Perspective of purified natural and recombinant allergens in diagnosis and treatment of inhalant allergies.
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Biomedical subjects
Publications and source records attributed to R van Ree.
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BACKGROUND: Lipid transfer proteins (LTPs) are stable and highly conserved proteins of around 10 kD. They have recently been identified as allergens in fruits of the Rosaceae family. OBJECTIVE: The aim of this study was to investigate whether the highly conserved structure of LTPs justifies a designation as a true pan-allergen, and to study the role of protein stability in allergenicity. METHODS: Thirty-eight patients with a positive skin prick test to Rosaceae fruit extracts were characterized by interviews and skin prick tests. To investigate IgE cross-reactivity between Rosaceae and non-Rosaceae LTPs, RAST and RAST inhibition as well as ELISA and ELISA inhibition were performed, using whole food extracts and purified natural and recombinant LTPs. To address the role of protein stability in the allergenicity of LTP, fruit extracts and LTPs were digested with pepsin. RESULTS: IgE antibodies to Rosaceae LTPs cross-reacted with a broad range of non-Rosaceae vegetable foods. Inhibition studies with purified natural and recombinant LTPs confirmed the role of LTP in this cross-reactivity. Many of the patients with this type of cross-reactive IgE antibodies had a clinical food allergy. In contrast to the typical birch Rosaceae cross-reactive patients, the oral allergy syndrome was frequently accompanied by more severe and systemic reactions. IgE reactivity to LTP was shown to be resistant to pepsin treatment of the allergen. CONCLUSION: LTP is a true pan-allergen with a degree of cross-reactivity comparable to profilin. Due to its extreme resistance to pepsin digestion, LTP is a potentially severe food allergen.
In approximately 25% of subjects receiving tetanus booster immunization (4 study groups A-D with n = 6, 25, 50 and 240, respectively; age 18-40 years for groups A-C, age 2 for group D), substantial IgE antibody levels were found. In groups A and B, sequential serum samples were available for analysis. The IgE response peaked before the IgG response and was often higher at week 1 than at week 2. The 6 subjects in group A (military recruits) received 2 booster injections. At the time of the second injection, 2 subjects had a very high IgE antibody titre (as well as a high IgG antibody titre), but no signs of an allergic reaction were noted. A significant association with atopy-related factors was found, but many apparently non-atopic subjects developed IgE antibodies.