AllAllergy.Net - Allergy Advisor Digest

Allergy Advisor Digest - March 2008
Editor: Dr. Harris A. Steinman

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This is a monthly digest of interesting information that is being added to Allergy Advisor. While we add a great deal of information every month, here we highlight some of the more interesting articles.
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Specific IgE in Sera of Japanese Birch-Allergic Patients Using Recombinant Allergens Bet v 1, Bet v 2 and Bet v 4.

Protease activity of allergenic pollen of cedar, cypress, juniper, birch and ragweed.

Correlations between Alder Specific IgE and Alder-related Tree Pollen Specific IgE by RAST Method.

Symptoms to pollen-related food allergens in grass pollen-allergic patients from northern Europe.

Lupin allergy in peanut-allergic children and teenagers.

Sensitization to Malassezia in infants and children with atopic dermatitis: prevalence and clinical characteristics.

Occupational asthma to ivy (Hedera helix).

Identification of vitellogenin as an allergen in Beluga caviar allergy.

Allergy to macrogol / Polyethylene glycol: Usefulness of oral macrogol challenge in anaphylaxis

Anaphylactic reaction to lupine flour because of a primary sensitization.

Occupational hypersensitivity pneumonitis due to molds in an onion and potato sorter.

A death from asthma associated with work-related environmental tobacco smoke.

Seafood allergy and radiocontrast media: are physicians propagating a myth?

Estimation of pollen and seed production of common ragweed in France.

Allergies to sulfonamide antibiotics and sulfur-containing drugs.

Correlation of oral allergy syndrome due to plant-derived foods with alder pollen, rbet v 1 and rbet v 2 sensitization in Yokohama region.

European agency rejects links between hyperactivity and food additives.

Severe atopic dermatitis is associated with a high burden of environmental Staphylococcus aureus.

Primary versus secondary immunoglobulin E sensitization to soy and wheat

Allergic contact dermatitis caused by sesame oil in a topical Chinese medicine, shi-un-ko.

Complementary and alternative remedies: an additional source of potential systemic nickel exposure.

Current Knowledge about the Presence of Amines in Wine.

The association between phthalates in dust and allergic diseases

The European Labelling Law for Foodstuffs Contains Life-Threatening Exemptions for Food-Allergic Consumers.

Vacuolar Serine Protease Is a Major Allergen of Cladosporium cladosporioides.

Characterization of IgE Binding to Lupin, Peanut and Almond with Sera from Lupin-Allergic Patients.

P39, a novel soybean protein allergen, belongs to a plant-specific protein family and is present in protein storage vacuoles.

Casein hydrolysate formula-induced liver dysfunction in a neonate with non-immunoglobulin E-mediated cow's milk allergy.

Protein-losing enteropathy associated with egg allergy in a 5-month-old boy.

Allergy to eggplant (Solanum melongena) caused by a putative secondary metabolite.

Prevalence of cypress pollen sensitization and its clinical importance in Izmir, Turkey.

Aerobiological investigation and in vitro studies of pollen grains from 2 dominant avenue trees in Kolkata, India.

Legumin allergens from peanuts and soybeans: Effects of denaturation and aggregation on allergenicity.

Purification and characterization of natural Bet v 1 from birch pollen and related allergens from carrot and celery.

Nutritional problems related to food allergy in childhood.

Correlation between specific immunoglobulin E levels and the severity of reactions in egg allergic patients.

Gold-induced contact eczema: A review and case report

Is it possible to treat peanut allergy by oral tolerance induction protocols?

The role of pollen allergy in atopic dermatitis

Buckwheat anaphylaxis by inhalation

Castor bean allergy

Indirect food contact in severe fish allergy

Can any protein become an allergen?

Common structures of allergens

Non-allergenic characteristics of allergens

Inflammatory occupational skin disease among hairdressers: Diagnosis and prevention

Flexural allergic contact dermatitis to benzalkonium chloride in antiseptic bath oil.

High frequency of contact allergy to gold in patients with endovascular coronary stents.

Pulmonary tumour caused by chronic propolis aspiration.

Specific IgE in Sera of Japanese Birch-Allergic Patients Using Recombinant Allergens Bet v 1, Bet v 2 and Bet v 4.
This study examined the IgE profiles to recombinant birch pollen allergens in birch-sensitive patients living in Sapporo, Japan. Of 40 sera with positive CAP results for natural birch pollen extract, 39 (97.5%) had specific IgE towards Bet v 1; 6 (15%) contained specific IgE against Bet v 2. Bet v 4 reactivity was documented in only one subject (2.5%). The present data suggest that the specific IgE reactivity profiles to birch pollen allergen in birch-sensitive patients in Sapporo correspond to those in Scandinavia, possibly due to the heavy birch pollen exposure in this area.

Detection of Specific IgE Antibodies in Sera of Japanese Birch-Allergic Patients Using Recombinant Allergens Bet v 1, Bet v 2 and Bet v 4.
Shirasaki H, Yamamoto T, Koyanagi Y, Watanabe N, Himi T.
Allergol Int 2008 Mar;57(1):93-96

Protease activity of allergenic pollen of cedar, cypress, juniper, birch and ragweed.
It is proposed that protease activity from allergen sources, such as mites, enhances allergenicity.This study analyzed the protease activities derived from allergenic pollen of Japanese cedar, Japanese cypress, and Rocky mountain juniper, which belong to the Cupressaceae/Taxodiaceae family, and white birch and short ragweed, and found that the pollen of the three members of the Cupressaceae/Taxodiaceae family contained serine protease activity, that the pollen of white birch and short ragweed contained not only serine protease activity but also cysteine protease activity, that all five types of pollen tested contained at least one other type of serine protease, whose sensitivity to a serine protease-specific inhibitor was relatively low, and that the content and releasability of the pollen-derived proteases differed according to the plant families.

Protease activity of allergenic pollen of cedar, cypress, juniper, birch and ragweed.
Gunawan H, Takai T, Ikeda S, Okumura K, Ogawa H.
Allergol Int 2008 Mar;57(1):83-91

Correlations between Alder Specific IgE and Alder-related Tree Pollen Specific IgE by RAST Method.
Wild birch trees grow in limited areas in Japan and are not a common aero-allergen. However, many patients who do not live in the area show positive birch pollen RAST. Therefore, being sensitized by another tree pollen which is closely related to birch may result in showing a specific IgE antibody to birch. Alder is a one of these trees and in the past it grew widely in Japan. This study measured the alder specific IgE (CAP-RAST) in stored sera which was positive in birch RAST (228 samples), beech RAST (36 samples), oak RAST (152 samples) and cedar RAST (411 samples) and examined correlations between the RAST of alder and other trees. The correlation coefficient value of birch was very high (0.971). The other coefficient values of beech and oak were high (0.884 in beech and 0.895 in oak) but were slightly lower than that of the birch. This means that in terms of allergenicities, birch pollen is almost the same as alder and beech and oak are partly different from the alder. Therefore the Japanese respond to alder pollen just same as they do to birch pollen in forming specific IgE antibody. In clinical practice, positive alder RAST has the same meaning as positive birch RAST.

