Sensitization from chestnuts and bananas in patients with urticaria and anaphylaxis from contact with latex.
ABSTRACT We present eight patients allergic to latex and fruit (chestnut and banana), seven of whom are women, and aged 17 to 42 years (mean 25 years). Four had family and five personal atopic histories. The total IgE varied from 41 to 520 Ku/L (mean 263). The symptoms followed ingestion of fruit (anaphylaxis) in four patients and contact with rubber (contact urticaria and anaphylaxis) in the other four. Skin prick test (SPT) with latex and radioallergosorbent test to latex were positive in all the patients. Histamine release (HR) to latex was carried out on six patients and was positive in three. In the six patients with symptoms after having eaten chestnuts the SPT was positive and specific IgE was detected in five of them. Histamine release to chestnuts was positive in three of the six patients tested and one of them (-SPT and + IgE) tolerated the fruit. Two out of five patients with symptomatic banana allergy had negative SPT with banana while the test was positive in one patient who tolerated this fruit, this being the only case with specific IgE to banana. Histamine release with banana was only positive in one case. The important correlation between SPT, RAST, and HR results to latex and chestnut together with the total inhibition of the chestnut RAST with a serum pool by preincubation with latex suggests cross-reactivity among these allergens.
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ABSTRACT: To evaluate the clinical significance of chestnut as a food allergen in Korea, skin prick test and ELISA were done in 1,738 patients with respiratory allergies. To identify the IgE binding components, IgE-immunoblotting, 2D IgE-immunoblotting and MALDITOF were performed. To observe the effects of digestive enzymes and a boiling treatment, simulated gastric fluid (SGF) and simulated intestinal fluids (SIF) were incubated with chestnut extracts, and IgE-immunoblotting were then repeated. Skin prick test revealed that 56 (3.2%) patients showed more than 2+ of allergen to histamine ratio to chestnut. Among the 21 IgE binding components, 9 bands were found in more than 50% of the sera tested and the 24 kDa protein had the highest binding intensity. The amino acid sequence of the 24 kDa protein (pI 6.3) had homology with legume protein of oak tree. SGF, SIF and boiling treatment were able to suppress the IgE binding components. In conclusion, chestnut ingestion was shown to induce IgE mediated responses with a 3.2% sensitization rate. Twenty one IgE binding components and one new allergen (the 24 kDa protein) were identified. Digestive enzymes and boiling treatment were able to decrease the allergenic potency.Journal of Korean Medical Science 09/2005; 20(4):573-8. · 0.99 Impact Factor
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ABSTRACT: Phuk-waan-ban, Euphorbiaceae Sauropus androgynus (Linn) Merr, belongs to the family Euphorbiaceae, which is the same as the rubber tree, Euphorbiaceae Hevea brasiliensis. The young leaves are edible. To the best of the authors knowledge, this is the first report of anaphylactic reaction to Phuk-waan-ban in latex allergic patients. Contact urticaria and anaphylactic reactions to latex-containing rubber products are being recognized with increasing frequency in all kinds of medical disciplines. The prevalence and incidence are both increasing. Recently, a number of reports have been published describing anaphylactic reactions to food items in patients with latex allergy. The authors present a patient with occupational natural rubber allergy who developed an anaphylactic reaction with urticarial rash 20-30 minutes after ingestion of phuk-waan-ban. The diagnostic work up showed specific IgE to latex (CAP class 3). Positive skin prick tests to latex and cooked and raw phuk-waan-ban crude extract confirmed allergic reactions. Moreover, the cross-reaction between phuk-waan-ban and latex can be confirmed by using IgE inhibition test.Journal of the Medical Association of Thailand = Chotmaihet thangphaet 05/2010; 93(5):616-9.
Article: Randomized, double-blind, placebo-controlled clinical trial of sublingual immunotherapy in natural rubber latex allergic patients.[show abstract] [hide abstract]
ABSTRACT: Natural rubber latex allergy is a common and unsolved health problem. Since the avoidance of exposure is very difficult, immunotherapy is strongly recommended, but before its use in patients, it is essential to prove the efficacy and safety of extracts.The aim of the present randomised, double-blind, placebo-controlled clinical trial was to assess the efficacy and tolerability of latex sublingual immunotherapy in adult patients undergoing permanent latex avoidance. Twenty-eight adult latex-allergic patients (5 males and 23 females), with mean age of 39 years (range 24-57) were randomized to receive a commercial latex-sublingual immunotherapy or placebo during one year, followed by another year of open, active therapy. The following outcomes were measured at baseline and at the end of first and second year of follow-up: skin prick test, gloves-use score, conjunctival challenge test, total and specific IgE, basophil activation test, and adverse reactions monitoring. No significant difference in any of the efficacy in vivo variables was observed between active and placebo groups at the end of the placebo-controlled phase, nor when each group was compared with their baseline values at the end of the two year-study. An improvement in the average percentage of basophils activated was observed. During the induction phase, 4 reactions in the active group and 5 in the placebo group were recorded. During the maintenance phase, two patients dropped out due to pruritus and to acute dermatitis respectively. Further studies are needed to evaluate latex-sublingual immunotherapy, since efficacy could not be demonstrated in adult patients with avoidance of the allergen. ACTRN12611000543987.Trials 08/2011; 12:191. · 2.02 Impact Factor