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Evaluation of food‐pollen cross‐reactivity by nose–mouth cross‐challenge in pollinosis with oral allergy syndrome
Author(s) -
Marcucci F.,
Frati F.,
Sensi L.,
Cara G. D.,
Novembre E.,
Bernardini R.,
Caica G. W.,
Passalacqua G.
Publication year - 2005
Publication title -
allergy
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.363
H-Index - 173
eISSN - 1398-9995
pISSN - 0105-4538
DOI - 10.1111/j.1398-9995.2004.00679.x
Subject(s) - oral allergy syndrome , food allergy , medicine , immunology , eosinophil cationic protein , nose , allergy , allergen , mucous membrane of nose , pollen , nasal provocation test , immunoglobulin e , oral food challenge , dermatology , cross reactivity , tryptase , cross reactions , eosinophil , antibody , mast cell , biology , surgery , botany , asthma
Background: Oral allergy syndrome (OAS) is often associated with pollen‐induced rhinitis, and there are preferential associations between causative substances. If OAS and rhinitis are both immunoglobulin (Ig)E‐mediated and there are cross‐reacting proteins, it is expected that similar reactions can be elicited in the nose and mouth. In order to test this hypothesis we performed a series of ‘cross‐challenges’ with foods and pollens in both the nose and the mouth. Methods: Nine patients with ascertained OAS due to vegetables and rhinitis due to pollens were studied. On the first day a nasal challenge with pollen extracts and an oral challenge with fresh food was carried out. After a week, washout nasal challenge with food and an oral challenge with pollens were performed. Immediate symptoms, mucosal tryptase and soluble eosinophil cationic protein (ECP) were assessed after each challenge. Results: The administration of pollen into the nose and food into the mouth elicited symptoms as expected, but the cross‐challenge had no clinical effect. In parallel, tryptase and ECP increased after nasal challenge with pollens, whereas foods did not elicit a measurable response. Conclusion: The cross‐reactivity between foods and pollens, when evaluated at the shock organ, was not clinically evident. This data can be explained with a low concentration of cross‐reagent epitopes in pollen extracts and food homogenized because of degradation. The different behaviour upon challenge suggests that different immunological mechanisms may act in the nose and mouth.