Correlations between Alder Specific IgE and Alder-related Tree Pollen Specific IgE by RAST Method.
Maeda Y, Ono E, Fukutomi Y, Taniguchi M, Akiyama K.
Allergol Int 2008 Mar;57(1):79-81

Symptoms to pollen-related food allergens in grass pollen-allergic patients from northern Europe.
This study concludes that sensitization to grass pollen alone is rare among grass pollen-allergic patients from northern Europe. The majority of patients are in addition sensitized to birch (Bet v 1), which seems to be closely related to their pollen-derived food allergy. The study highlights the advantage of using well-defined allergen molecules for the diagnosis of cross-reactivity between pollen and food allergens.

Antibody profiles and self-reported symptoms to pollen-related food allergens in grass pollen-allergic patients from northern Europe.
Ghunaim N, Gronlund H, Kronqvist M, Gronneberg R, Soderstrom L, Ahlstedt S, van Hage-Hamsten M.
Allergy 2005 Feb;60(2):185-91.

Lupin allergy in peanut-allergic children and teenagers.
Lupin has now been introduced into food production in the UK. There is a concern that, on account of cross-reactivity, peanut-allergic children are at high risk for lupin allergy. Fourty seven Peanut-allergic subjects with either a convincing history of peanut allergy with diagnostic peanut skin prick test (SPT) or specific-immunoglobulin E (IgE) results or a positive food challenge were recruited. Sixteen peanut-allergic children were sensitized to lupin. Nine were challenged to lupin. Two reacted (itchy mouth and urticaria; itchy mouth and 20% drop in peak expiratory flow rate) giving a minimum prevalence of lupin allergy in peanut-allergic children of 4.0% (95% CI: 1-15%). Atopic controls were significantly (P = 0.001) less likely to be sensitized to lupin and had smaller wheals and serum-specific IgE results. None of the atopic controls reacted on lupin challenge, giving a rate of allergy in the atopic controls of 0% (95% CI: 0-8%). Therefore a small but significant number of children with peanut allergy are allergic to lupin. Sensitization to lupin is much rarer in nonpeanut-allergic atopic subjects.

Lupin allergy in peanut-allergic children and teenagers.
Shaw J, Roberts G, Grimshaw K, White S, Hourihane J.
Allergy 2008 Mar;63(3):370-373

Sensitization to Malassezia in infants and children with atopic dermatitis: prevalence and clinical characteristics.
"There is increasing evidence that sensitization to Malassezia plays an important role as a trigger factor in atopic dermatitis. Sensitization is reported to occur in adults with head and neck dermatitis and in older children mainly after puberty. In infants and toddlers-specific immunoglobulin E (IgE) antibodies to Malassezia have rarely been found."

The aim of this study was to investigate the rate of sensitization to three different Malassezia species in a cohort of children suffering from AD of all age groups and severity degrees. Specific IgE to Malassezia was measured using the ImmunoCAP m227 to Malassezia species, which is a mixture of M. sympodialis, M. globosa, and M. restricta. One hundred and forty-one children aged between 3 and 196 months with AD were included in the study. Twenty-four of the 141 sera (17%) were tested positive for specific IgE to Malassezia species. Nine of 58 patients (15.2%) aged 12 months or younger were positive compared to 15 of 83 (18.1%) in the older age group. The youngest sensitized patient was 4 months old. The risk for sensitization to Malassezia correlated significantly with total IgE value and weakly with the SCORAD index. There was no significant correlation between sensitization to Malassezia species and age, duration, or period of onset of the disease. In conclusion, sensitization to Malassezia does occur even in young infants. In patients at risk, testing should be considered in order to initiate anti-fungal treatment. Future studies should address the effectiveness of antifungal treatment in Malassezia-sensitized infants and children with AD.

Sensitization to Malassezia in infants and children with atopic dermatitis: prevalence and clinical characteristics.
Lange L, Alter N, Keller T, Rietschel E.
Allergy 2008 Apr;63(4):486-487

Occupational asthma to ivy (Hedera helix).
Ivy-induced OA has not been reported previously. This case report presents a 40-year-old female who had worked in her own flower shop for the past 11 years, who developed a cough only appearing when she handled ivy. One year later she began to experience dyspnoea, and she was treated with inhaled steroids for a short time. She also had work-related skin symptoms, which were later diagnosed as nonimmunologic contact urticaria for narcissus and rose. The diagnosis of OA was made according to the European guidelines. A RAST for ivy was not available. SPT to 18 common allergens, storage mites, and a number of common indoor plants including Ficiis benjamina (leaf), were negative. The handling of ivy caused an immediate asthmatic reaction, with 21% reduction in FEVi and with 20-30% reductions in PEF, with simultaneous subjective symptoms of dyspnoea.

Occupational asthma to ivy (Hedera helix).
Hannu T, Kauppi P, Tuppurainen M, Piirila P.
Allergy 2008 Apr;63(4):482-483

Identification of vitellogenin as an allergen in Beluga caviar allergy.
A 55-year-old woman who experienced two episodes of intense abdominal pain, followed by discomfort, nausea and diarrhoea within 10 min of intake of Beluga caviar. The patient had never had any food hyper-sensitivity before. SPT to the a battery of allergenic foods, including fish, shellfish, chicken egg and nuts was negative, but positive to Iranian Beluga caviar extract, but negative to other fish roes (lumpfish, trout and salmon), 'false' caviars (anchovy and salmon), fish, shellfish, chicken egg and nuts. The patient refused an oral challenge test

A broad spectrum of IgE binding bands was detected ranging from 23 to 120 kDa. Inhibition immunoblot with Beluga caviar extract and patient's serum demonstrated that the patient's serum indeed contained specific IgE to Iranian Beluga caviar.

Four out of six of these bands were identified as vitellogenin. Thus, these protein bands were fragments of the same protein, vitellogenin (118 kDa) an egg yolk precursor protein expressed in female fish. The IgE immunoblot of other fish roes, 'false' caviars and chicken egg showed no IgE-binding bands

Vitellogenin has been described as allergen in chicken egg (Gal d vitellogenin); however, homology with caviar vitellogenin is low and cross-reactivity has not been found in this case report, as previously described . This patient eats eggs without any problem.

