1. New light on an old syndrome: Role of Api g 7 in mugwort pollen-related celery allergy.
- Author
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Ballmer-Weber BK, Wangorsch A, Bures P, Hanschmann KM, Gadermaier G, Mattsson L, Mills CEN, van Ree R, Lidholm J, and Vieths S
- Subjects
- Adolescent, Adult, Aged, Child, Female, Humans, Male, Middle Aged, Young Adult, Anaphylaxis immunology, Anaphylaxis etiology, Anaphylaxis diagnosis, Artemisia immunology, Immunoglobulin E immunology, Immunoglobulin E blood, Rhinitis, Allergic, Seasonal immunology, Rhinitis, Allergic, Seasonal diagnosis, Syndrome, Allergens immunology, Antigens, Plant immunology, Apium immunology, Apium adverse effects, Food Hypersensitivity immunology, Food Hypersensitivity diagnosis, Plant Proteins immunology, Pollen immunology
- Abstract
Background: Celery root is known to cause severe allergic reactions in patients sensitized to mugwort pollen., Objective: We studied clinically well-characterized patients with celery allergy by IgE testing with a comprehensive panel of celery allergens to disentangle the molecular basis of what is known as the celery-mugwort syndrome., Methods: Patients with suspected food allergy to celery underwent a standardized interview. Main inclusion criteria were a positive food challenge with celery or an unambiguous case history of severe anaphylaxis. IgE to celery allergens (rApi g 1.01, rApi g 1.02, rApi g 2, rApi g 4, nApi g 5, rApi g 6, rApi g 7) and to mugwort allergens (rArt v 1, rArt v 3, rArt v 4) were determined. IgE levels ≥0.35 kU
A /L were regarded positive., Results: Seventy-nine patients with allergy to celery were included. Thirty patients had mild oral or rhinoconjunctival symptoms, and 49 had systemic reactions. Sixty-eight percent had IgE to celery extract, 80% to birch pollen, and 77% to mugwort pollen. A combination of Api g 1.01, 1.02, 4, 5, and 7 increased the diagnostic sensitivity for celery allergy to 92%. The lipid transfer proteins Api g 2 and Api g 6 were not relevant in our celery-allergic population. IgE to Api g 7, detected in 52% of patients, correlated closely (r = 0.86) to Art v 1 from mugwort pollen. Eleven of 12 patients with monosensitization to Api g 7 were IgE negative to celery extract. The odds ratio for developing a severe anaphylactic reaction rather than only mild oral symptoms was about 6 times greater (odds ratio, 5.87; 95% confidence interval, 1.08-32.0; P = .0410) for Api g 7-sensitized versus -nonsensitized subjects., Conclusion: There is an urgent need for routine diagnostic tests to assess sensitization to Api g 7, not only to increase test sensitivity but also to identify patients at risk of a severe allergic reaction to celery., (Copyright © 2024 American Academy of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.)- Published
- 2024
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