evaluate the peripheral blood eosinophilia, serum ECP levels and presence of eosinophils in inflammatory infiltrates of the gastric mucosa in food allergy patients.