Identification of vitellogenin as an allergen in Beluga caviar allergy.
Perez-Gordo M, Sanchez-Garcia S, Cases B, Pastor C, Vivanco F, Cuesta-Herranz J.
Allergy 2008 Apr;63(4):479-480

Allergy to macrogol / Polyethylene glycol: Usefulness of oral macrogol challenge in anaphylaxis
A report for the first time an immediate hypersensitivity reaction during an oral challenge with macrogol 4000 in a patient who experienced anaphylaxis after intra-articular injection of methylprednisolone acetas-lidocaini hydrochloridum (Depo-medrol lidocain). A 44-year-old woman without previous history of allergy received an intra-articular infiltration of Depo-medrol lidocaine. Ten minutes later, she developed generalized urticaria, bronchospasm and systolic hypotension. Three months later, skin tests were performed with various components of Depo-medrol lidocaine. The patient had a positive skin prick test with 0.4 mg/ml Depo-medrol lidocain and 0.1% preparation of macrogol 4000. The patient had previously taken oral medications containing macrogol 4000 or 6000 as excipient without experiencing allergic manifestation. Therefore, a single blind placebo-controlled oral challenge test with macrogol 4000 was carried out with the patient's informed consent. After a negative labial test, the oral test was started with a dose of 1 mg of macrogol 4000 and the dose was increased at 30-min intervals. Thirty minutes after ingestion of a cumulative dose of 7.1 g (equivalent-to the minimal dose contained in some osmotic laxatives) the patient developed palmo-plantar pruritus followed by edema of the Ups, lids, feet, and hands.

Polyethylene glycols (or PEGs or macrogols) are polymers of ethylene oxide with molecular weight varying from 200 to < 10 000 daltons widely used as dispersing agents, solvents and excipients in the production of pharmaceutical preparations as well as in food and cosmetic industry.

Usefulness of oral macrogol challenge in anaphylaxis after intra-articular injection of corticosteroid preparation.
Sohy C, Vandenplas O, Sibille Y.
Allergy 2008 Apr;63(4):478-479

Anaphylactic reaction to lupine flour because of a primary sensitization.
Two patients with an anaphylactic reaction to lupine are reported. The first patient, a 24-year-old student with known severe peanut allergy, reacted after eating a pizza which had lupine flour as an ingredient. Severe respiratory symptoms developed, which required emergency intubation. The SPT was positive to native lupine flour and serum IgE was 44.30 kU/L (class 4). IgE-binding to major proteins at 20, 34, 60 and 62 kDa was detected by means of immunoblotting. In the inhibition experiments, IgE-binding to lupine proteins was partially inhibited by peanut extract. The second patient, a 27-year-old female, experienced an allergic reaction including facial oedema and abdominal pain after ingestion of gingerbread that was declared to contain lupine flour. SPT was positive for lupine flour and serum specific IgE to lupine was 7.59 kU/L (class 3). The immunoblot analysis showed IgE-binding to a major protein at 50 kDa and to minor proteins of low molecular weight. Contrary to the first case, the IgE-binding to lupine flour was not inhibited by peanut extract. Therefore, lupine allergy with isolated sensitization to lupine seeds.

Anaphylactic reaction to lupine flour because of a primary sensitization.
Wuthrich B.
Allergy 2008 Apr;63(4):476-477

Occupational hypersensitivity pneumonitis due to molds in an onion and potato sorter.
A 42-year-old female non-smoking onion and potato sorter developed work-related shortness of breath, cough, fatigue and flu-like symptoms. The diagnosis of hypersensitivity pneumonitis was based on patchy infiltrates in both lungs on high resolution computed tomography and lymphocytosis of 71% in a bronchoalveolar lavage sample with a CD4/CD8 ratio of 0.4. Exposure cessation and initial corticosteroid therapy resulted in complete recovery. IgG antibodies to Penicillium species and Fusarium solani cultivated from samples from the patient's workplace were detected in the patient's serum and cross-reactivity was demonstrated within Penicillium species, but also between Penicillium species and Aspergillus fumigatus. Occupational hypersensitivity pneumonitis due to molds may develop in onion and potato sorters.

Occupational hypersensitivity pneumonitis due to molds in an onion and potato sorter.
Merget R, Sander I, Rozynek P, Raulf-Heimsoth M, Bruening T.
Am J Ind Med 2008 Feb;51(2):117-119

A death from asthma associated with work-related environmental tobacco smoke.
Three public health surveillance systems were used to identify and conduct a follow-up investigation of a reported acute asthma death of a young waitress in a bar. The waitress collapsed at the bar where she worked and was declared dead shortly thereafter. Evaluation of the circumstances of her death and her medical history concluded that her death was from acute asthma due to environmental tobacco smoke at work. This is the first reported acute asthma death associated with work-related ETS. Recent studies of asthma among bar and restaurant workers before and after smoking bans support this association. This death dramatizes the need to enact legal protections for workers in the hospitality industry from secondhand smoke.

How many deaths will it take? A death from asthma associated with work-related environmental tobacco smoke.
Stanbury M, Chester D, Hanna EA, Rosenman KD.
Am J Ind Med 2008 Feb;51(2):111-116

Seafood allergy and radiocontrast media: are physicians propagating a myth?
Recent surveys have indicated that the misconception that seafood allergy confers a disproportionately increased risk of adverse reactions to radiocontrast media remains pervasive among physicians and patients. One possible explanation for the persistence of this notion is that physicians responsible for radiocontrast administration are inadvertently contributing to its propagation. An anonymous survey was sent to 231 faculty radiologist and interventional cardiologists at 6 Midwest academic medical centers. Two questions dealt directly with seafood allergy related to radiocontrast media administration, and 6 questions served as distracters. Sixty-nine percent of responders indicated that they inquire about a history of seafood allergy before radiocontrast media administration. Some 37.2% of responders replied that they would withhold radiocontrast media or recommend premedication on the basis of a history of seafood allergy.

Seafood allergy and radiocontrast media: are physicians propagating a myth?
Beaty AD, Lieberman PL, Slavin RG.
Am J Med 2008 Feb;121(2):158-4

Estimation of pollen and seed production of common ragweed in France.
Ragweed is a threat to human health due to its abundant allergenic pollen release. Most studies have been focused on airborne pollen monitoring, but to date, no data have been available on precise individual plant pollen and seed production related to plant traits growing in natural environment and on their corresponding source of variation. This study evaluated pollen and seed production of common ragweed plants in several populations in France. Seasonal pollen production per plant ranged from 100 million to 3 billion and seed production from 346 to 6,114, depending on plant size and habitat. Common ragweed plants developing in field crops produced more pollens and seeds than those growing in other habitats. Pollen and seed production was closely related to plant volume and biomass, thus providing a means of estimating potential pollen and seed production in given target areas. Such biological data could be integrated into population management strategies or into airborne pollen modelling.

Estimation of pollen and seed production of common ragweed in France.
Fumanal B, Chauvel B, Bretagnolle F.
Ann Agric Environ Med 2007 Dec;14(2):233-236

Allergies to sulfonamide antibiotics and sulfur-containing drugs.
"The objective of this study was to provide a literature review and clinical summary of the evaluation and management of sulfonamide drug reactions. Obtaining a detailed history is invaluable in assessing a history of reactions to sulfonamide medications, because allergy to these drugs remains a clinical diagnosis at present. Numerous efficacious drug desensitization protocols for management have been published and are reviewed in detail. The term sulfa allergy is imprecise and misleading and therefore should be discouraged. There are important distinctions between sulfonylarylamines (antimicrobial sulfonamides), nonarylamine (nonantimicrobial) sulfonamides, and sulfones, with regard to allergic and other adverse drug reactions. Most reactions to sulfonylarylamines probably result from multifactorial immunologic and toxic metabolic mechanisms, whereas less is known about the precise mechanisms of reactions to other sulfur-containing drugs."

