How accurate and safe is the diagnosis of hazelnut allergy by means of commercial skin prick test reagents?
Identifieur interne : 000461 ( Main/Corpus ); précédent : 000460; suivant : 000462How accurate and safe is the diagnosis of hazelnut allergy by means of commercial skin prick test reagents?
Auteurs : Jaap H. Akkerdaas ; Marjolein Wensing ; André C. Knulst ; Monika Krebitz ; Heimo Breiteneder ; Sacco De Vries ; André H. Penninks ; Rob C. Aalberse ; Sue L. Hefle ; Ronald Van ReeSource :
- International archives of allergy and immunology [ 1018-2438 ] ; 2003.
English descriptors
- KwdEn :
- Adolescent (MeSH), Adult (MeSH), Aged (MeSH), Blotting, Western (MeSH), Contractile Proteins (MeSH), False Negative Reactions (MeSH), Humans (MeSH), Immunoglobulin E (immunology), Microfilament Proteins (immunology), Middle Aged (MeSH), Nut Hypersensitivity (diagnosis), Nut Hypersensitivity (immunology), Nuts (immunology), Plant Proteins (chemistry), Plant Proteins (immunology), Profilins (MeSH), Radioallergosorbent Test (MeSH), Reagent Kits, Diagnostic (standards), Skin Tests (adverse effects), Skin Tests (methods).
- MESH :
- chemical , chemistry : Plant Proteins.
- chemical , immunology : Immunoglobulin E, Microfilament Proteins, Plant Proteins.
- chemical , standards : Reagent Kits, Diagnostic.
- chemical : Contractile Proteins, Profilins.
- adverse effects : Skin Tests.
- diagnosis : Nut Hypersensitivity.
- immunology : Nut Hypersensitivity, Nuts.
- methods : Skin Tests.
- Adolescent, Adult, Aged, Blotting, Western, False Negative Reactions, Humans, Middle Aged, Radioallergosorbent Test.
Abstract
BACKGROUND
Allergy to tree nuts, like hazelnuts, ranks among the most frequently observed food allergies. These allergies can start at early childhood and are, in contrast to other food allergies, not always outgrown by the patient. Tree nut allergy is frequently associated with severe reactions. Diagnosis partially relies on in vivo testing by means of a skin prick test (SPT) using commercially available SPT reagents.
METHODS
Protein and allergen composition of nine commercial SPT solutions was evaluated using standard protein detection methods and specific immunoassays for measurement of five individual allergens. Diagnostic performance was assessed by SPT in 30 hazelnut-allergic subjects, of which 15 were provocation proven.
RESULTS
Protein concentrations ranged from 0.2-14 mg/ml. SDS-PAGE/silver staining revealed clear differences in protein composition. The major allergen Cor a 1 was present in all extracts but concentrations differed up to a factor 50. An allergen associated with severe symptoms, Cor a 8 (lipid transfer protein), was not detected on immunoblot in three products, and concentrations varied by more than a factor 100 as was shown by RAST inhibition. Similar observations were made for profilin, thaumatin-like protein and a not fully characterized 38-kD allergen. Ratios of individual allergens were variable among the nine extracts. SPT showed significant difference, and 6/30 patients displayed false-negative results using 3/9 products.
CONCLUSION
Variability in the composition of products for the diagnosis of hazelnut allergy is extreme. Sometimes, allergens implicated in severe anaphylaxis are not detected by immunoblotting. These shortcomings in standardisation and quality control can potentially cause a false-negative diagnosis in subjects at risk of severe reactions to hazelnuts.
DOI: 10.1159/000073714
PubMed: 14600425
Links to Exploration step
pubmed:14600425Le document en format XML
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Knulst</name></author><author><name sortKey="Krebitz, Monika" sort="Krebitz, Monika" uniqKey="Krebitz M" first="Monika" last="Krebitz">Monika Krebitz</name></author><author><name sortKey="Breiteneder, Heimo" sort="Breiteneder, Heimo" uniqKey="Breiteneder H" first="Heimo" last="Breiteneder">Heimo Breiteneder</name></author><author><name sortKey="De Vries, Sacco" sort="De Vries, Sacco" uniqKey="De Vries S" first="Sacco" last="De Vries">Sacco De Vries</name></author><author><name sortKey="Penninks, Andre H" sort="Penninks, Andre H" uniqKey="Penninks A" first="André H" last="Penninks">André H. Penninks</name></author><author><name sortKey="Aalberse, Rob C" sort="Aalberse, Rob C" uniqKey="Aalberse R" first="Rob C" last="Aalberse">Rob C. Aalberse</name></author><author><name sortKey="Hefle, Sue L" sort="Hefle, Sue L" uniqKey="Hefle S" first="Sue L" last="Hefle">Sue L. Hefle</name></author><author><name sortKey="Van Ree, Ronald" sort="Van Ree, Ronald" uniqKey="Van Ree R" first="Ronald" last="Van Ree">Ronald Van Ree</name></author></titleStmt><publicationStmt><idno type="wicri:source">PubMed</idno><date when="2003">2003</date><idno type="RBID">pubmed:14600425</idno><idno type="pmid">14600425</idno><idno type="doi">10.1159/000073714</idno><idno type="wicri:Area/Main/Corpus">000461</idno><idno type="wicri:explorRef" wicri:stream="Main" wicri:step="Corpus" wicri:corpus="PubMed">000461</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en">How accurate and safe is the diagnosis of hazelnut allergy by means of commercial skin prick test reagents?