M.San Miguel-Moncin

An Observational Study on Outgrowing Food Allergy during Non-Birch Pollen-Specific, Subcutaneous Immunotherapy

Background: Birch pollen-specific immunotherapy (SIT) decreases allergy to foods containing birch pollen-homologous allergens. Cross-reactivity was also observed between plane tree pollen and some vegetable foods. Objective: The aim of this study was to evaluate the outgrowing of food allergy by patients suffering from vegetable food allergy associated with plane tree pollinosis (rhinoconjunctivitis and/or asthma) during plane tree pollen SIT. Methods: An observational and prospective study was conducted in 16 adult patients suffering from vegetable food allergy (hazelnut, walnut, lettuce, peach and cherry) and from plane tree pollinosis receiving plane tree pollen SIT for 1 year. Open oral challenges with the implicated food were performed before and after SIT. Blood samples were drawn for measurement of pollen- and food-specific IgE and IgG4 before and after treatment. Results: Plane tree SIT resulted in a significant decrease in food allergy, since the mean food quantity provoking objective symptoms increased from 2.19 to 13.74 g (p < 0.05), and 6 of the 11 patients tolerated the highest level (25 g) of the challenged food after plane tree SIT. Laboratory data also showed a decrease in IgE levels and an increase in IgG4 levels after immunotherapy. Conclusion: SIT with plane tree pollen has a positive impact on food allergy in plane tree pollen-allergic subjects.

AbstractNew pets: New allergenic sources☆

Abstract Rationale Although furry animals are known sources of respiratory allergy, scaly animals are assumed not to be allergenic. A patient suffering from allergic rhinoconjunctivitis and asthma to a Iguana pet is described. Methods A 42-year-old woman complained of allergic rhinoconjunctivitis and asthma symptoms occurring exclusively in her own home. She had a past history of rhinoconjunctivitis and asthma which completely disappeared after removal of a Siberian hamster a year ago. Later, she denied presence of new pets at her home. Nasal and bronchial functional tests were performed. Skin prick testing (SPT) with different aeroallergens elicited negative. After insisting on possible allergenic sources at her home, she admitted current presence of an Iguana from his son ownership . Extracts with hamster hair and epithelium and scales and urine from her Iguana were prepared. SPT and nasal challenge were performed with Iguana scales extract. SDS-PAGE- Immunoblotting experiments were carried out to study IgE-binding bands profile. Results SPT and nasal challenge with Iguana scales extract were positive (negative in ten controls). IgE antibody-binding revealed two major bands in the molecular weight range of 40–50 kDA in the Iguana scales extract. Faint bands could be spotted in the urine extract, and none in hamster hair/epithelium. After removal of Iguana from her home, patients asthma and rhinoconjunctivitis completely disappeared. Conclusions In this study, clear IgE-sensitization and respiratory allergy to Iguana scales is demonstrated. Allergy history should include questions about any kind of pets. Allergy to scaly pets should be taken into account, because if not such allergies may go undiagnosed.

New pets: New allergenic sources☆

Abstract Rationale Although furry animals are known sources of respiratory allergy, scaly animals are assumed not to be allergenic. A patient suffering from allergic rhinoconjunctivitis and asthma to a Iguana pet is described. Methods A 42-year-old woman complained of allergic rhinoconjunctivitis and asthma symptoms occurring exclusively in her own home. She had a past history of rhinoconjunctivitis and asthma which completely disappeared after removal of a Siberian hamster a year ago. Later, she denied presence of new pets at her home. Nasal and bronchial functional tests were performed. Skin prick testing (SPT) with different aeroallergens elicited negative. After insisting on possible allergenic sources at her home, she admitted current presence of an Iguana from his son ownership . Extracts with hamster hair and epithelium and scales and urine from her Iguana were prepared. SPT and nasal challenge were performed with Iguana scales extract. SDS-PAGE- Immunoblotting experiments were carried out to study IgE-binding bands profile. Results SPT and nasal challenge with Iguana scales extract were positive (negative in ten controls). IgE antibody-binding revealed two major bands in the molecular weight range of 40–50 kDA in the Iguana scales extract. Faint bands could be spotted in the urine extract, and none in hamster hair/epithelium. After removal of Iguana from her home, patients asthma and rhinoconjunctivitis completely disappeared. Conclusions In this study, clear IgE-sensitization and respiratory allergy to Iguana scales is demonstrated. Allergy history should include questions about any kind of pets. Allergy to scaly pets should be taken into account, because if not such allergies may go undiagnosed.