Allergies to sulfonamide antibiotics and sulfur-containing drugs.
Dibbern DA, Montanaro A.
Ann Allergy Asthma Immunol 2008 Feb;100(2):91-100

Correlation of oral allergy syndrome due to plant-derived foods with alder pollen, rbet v 1 and rbet v 2 sensitization in Yokohama region.
Oral allergy syndrome (OAS) to plant foods is often caused by cross-reactivity to pollen. This study investigated whether there was any significant correlation between sensitization to the pollen of alder and Japanese cedar flying off in spring and prevalence of OAS in Yokohama region. Specific IgE antibodies against alder and Japanese cedar in 337 outpatients with skin allergy in 2005 was assessed. Ratio of positive response to CAP against alder was 23.4% (79 cases) while that to CAP against Japanese cedar was 73.7% (244 cases). Response to CAP against rBet v 1 and rBet v 2 was tested in 55 cases, and the ratio of positive response to CAP against rBet v 1 was 43.6% (24 cases) while that to CAP against rBet v 2 was 27.3% (15 cases). Prevalence of OAS showed a significant positive correlation (p<0.001) with sensitization to alder, but no correlation with sensitization to Japanese cedar. Therefore is suggests that sensitization to alder pollen would be involved in prevalence of OAS in Yokohama region.

Correlation of oral allergy syndrome due to plant-derived foods with alder pollen, rbet v 1 and rbet v 2 sensitization in Yokohama region. [Japanese]
Morita A, Inomata N, Kirino M, Ikezawa Z.
Arerugi 2008 Feb;57(2):138-146

European agency rejects links between hyperactivity and food additives.
The European Food Safety Authority has rejected suggestions in a study by researchers at Southampton University last year of a link between hyperactivity in children and two mixtures of food colours and the preservative sodium benzoate (Lancet 2007;370:1560-7; doi:10.1016/S0140-6736(07)61306-3).

In a highly critical assessment, the authority points to considerable uncertainties, lack of consistency, and absence of information in the study, which was commissioned by the UK Food Standards Agency.

As a result, the authority, which advises the European Union on food safety, maintained that there is no basis for changing present recommendations on the acceptable daily intake of the food colours or sodium benzoate.

After a request from the European Commission, the Parma based authority asked its panel on food additives, flavourings, processing aids, and food contact materials to assess the study's findings that the colourings and preservative in the diet led to more hyperactivity in 3 and 8-9 year old children.

The panel, helped by behavioural experts, considered that the implication of the effects of the substances on children was unclear because it was not known if the small changes in attention and activity that had been seen in the study would interfere with schoolwork or other intellectual activity.

In its report, published on 14 March, the panel listed its many reservations about the study's findings. It pointed to the lack of consistency in the results with respect to the age and sex of the children and the type of observer (parent, teacher, or independent assessor); the unknown clinical relevance of the effects measured; and the lack of information on dose-response.

The panel also maintained that the fact that mixtures were studied made it impossible to identify the effects of individual additives and noted the absence of a plausible biological mechanism that might explain the possible link between behaviour and the consumption of colours.

The panel, which evaluated the Southampton findings against earlier research on the effect of food additives on behaviour dating from the 1970s, acknowledged that this had been the largest study to date.

It also accepted that the findings might be relevant for specific people in the population who show sensitivity to food additives in general or to food colours in particular. But it concluded that it was not possible to assess the overall prevalence of such sensitivity in the population as a whole and that reliable data on sensitivity to individual additives were not available.

The panel is reviewing the safety of all food colours authorised in the European Union on a case by case basis. The additives in the mixtures examined in the Southampton study-tartrazine (E102), quinoline yellow (E104), sunset yellow FCF (E110), ponceau 4R (E124), allura red AC (E129), carmoisine (E122), and sodium benzoate (E211)-are included in the review. Opinions on some of the colours, such as allura red, are expected by the end of the year.

European agency rejects links between hyperactivity and food additives.
Watson R.
BMJ 2008 Mar 29;336(7646):687.

Severe atopic dermatitis is associated with a high burden of environmental Staphylococcus aureus.
Background About 90% of patients with atopic dermatitis (AD) are colonized with Staphylococcus aureus. S. aureus worsens AD by secreting superantigens and structural molecules within the cell wall that induce skin inflammation. Therefore, S. aureus in the home may contribute to persistent skin inflammation and disease severity. This study concludes that in the home and especially the bedroom, higher levels of S. aureus may contribute to disease severity and persistence in AD patients.

Severe atopic dermatitis is associated with a high burden of environmental Staphylococcus aureus.
Leung AD, Schiltz AM, Hall CF, Liu AH.
Clin Exp Allergy 2008 Mar 13;

Primary versus secondary immunoglobulin E sensitization to soy and wheat
IgE sensitization to soy and wheat is classified as 'primary' when generated by food ingestion and 'secondary' when it as a consequence of primary sensitization to cross-reacting pollen antigens via inhalation. The age-specific relevance of these categories of sensitization throughout childhood is unknown.

In a German Multi-Centre Allergy Study with follow-up from birth to age 13, 1314 children were initially recruited. The point prevalence of sensitization (>1.0 kU/L) to milk and egg allergens progressively decreased from about 4% at 2 years to <1% at 10 years. By contrast, the prevalence of IgE to wheat and soy progressively increased with age, from 2% to 7% (soy) and from 2% to 9% (wheat). At 10 years of age, IgE to grass pollen was detected in 97% and 98% of the children reacting against soy and wheat, respectively; IgE to birch pollen was observed in 86% and 82% of the children reacting against soy and wheat, respectively. Early IgE sensitization to soy or wheat preceded that to grass or birch pollen in only 4% and 8% of participants sensitized to soy and wheat, respectively. The study concludes that IgE sensitization to soy and wheat is relatively uncommon and mostly primary in early infancy, more frequent and mostly secondary to pollen sensitization at school age. Awareness should be raised to avoid unnecessary diet restrictions due to the high frequency of clinically irrelevant, secondary sensitization to soy and wheat in schoolchildren with pollinosis.

Primary versus secondary immunoglobulin E sensitization to soy and wheat in the Multi-Centre Allergy Study cohort.
Matricardi PM, Bockelbrink A, Beyer K, Keil T, Niggemann B, Gruber C, Wahn U, Lau S.
Clin Exp Allergy 2008 Mar;38(3):493-500

Allergic contact dermatitis caused by sesame oil in a topical Chinese medicine, shi-un-ko.
Topical Chinese medicines are used for skin disorders as traditional medicine in Japan. We describe a case of allergic contact dermatitis caused by sesame oil present in a topical Chinese medicine, shi-un-ko.

