Fachdokumente Online der Landesanstalt für Umwelt Baden-Württemberg

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Latex Type I Allergy: Risk evaluation under specific considerations of cross-reactive proteins in food


The prevalence of latex-associated food sensitization was studied in two risk groups. In a group of adult latex allergics (n=69), the number of positive skin prick tests (SPT) to one food type was significantly higher than in the control group (n=163) (p<1x10-9; 25.5 % versus 4.6 %). Sensitization to avocado (39.1%) and chestnut (38.8%) was most pronounced. In children with atopic dermatitis (n=74). 16.2% had latex specific-IgE. 70 % of specific IgE tests with latex-associated food were positive in these latex-sensitized children. In contrast, in the control group without latex-specific IgE (n=62), only 6.7% of food specific-IgE determinations were positive. Significant differences between these two groups existed for tomato, avocado and sweet pepper. Differences in the prevalence of specific IgE to chestnut, potato and kiwi were smaller. Avocado-specific IgE was exclusively found in the latex-sensitized children group. Double-blind placebo-controlled food challenge tests in the adults and in the children group confirmed the anamnestic indication, serological and SPT results. In addition to the fact that avocado-specific IgE was only detected in sera of latex-IgE positive children, the high degree of cross-inhibition confirms the assumption that especially a lot of avocado and some latex proteins share similar IgE-binding epitopes. Immunological crossreactivity between hevein and avocado class I chitinase that contains a hevein domain at the N-terminus was the molecular explanation for this phenomenon. Comparable to avocado, class I chitinase seemed to be relevant as major crossreacting protein in banana. In case of the other foods, the diversity of IgE epitopes seems to be greater when compared to latex. Our data indicate that only few similarities of IgE epitopes exist between latex and kiwi; sensitization to latex and kiwi seems to be independent. Especially in case of potato, latex-dependent and -independent ways of sensitization seem to exist. The generation of a latex allergen database increased the detailed knowledge of the IgE-binding latex proteins. Additionally, the localisation of IgE-binding proteins in latex-associated foods allowed the identification of allergenic proteins with homology to described latex allergens. Patatin of potatoes with homology to the latex allergen Hev b 7 was isolated and identified as the major crossreacting protein in potato and latex sensitization. Based on its stability in in vitro ingestion experiments, patatin was a potential food allergen.


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