Sensitization to PR‐10 proteins is indicative of distinctive sensitization patterns in adults with a suspected food allergy

• Published in: Clinical and translational allergy 2017-11, Vol.7 (1), p.42-n/a, Article 42
• Main Authors: Blankestijn, Mark A., Knulst, André C., Knol, Edward F., Le, Thuy‐My, Rockmann, Heike, Otten, Henny G., Klemans, Rob J. B.
• Format: Article
• Language: English
• Subjects: Adults; Age; Allergens; Asthma; Dermatology; Food allergies; Food allergy; Hay fever; ImmunoCAP ISAC; Immunoglobulin E; Immunoglobulins; Immunotherapy; Legumes; Patients; Population; PR-10; Proteins; Rhinitis; Specific IgE; Storage proteins; Trees
• ISSN: 2045-7022; 2045-7022
• DOI: 10.1186/s13601-017-0177-4

Background The extent of co‐sensitization within and between food protein families in an adult population is largely unknown. This study aimed to identify the most frequently recognized components in the PR‐10 and storage protein family, as well as patterns in (co‐)sensitization, in a birch‐endemic area. Methods Results of ImmunoCAP ISAC, performed during routine care in Dutch adult outpatients suspected of food allergy, were collected. Results A total of 305 patients were selected, aged 16–79 years (median 32 years). Sensitization to one or more PR‐10 proteins was most frequent (74% of all subjects), followed by 35% to storage protein and 15% to nsLTPs. Within the PR‐10 family, subjects were most often sensitized to Bet v 1 (73% of 305), Cor a 1.04 (72%) and Mal d 1 (68%). Sensitization to PR‐10s from soy, celery and kiwi occurred distinctively less often (< 55% of Bet v 1 sensitized subjects) compared to other food PR‐10s (all > 70%). Subjects sensitized to these ‘less common PR‐10 proteins’ were sensitized to more food and inhalant components on the ISAC, compared to subjects sensitized to ‘common PR‐10 proteins’ (median 22 vs 13 out of 112, p < 0.0001). Seven subjects demonstrated sensitization to food PR‐10 proteins, without concomitant sensitization to pollen PR‐10s. Within the storage proteins, sensitization to multiple peanut allergens was most common (on average 3 out of 4). Conclusions Sensitization to PR‐10 food proteins could occur without concomitant sensitization to common PR‐10 from pollen in a subset of subjects. Less commonly recognized PR‐10 proteins appear to be an indication of polysensitization.