Allergic contact dermatitis caused by sesame oil in a topical Chinese medicine, shi-un-ko.
Oiso N, Yamadori Y, Higashimori N, Kawara S, Kawada A.
Contact Dermatitis 2008 Feb;58(2):109

Complementary and alternative remedies: an additional source of potential systemic nickel exposure.
Systemic contact dermatitis from nickel has been reported from a number of sources including medical devices and following experimental oral exposure. This study identified and evaluated sources of nickel exposure in 4 homeopathic preparations, which are advertised to treat common skin diseases, as well as in a number of other homeopathic remedies, several herbal products and multivitamin mineral complexes. Complementary and alternative remedies are an additional source of systemic nickel exposure and at highest doses the potential risk for systemic contact dermatitis in nickel allergic patients should be considered.

Complementary and alternative remedies: an additional source of potential systemic nickel exposure.
de Medeiros LM, Fransway AF, Taylor JS, Wyman M, Janes J, Fowler JF, Rietschel RL.
Contact Dermatitis 2008 Feb;58(2):97-100

Current Knowledge about the Presence of Amines in Wine.
"This review discusses those factors that have an influence on amine concentration in wine, as well as the vinification stages when these amines are formed and their evolution during the storage of the product. It also outlines the importance of these biogenic and volatile amines both in the sensorial aspect as well as the toxic action. Amines are nitrogenous bases of low molecular weight, which are especially found in food and beverages from the fermentation process, as is the case of wine. Amine concentration in wine can be very variable, ranging from trace levels up to 130 mg/L, so it is difficult to predict the content of these compounds in the product. At present this variability is of some concern in many countries, especially for the toxic effect that some amines can have on people who are susceptible to these substances. Consequently, it is necessary to develop new studies to learn more about the factors, which have an influence on their concentration in wine, and to establish limits for these substances in the product so as to prevent any toxic effects on the consumer."

Current Knowledge about the Presence of Amines in Wine.
ncin-Azpilicueta C, Gonzalez-Marco A, Jimenez-Moreno N.
Crit Rev Food Sci Nutr 2008;48(3):257-275

The association between phthalates in dust and allergic diseases
Recent studies have identified associations between the concentration of phthalates in indoor dust and allergic symptoms in the airways, nose, and skin. The goal of this study was to investigate the associations between allergic symptoms in children and the concentration of phthalate esters in settled dust collected from children's homes in Sofia and Burgas, Bulgaria, and concludes that the study shows an association between concentration of DEHP in indoor dust and wheezing among preschool children.

The association between phthalates in dust and allergic diseases among Bulgarian children.
Kolarik B, Naydenov K, Larsson M, Bornehag CG, Sundell J.
Environ Health Perspect 2008 Jan;116(1):98-103

The European Labelling Law for Foodstuffs Contains Life-Threatening Exemptions for Food-Allergic Consumers.
The prevalence of food allergies still continues to rise in western Europe. As the strict avoidance of food allergens represents a major issue in the management of this disease, information for consumers on food labels about allergenic ingredients is crucial. The European labelling law for foodstuffs excludes declarations of the ingredients on individually wrapped foodstuffs with outer packages and products whose largest single surface area falls below 10 cm(2). One potentially avoidable case, with fatal consequences due to this law and the current legal situation, is discussed herein. We suggest evaluating the benefits of a mandatory safety warning (symbol) for major allergenic food ingredients on every foodstuff package, without any exceptions based on the size of the product or the presence of secondary packages.

The European Labelling Law for Foodstuffs Contains Life-Threatening Exemptions for Food-Allergic Consumers.
Buhl T, Kampmann H, Martinez J, Fuchs T.
Int Arch Allergy Immunol 2008 Mar 21;146(4):334-337

Vacuolar Serine Protease Is a Major Allergen of Cladosporium cladosporioides.
This study reports on a major allergen of C. cladosporioides. Seventy-four sera (38%) from 197 bronchial asthmatic patients demonstrated IgE binding against C. cladosporioides extracts. Among these 74 sera, 41 (55%) and 38 (51%) showed IgE binding against a 36- and a 20-kDa protein of C. cladosporioides, respectively. Both IgE-reacting components reacted with FUM20, a monoclonal antibody against fungal serine proteases. N-terminal amino acid sequencing results suggest that they are vacuolar serine proteases, and the 20-kDa component is possibly a degraded product of the 36-kDa allergen. The protein sequence deduced shares 69-72% sequence identity with Penicillium vacuolar serine proteases and was designated as Cla c 9. The purified 36-kDa Cla c 9 allergen showed proteolytic activity. IgE cross-reactivity was detected between the purified Cla c 9 and serine protease allergens from Aspergillus fumigatus and Penicillium chrysogenum.

Vacuolar Serine Protease Is a Major Allergen of Cladosporium cladosporioides.
Chou H, Tam MF, Lee LH, Chiang CH, Tai HY, Panzani RC, Shen HD.
Int Arch Allergy Immunol 2008 Mar 21;146(4):277-286

Characterization of IgE Binding to Lupin, Peanut and Almond with Sera from Lupin-Allergic Patients.
The increasing number of applications of sweet lupins in food is paralleled by an increase in immunoglobulin E (IgE)-mediated allergic reactions to lupin proteins. In particular, lupin allergy seems to appear in patients with an existing peanut allergy. Immunoblotting and ELISA experiments demonstrate IgE binding to all lupin conglutins (alpha, beta, gamma and delta) as well as to peanut and almond proteins, with a unique IgE-binding profile for each patient. High IgE binding to alpha-conglutin was observed and IgE from the majority of patients similarly recognized two proteins within the alpha-conglutin-containing fraction, 40 and 43 kDa in size. Inhibition ELISA experiments showed that preincubation of sera with lupin conglutins, peanut and almond resulted in decreased IgE binding to lupin flour. Overall, these results indicate that alpha-, beta-, gamma- and delta-conglutins are candidate allergens in lupin and suggest a particularly strong allergenicity of alpha-conglutins. Furthermore, the results indicate the presence of cross-reactive allergens in lupin, peanut and almond.

Characterization of IgE Binding to Lupin, Peanut and Almond with Sera from Lupin-Allergic Patients.
Holden L, Sletten GB, Lindvik H, Faeste CK, Dooper MM.
Int Arch Allergy Immunol 2008 Mar 21;146(4):267-276

P39, a novel soybean protein allergen, belongs to a plant-specific protein family and is present in protein storage vacuoles.
Soybean lecithins are seeing increasing use in industry as an emulsifier and food additive. They are also a growing source of human food allergies, which arise principally from the proteins fractionating with the lecithin fraction during manufacture. A previous study identified several allergenic proteins in soybean lecithins and a soybean IgE-binding protein termed P39 was discovered. This study investigated this allergen. They belong to a family of plant-specific proteins of unknown function. In soybeans, P39-1 is seed specific, and its transcript levels are highest in developing seeds and decline during seed maturation. In contrast, P39 protein was detectable only in the fully mature, dry seed. P39 protein was strongly associated with oil bodies; however, immunolocalization indicated P39 was distributed in the matrix of the protein storage vacuoles, suggesting that association with oil bodies was an artifact arising from the extraction procedure. It was also documented that IgE-binding epitopes are present on several different portions of the P39-1 polypeptide.

