Hazelnut allergy across Europe dissected molecularly: A EuroPrevall outpatient clinic survey.

Abstract

BACKGROUND:

Hazelnut allergy is birch pollen-driven in Northern/Western Europe and lipid transfer protein-driven in Spain and Italy. Little is known about other regions and other allergens.

OBJECTIVE:

Establishing a molecular map of hazelnut allergy across Europe.

METHODS:

In 12 European cities, subjects reporting reactions to hazelnut (n = 731) were evaluated and sensitization to 24 foods, 12 respiratory allergen sources, and latex was tested by using skin prick test and ImmunoCAP. A subset (124 of 731) underwent a double-blind placebo-controlled food challenge to hazelnut. Sera of 423 of 731 subjects were analyzed for IgE against 7 hazelnut allergens and cross-reactive carbohydrate determinants by ImmunoCAP.

RESULTS:

Hazelnut allergy was confirmed in 70% of those undergoing double-blind placebo-controlled food challenges. Birch pollen-driven hazelnut sensitization (Cor a 1) dominated in most cities, except in Reykjavik, Sofia, Athens, and Madrid, where reporting of hazelnut allergy was less frequent anyhow. In Athens, IgE against Cor a 8 dominated and strongly correlated with IgE against walnut, peach, and apple and against Chenopodium, plane tree, and mugwort pollen. Sensitization to seed storage proteins was observed in less than 10%, mainly in children, and correlated with IgE to nuts, seeds, and legumes. IgE to Cor a 12, observed in all cities (10% to 25%), correlated with IgE to nuts, seeds, and pollen.

CONCLUSIONS:

In adulthood, the importance of hazelnut sensitization to storage proteins, oleosin (Cor a 12), and Cor a 8 is diluted by the increased role of birch pollen cross-reactivity with Cor a 1. Cor a 8 sensitization in the Mediterranean is probably driven by diet in combination with pollen exposure. Hazelnut oleosin sensitization is prevalent across Europe; however, the clinical relevance remains to be established.

• Authors: Mareen R Datema, Laurian Zuidmeer-Jongejan, Riccardo Asero, Laura Barreales, Simona Belohlavkova, Frédéric de Blay, Peter Bures, Michael Clausen, Ruta Dubakiene, David Gislason, Monika Jedrzejczak-Czechowicz, Marek L Kowalski, André C Knulst, Tanya Kralimarkova, Thuy-My Le, Alison Lovegrove, Justin Marsh, Nikolaos G Papadopoulos, Todor Popov, Náyade Del Prado, Ashok Purohit, Gerald Reese, Isabel Reig, Suranjith L Seneviratne, Athanasios Sinaniotis, Serge A Versteeg, Stefan Vieths, Aeilko H Zwinderman, Clare Mills, Jonas Lidholm, Karin Hoffmann-Sommergruber, Montserrat Fernández-Rivas, Barbara Ballmer-Weber, Ronald van Ree
• Journal: The Journal of allergy and clinical immunology (J Allergy Clin Immunol) Vol. 136 Issue 2 Pg. 382-91 (Aug 2015) ISSN: 1097-6825 [Electronic] United States
• PMID: 25772593 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: Copyright © 2015 American Academy of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

Chemical References

• Allergens
• Antigens, Plant
• Carrier Proteins
• Cor a 8 allergen, Corylus avellana
• lipid transfer protein
• oleosin, Corylus avellana
• Immunoglobulin E

Topics

• Adolescent
• Adult
• Allergens (immunology)
• Ambulatory Care Facilities (statistics & numerical data)
• Antigens, Plant (immunology)
• Betula (chemistry, immunology)
• Carrier Proteins (immunology)
• Corylus (chemistry, immunology)
• Cross Reactions
• Double-Blind Method
• Europe (epidemiology)
• Female
• Humans
• Immunoglobulin E (blood)
• Male
• Middle Aged
• Molecular Epidemiology
• Nut Hypersensitivity (epidemiology, etiology, immunology, physiopathology)
• Pollen (immunology)
• Skin Tests