Lipid transfer protein-linked hazelnut allergy in children from a non-Mediterranean birch-endemic area

A.E. Flinterman, J.H. Akkerdaas, C.F. den Hartog Jager, N. Rigby, M. Fernandez-Rivas, M.O. Hoekstra, C.A.F.M. Bruijnzeel - Koomen, A.C. Knulst, R. van Ree, S.G.M.A. Pasmans

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

BACKGROUND: Hazelnut allergy in birch pollen-exposed areas is usually due to cross-reactivity (Cor a 1 and 2) and is usually mild in nature (oral allergy). In areas without birches, severe reactions are more prevalent and linked to sensitization to the lipid transfer protein (LTP) Cor a 8.

OBJECTIVE: We sought to investigate whether sensitization to LTP plays a role in more severe (objective) hazelnut-induced symptoms in children from a birch-endemic area.

METHODS: Sensitization to Cor a 8, Cor a 2, Cor a 1, and Bet v 1 was determined by means of RASTs and immunoblotting in hazelnut-sensitized children with (n = 8) and without (n = 18) objective reactions during double-blind, placebo-controlled food challenges. Additionally, samples from 191 hazelnut-sensitized nonchallenged children were analyzed.

RESULTS: Children with objective reactions during double-blind, placebo-controlled food challenge had higher IgE titers to hazelnut (P < .001) and recognized more allergens on immunoblotting (P = .001) than those without such reactions. All children with objective symptoms were sensitized to Cor a 8 (0.51-23.3 IU/mL) compared with only 1 child without objective reactions (0.90 IU/mL). In a multivariate analysis only IgE against Cor a 8 remained as an independent risk factor (undefined odds ratio; P < .0001). In the group of nonchallenged children (n = 191), the prevalence of LTP sensitization was greater than 30%. Unexpectedly, sensitization to Cor a 1 was observed in children not sensitized to Bet v 1.

CONCLUSION: Sensitization to hazelnut LTP is a risk factor for objective symptoms in children from a birch-endemic area.

Original languageEnglish
Pages (from-to)423-428
Number of pages6
JournalJournal of Allergy and Clinical Immunology
Volume121
Issue number2
DOIs
Publication statusPublished - Feb 2008

Keywords

  • Aging
  • Antigens, Plant
  • Betula
  • Carrier Proteins
  • Child
  • Corylus
  • Double-Blind Method
  • Environment
  • Female
  • Humans
  • Immunization
  • Immunoglobulin E
  • Male
  • Nut Hypersensitivity
  • Plant Proteins
  • Risk Factors
  • Severity of Illness Index

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