P39, a novel soybean protein allergen, belongs to a plant-specific protein family and is present in protein storage vacuoles.
Xiang P, Baird LM, Jung R, Zeece MG, Markwell J, Sarath G.
J Agric Food Chem 2008 Mar 26;56(6):2266-2272

Casein hydrolysate formula-induced liver dysfunction in a neonate with non-immunoglobulin E-mediated cow's milk allergy.
"A 10-day-old male neonate was admitted with bilious vomiting and gross hematochezia. Peripheral eosinophilia, delayed positive skin prick test to artificial milk, and elevated eosinophil cationic protein levels suggested cow's milk allergy. Fluid infusion with prohibition of oral intake improved the digestive symptoms. Breast-feeding was resumed on hospital day 3 and only casein hydrolysate formula was fed from day 7 onward. Nevertheless, eosinophilia and elevated transaminase levels developed on day 14. Liver dysfunction associated with casein hydrolysate formula was suspected and the infant was transferred to soy formula. Eosinophil counts decreased and transaminase levels were normalized on day 19. A cow's milk protein-specific lymphocyte proliferation test was positive for alpha-casein, beta-lactoglobulin, and bovine serum albumin, indicating sensitization of T cells to cow's milk proteins. These observations suggest that careful attention should be paid to liver dysfunction in non-immunoglobulin E-mediated cow's milk allergy, even when hypoallergenic formula is used."

Casein hydrolysate formula-induced liver dysfunction in a neonate with non-immunoglobulin E-mediated cow's milk allergy.
Yada K, Yoshida K, Sakurai Y, Kimura M, Yasuhara H, Tanaka I, Yoshioka A.
J Investig Allergol Clin Immunol 2008;18(1):67-70

Protein-losing enteropathy associated with egg allergy in a 5-month-old boy.
"Protein-losing enteropathy (PLE), the manifestation of a diverse set of disorders, is characterized by excessive loss of plasma proteins into the affected portions of the gastrointestinal tract, and this results in hypoalbuminemia. A 5-month-old breastfed boy presented severe PLE with hypogammaglobulinemia, hypocalcemia, and hypomagnesemia induced by an egg allergy. He developed hypocalcemic convulsions. The diagnosis of PLE was confirmed by elevated fecal alpha1-antitrypsin clearance and a positive finding on a protein-losing scintigram. His allergy to egg delivered through maternal milk was confirmed as the cause of PLE, since the mother's elimination of egg from her diet improved his condition and maternal egg challenge provoked symptoms of diarrhea, vomiting, and elevated alpha1-antitrypsin clearance. At the time of writing, he is 22 months old and has experienced no further episodes after the elimination of egg-containing food."

Protein-losing enteropathy associated with egg allergy in a 5-month-old boy.
Kondo M, Fukao T, Omoya K, Kawamoto N, Aoki M, Teramoto T, Kaneko H, Kondo N.
J Investig Allergol Clin Immunol 2008;18(1):63-66

Allergy to eggplant (Solanum melongena) caused by a putative secondary metabolite.
Allergy caused by ingestion of eggplant in an atopic subject. Symptoms included urticaria, itching of the throat, and hoarseness. Skin prick test (SPT) was positive with 4 varieties of eggplant; however, allergen-specific immunoglobulin E was not detected. SPT with fractions of green long eggplant extract suggested the allergen to be less than 10 kd. SPT following acetone precipitation of eggplant extract revealed that the allergen was present in the supernatant portion. Further analysis of the 10 kd filtrate of eggplant extract followed by SPT of fractions revealed that the causative allergen was a low molecular weight nonprotein secondary metabolite of less than 1 kd.To our knowledge, this is the first report of allergy to the ingestion of eggplant in which a nonprotein secondary metabolite has been detected as an allergen.

Allergy to eggplant (Solanum melongena) caused by a putative secondary metabolite.
Pramod SN, Venkatesh YP.
J Investig Allergol Clin Immunol 2008;18(1):59-62

Prevalence of cypress pollen sensitization and its clinical importance in Izmir, Turkey.
Pollens from the Cupressaceae family are considered important allergens in the Mediterranean area, though reports of the prevalence of allergic symptoms have ranged from 1.04% to 35.4%. The aim of this study was to detect the prevalence of cypress pollen sensitization and determine its clinical importance in patients in Izmir, Turkey, with seasonal respiratory allergy. Sixty-five (14.3%) of 455 patients showed positive SPT responses to Cupressus sempervirens extract. Only 1 patient was monosensitized while 64 patients were polysensitized. Among those, 2 pollen cosensitizations were found to be significant (86% were cosensitized to grasses and 72% were cosensitized to olive. Serum specific IgE to cypress pollen was measured in 50 of the 65 patients; findings were positive for 37. When these 37 patients underwent NPT with C sempervirens allergen extract, only the single monosensitized patient had a positive NPT. The study concludes that a positive SPT to cypress pollen may not reflect the true prevalence of sensitization. We assume that in the absence of a positive NPT, positive SPT results might be related to the presence of cross-reactivity between pollen species.

Prevalence of cypress pollen sensitization and its clinical importance in Izmir, Turkey, with cypress allergy assessed by nasal provocation.
Sin AZ, Ersoy R, Gulbahar O, Ardeniz O, Gokmen NM, Kokuludag A.
J Investig Allergol Clin Immunol 2008;18(1):46-51

Aerobiological investigation and in vitro studies of pollen grains from 2 dominant avenue trees in Kolkata, India.
Peltophorum pterocarpum and Delonix regia are dominant avenue trees in the city of Kolkata in India. The aim of this study was to conduct an aerobiological survey in Kolkata to determine the concentration and seasonal periodicity of pollen grains from P pterocarpum and D regia and to analyze the meteorological factors responsible for their levels in the atmosphere. P pterocarpum and D regia pollen grains occur from March to June and April to July, respectively. The pollen concentrations showed statistically significant positive correlations with maximum temperature and wind speed. Positive reactions to P pterocarpum and D regia were observed in 26% and 22% of the patients, respectively. Many protein bands were detected in the pollen extracts over a wide molecular weight range. A total of 5 (P pterocarpum pollen) and 8 (D regia pollen) protein fractions were detected by IgE immunoblotting. Therefore P pterocarpum and D regia pollen grains are dominant in the atmosphere of south Kolkata and they are influenced by temperature.

Aerobiological investigation and in vitro studies of pollen grains from 2 dominant avenue trees in Kolkata, India.
Mandal J, Roy I, Chatterjee S, Gupta-Bhattacharya S.
J Investig Allergol Clin Immunol 2008;18(1):22-30

Legumin allergens from peanuts and soybeans: Effects of denaturation and aggregation on allergenicity.
This study investigated the effects of heating and digestion on the IgE binding of Ara h 3 and glycinin from soybean. Both proteins are relatively stable to denaturation, having denaturation temperatures ranging from 70 to 92 degrees C, depending on their quaternary structure and the ionic strength. Aggregates were formed upon heating, which were partly soluble for glycinin. Heating slightly decreased the pepsin digestion rate of both allergens. However, heating did not affect the IgE binding capacity of the hydrolyzates, as after only 10 min of hydrolysis no IgE binding could be detected any more in all samples. Peanut allergen Ara h 1, when digested under equal conditions, still showed IgE binding after 2 h of hydrolysis. These results indicate that the IgE binding capacity of legumin allergens from peanuts and soybeans does not withstand peptic digestion. Consequently, these allergens are likely unable to sensitize via the gastro-intestinal tract and cause systemic food allergy symptoms. These proteins might thus be less important allergens than was previously assumed.

Legumin allergens from peanuts and soybeans: Effects of denaturation and aggregation on allergenicity.
van Boxtel EL, van den Broek LA, Koppelman SJ, Gruppen H.
Mol Nutr Food Res 2008 Mar 13;

Purification and characterization of natural Bet v 1 from birch pollen and related allergens from carrot and celery.
Birch pollen allergy is predominantly caused by the major allergen Bet v 1 and can lead to crossreactions with homologous proteins in food. Two major cross-reactive food allergens are Dau c 1 from carrot and Api g 1 from celery, which have never been purified from their natural source. This study describes the purification of natural Bet v 1, Dau c 1 and Api g 1 resulting in earlier reported isoforms of Bet v 1, Dau c 1 and Api g 1, but also new isoforms. The immune reactivity of the natural allergens showed similar reactivity as recombinant proteins.

Purification and characterization of natural Bet v 1 from birch pollen and related allergens from carrot and celery.
Bollen MA, Garcia A, Cordewener JH, Wichers HJ, Helsper JP, Savelkoul HF, van Boekel MA.
Mol Nutr Food Res 2007 Dec;51(12):1527-1536

Nutritional problems related to food allergy in childhood.
"Food allergy is becoming an increasing problem worldwide with an estimated 6-8% of children affected at some point in their childhood. The perceived prevalence of food allergy is even higher with an estimated 20% of children adhering to some form of elimination diet. Against this background, accurate diagnosis is essential to prevent the imposition of unnecessarily restrictive diets on young children. Raising clinical awareness amongst health professionals as to the clinical characteristics, epidemiology, investigation, and management of food allergic disorders is key to tackling this growing problem. In this article, three separate cases of children with poor nutrition and secondary morbidity are presented, highlighting the varying scenarios in which these conditions can be encountered. In the first child, the features clinically displayed were hypocalcemic seizures and rickets due to prolonged breast feeding, poor weaning, and inadequate dietary supplementation. The second case reveals the dangers of complementary diagnostic allergy testing leading to poor nutrition as a consequence of an unsupervised elimination diet. The last report describes a child with multiple food allergies, failure to thrive, and protein losing enteropathy to highlight the diversity of nutritional problems faced by allergists and to underline the importance of specialist dietetic input in the management of a child with food allergy."

Nutritional problems related to food allergy in childhood.
Noimark L, Cox HE.
Pediatr Allergy Immunol 2008 Mar;19(2):188-195

Correlation between specific immunoglobulin E levels and the severity of reactions in egg allergic patients.
Different studies proposed specific immunoglobulin E (IgE) cut-off levels for the diagnosis of egg allergy. Little is known if IgE titres could be helpful for prediction of the severity of the reaction. The aim of this study was to determine whether IgE titres are associated with the severity of the reaction during a standardized egg challenge. Data obtained during oral challenge tests to egg performed between 2003 and 2005, and attributed a clinical score to the positive reactions were reviewed. Data from 51 oral food challenges to egg, raw or cooked was analyzed. Sixteen challenges (31%) were negative and 35 (69%) were positive of which 13 challenges (37% of positive reactions) elicited a severe reaction. IgE levels in our patients ranged from undetectable to 14.90 kU/l. We could determine a cut-off level of 8.20 kU/l for a 90% probability of clinical reactivity. IgE titres were statistically significantly different between the patients with absent, mild and moderate or severe reaction. Patients with negative challenge had IgE levels between 0.35 and 6.41 kU/l (median 1.17), those with mild and moderate reaction had IgE levels ranging from 0.35 to 14.90 (median 2.47) and patients with severe reactions had IgE between 1.18 and 11.00 (median 3.70) (p = 0.006). These results show a correlation between IgE titres and the severity of the clinical reaction to egg. IgE titres may help to determine the potential risk of a reaction to eggs.

Correlation between specific immunoglobulin E levels and the severity of reactions in egg allergic patients.
Benhamou AH, Zamora SA, Eigenmann PA.
Pediatr Allergy Immunol 2008 Mar;19(2):173-179

Gold-induced contact eczema: A review and case report
"Gold is an inert and stable precious metal, and is usually well tolerated. Allergic adverse events have been reported in patients treated with gold salts, but the immunologic consequences of skin exposure to gold metal are not precisely known. The authors report a case of gold-induced contact eczema and mouth lesions in a jeweller woman, and review the literature on gold-induced contact allergy. Although the results of epidemiological studies are highly variable, contact allergy to gold seems to be more frequent than usually suspected. The diagnostic value of epicutaneous tests (patch) with gold sodium thiosulfate (GST) is controversial. Thus, diagnosis of gold-induced contact allergy is based on positive skin tests in patients with a suggestive clinical history only. Prevention is based on the eviction of gold, which may be difficult to realize and expensive in patients with dental prosthesis."

Eczéma de contact à lor : une revue de la littérature à propos dun cas dallergie professionnelle / Gold-induced contact eczema: A review and case report
A. Bubnic, M.-N. Crépy, C. Ponvert and D. Choudat
Revue francaise d allergologie 2008;48(1):4-8

Is it possible to treat peanut allergy by oral tolerance induction protocols?
"Peanut allergy is one of the commonest food allergies in children and has a low natural recovery rate. It is severe and possibly causes fatal anaphylaxis. Current treatment is limited to strict eviction which, although it prevents accidents, does not abate sensitization and the risk of recurrence remains. A risk of increased sensitization has been demonstrated for milk and egg allergy in a randomized study comparing eviction with an oral tolerance induction protocol. Trials evaluating injectable immunotherapy could only be conducted when recombinant allergens, mutated to remove decisive B cell epitopes, would become available. Induction of specific oral tolerance is possible in experimental models. Studies in allergic children whose allergy resolved spontaneously have showed immunological modifications involving Th1-Th2 balance and indicating the role of regulatory T-lymphocytes. However, the slow natural evolution of food allergy in children justifies a therapeutical intervention consisting in daily administration of increasing doses of the food to reach the amount normally eaten. This aims to trigger, or accelerate, immunological tolerance. Studies on egg, milk and wheat flour allergies have produced satisfactory results, indicating a possible application to peanut allergy. This paper summarizes the main facts concerning natural oral tolerance mechanisms, the development of food allergy and spontaneous recovery, before considering specific oral tolerance induction protocols. Criteria of selection of patients are discussed. Protocol implementation modalities are presented, including the increment of doses, the duration of the treatment, parameters for the specific monitoring and later prescription concerning maintenance doses."

Traitement des allergies alimentaires par protocoles dinduction de tolérance orale. Sont-ils applicables au cas de lallergie à larachide / Is it possible to treat peanut allergy by oral tolerance induction protocols
Moneret-Vautrin D -A.
Revue francaise d allergologie 2008;48(1):20-25

The role of pollen allergy in atopic dermatitis
"Atopic dermatitis (DA) affects about 20% of children, being most prevalent in developed countries. It is a multifactorial disease characterized especially by an immunological response to environmental allergens. Many factors are thought to be at the origin of exacerbations of DA but few scientific data are available to validate their clinical importance. Among these factors are food, airborne allergens such as house dust mites and pollen, contact allergens, bacterial infection, certain atmospheric conditions and stress. The aim of this literature review is to analyze arguments for the clinical relevance of pollen as triggers of exacerbations of AD and for the efficacy of specific therapeutic options that could control this potential triggering factor."

Place de lallergie des pollens et dermatite atopique / The role of pollen allergy in atopic dermatitis
B. Nicolie
Revue francaise d allergologie 2008;48(2):67-69

Buckwheat anaphylaxis by inhalation
A young woman had an anaphylactic shock after entering a pancake restaurant But before consuming any food or drink! Allergologic testing showed dust mites and buckwheat sensitization. Clinical history and allergologic tests incriminated airborne buckwheat allergens for the anaphylactic reaction. The patient sera reacts against a 2S albumin, a buckwheat major allergen, as against a 13S globulin, that could be implicated in this reaction.

Anaphylaxie au sarrasin par voie inhalée / Buckwheat anaphylaxis by inhalation
M. Mittaine, C. Sordet, R. Culerrier, A. Barre, P. Rouge and A. Didier
Revue francaise d allergologie 2008;48(2):106-108

Castor bean allergy
A botanist with a history of an IgE-dependant anaphylactic reaction when coming in contact with castor bean oilcake while going about eliminating moles from his lawn. A prick test resulted in a 10 mm reaction and the specific serum IgE level was greater than 100 kU/L. Questioning the patient revealed that he had made a number of trips to Africa and around the Mediterranean area as a result of which he had become sensitized to ricin pollen.

Allergie champêtre / Rural allergy
C. Ledent and M. Mairesse
Revue francaise d allergologie 2008;48(2):109-110

Indirect food contact in severe fish allergy
"The case reported here is one of a severe IgE-mediated fish allergy, triggered by various kinds of indirect contact: inhalation of airborne cooking fish particles, kissing, both passionate and platonic, and eating chicken fed with fish-based fodder."

Indirect food contact in severe fish allergy / Contact indirect avec les aliments dans les cas graves dallergie au poisson
Caiaffa MF, De Serio A, Lotti A, Kourtis G, Macchia L.
Revue francaise d allergologie 2008;48(2):111-112

Can any protein become an allergen?
"Allergens of plant and animal foods and pollen belong to a highly restricted number of protein families. The AllFam Database (http://www.meduniwien.ac.at/allergens/allfam/) provides regularly updated lists of protein families that contain allergens. At present, 2% of the 9318 protein families defined by the Pfam Database (http://pfam.sanger.ac.uk/) contain allergens. Related protein families can be grouped into superfamilies placing allergenic proteins in an evolutionary context. With the exception of the prolamin superfamily, allergenic plant proteins are found in few member families of their respective superfamilies. This might indicate that allergenicity emerged rather infrequently in a very limited number of protein families. Moreover, most members of a given protein family seem to be non-allergenic. In contrast to plant allergens, the allergenicity of animal food allergens seems to be dependent on the degree of identity to a human homologue. The closer a potential animal allergen is to a human protein, the less likely it is to act as allergen."

Can any protein become an allergen? / Est-ce nimporte quelle protéine peut devenir un allergène ?
Breiteneder H.
Revue francaise d allergologie 2008;48(3):135-138

Common structures of allergens
"Allergens can be classified into different families of proteins with common structural features, but there are not structures and functions in common to all allergens. High degree of amino acid sequence identity between homologous proteins reflects on common molecular surface patches that are the basis of allergenic cross-reactivity. Allergens need to be available for exposure (dose) to individuals susceptible (genetic predisposition) to develop allergies."

Common structures of allergens / Les structures communes des allergènes
Pomés A.
Revue francaise d allergologie 2008;48(3):139-142

Non-allergenic characteristics of allergens
"Allergens are capable of inducing specific IgE production and are recognized by IgE-receptor bearing cells, more particularly mast cells and basophils expressing FcRI, the high affinity IgE receptor. However, they are also capable of directly stimulating certain cells of the bronchial mucosa, especially in a protease-dependent way. For example, many allergens such as those from house dust mites (Dermatophagoides pteronyssinus et Dermatophagoides farinae) have protease activity which is involved in the activation of bronchial epithelial cells, dendritic cells, T lymphocytes, B cells, eosinophils and airway smooth muscle cells. Overall, these activations amplify Th2 polarization, recruitment and activation of inflammatory cells, and airway smooth muscle cell contraction. Receptors such as the protease-activated receptor (PAR) have been involved in these functions. PAR-2, which has a role in protease-dependent activation by many allergens, is over-expressed in bronchial biopsies from asthmatic patients. Both phenomena may be involved in the development and amplification of allergic asthma."

Caractéristiques non allergéniques des allergènes / Non-allergenic characteristics of allergens
C. Duez
Revue francaise d allergologie 2008;48(3):143-14

Inflammatory occupational skin disease among hairdressers: Diagnosis and prevention
"Occupational skin diseases of chemical origin are frequent among hairdressers. They can be caused by hair dyes, in particular those containing para-amines (especially paraphenylenediamine); bleaching agents containing alkaline persulphates, which can cause eczema, contact urticaria, rhinitis and asthma; liquids used in permanents containing products derived from irritant, sensitizing glycolic acid; irritant and sensitizing shampoos, in particular those with coconut derivatives, proteins hydrolysates and ubiquitous perfumes. Other allergic factors which are observed episodically include nickel, glutaraldehyde, formaldehyde, ethyl cyanoacrylate and minoxidil (Regaine®). Prevention, which is essential, should start at the beginning of the training."

Dermatoses inflammatoires professionnelles dans les métiers de la coiffure : diagnostic et prévention / Inflammatory occupational skin disease among hairdressers: Diagnosis and prevention
C. Géraut, M.B. Cleenewerck and D. Tripodi
Revue francaise d allergologie 2008;48(3):256-263

Flexural allergic contact dermatitis to benzalkonium chloride in antiseptic bath oil.
Benzalkonium chloride (BAK) is an acknowledged irritant but has also been identified as a cause of allergic contact dermatitis. The antiseptic bath emollient Oilatum Plu