</title><author><name sortKey="Akkerdaas, Jaap H" sort="Akkerdaas, Jaap H" uniqKey="Akkerdaas J" first="Jaap H" last="Akkerdaas">Jaap H. Akkerdaas</name><affiliation><nlm:affiliation>Department of Immunopathology, Sanquin Research at CLB, Amsterdam, The Netherlands.</nlm:affiliation></affiliation></author><author><name sortKey="Wensing, Marjolein" sort="Wensing, Marjolein" uniqKey="Wensing M" first="Marjolein" last="Wensing">Marjolein Wensing</name></author><author><name sortKey="Knulst, Andre C" sort="Knulst, Andre C" uniqKey="Knulst A" first="André C" last="Knulst">André C. Knulst</name></author><author><name sortKey="Krebitz, Monika" sort="Krebitz, Monika" uniqKey="Krebitz M" first="Monika" last="Krebitz">Monika Krebitz</name></author><author><name sortKey="Breiteneder, Heimo" sort="Breiteneder, Heimo" uniqKey="Breiteneder H" first="Heimo" last="Breiteneder">Heimo Breiteneder</name></author><author><name sortKey="De Vries, Sacco" sort="De Vries, Sacco" uniqKey="De Vries S" first="Sacco" last="De Vries">Sacco De Vries</name></author><author><name sortKey="Penninks, Andre H" sort="Penninks, Andre H" uniqKey="Penninks A" first="André H" last="Penninks">André H. Penninks</name></author><author><name sortKey="Aalberse, Rob C" sort="Aalberse, Rob C" uniqKey="Aalberse R" first="Rob C" last="Aalberse">Rob C. Aalberse</name></author><author><name sortKey="Hefle, Sue L" sort="Hefle, Sue L" uniqKey="Hefle S" first="Sue L" last="Hefle">Sue L. Hefle</name></author><author><name sortKey="Van Ree, Ronald" sort="Van Ree, Ronald" uniqKey="Van Ree R" first="Ronald" last="Van Ree">Ronald Van Ree</name></author></analytic><series><title level="j">International archives of allergy and immunology</title><idno type="ISSN">1018-2438</idno><imprint><date when="2003" type="published">2003</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Adolescent (MeSH)</term><term>Adult (MeSH)</term><term>Aged (MeSH)</term><term>Blotting, Western (MeSH)</term><term>Contractile Proteins (MeSH)</term><term>False Negative Reactions (MeSH)</term><term>Humans (MeSH)</term><term>Immunoglobulin E (immunology)</term><term>Microfilament Proteins (immunology)</term><term>Middle Aged (MeSH)</term><term>Nut Hypersensitivity (diagnosis)</term><term>Nut Hypersensitivity (immunology)</term><term>Nuts (immunology)</term><term>Plant Proteins (chemistry)</term><term>Plant Proteins (immunology)</term><term>Profilins (MeSH)</term><term>Radioallergosorbent Test (MeSH)</term><term>Reagent Kits, Diagnostic (standards)</term><term>Skin Tests (adverse effects)</term><term>Skin Tests (methods)</term></keywords><keywords scheme="MESH" type="chemical" qualifier="chemistry" xml:lang="en"><term>Plant Proteins</term></keywords><keywords scheme="MESH" type="chemical" qualifier="immunology" xml:lang="en"><term>Immunoglobulin E</term><term>Microfilament Proteins</term><term>Plant Proteins</term></keywords><keywords scheme="MESH" type="chemical" qualifier="standards" xml:lang="en"><term>Reagent Kits, Diagnostic</term></keywords><keywords scheme="MESH" type="chemical" xml:lang="en"><term>Contractile Proteins</term><term>Profilins</term></keywords><keywords scheme="MESH" qualifier="adverse effects" xml:lang="en"><term>Skin Tests</term></keywords><keywords scheme="MESH" qualifier="diagnosis" xml:lang="en"><term>Nut Hypersensitivity</term></keywords><keywords scheme="MESH" qualifier="immunology" xml:lang="en"><term>Nut Hypersensitivity</term><term>Nuts</term></keywords><keywords scheme="MESH" qualifier="methods" xml:lang="en"><term>Skin Tests</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Adolescent</term><term>Adult</term><term>Aged</term><term>Blotting, Western</term><term>False Negative Reactions</term><term>Humans</term><term>Middle Aged</term><term>Radioallergosorbent Test</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p><b>BACKGROUND</b></p><p>Allergy to tree nuts, like hazelnuts, ranks among the most frequently observed food allergies. These allergies can start at early childhood and are, in contrast to other food allergies, not always outgrown by the patient. Tree nut allergy is frequently associated with severe reactions. Diagnosis partially relies on in vivo testing by means of a skin prick test (SPT) using commercially available SPT reagents.</p></div><div type="abstract" xml:lang="en"><p><b>METHODS</b></p><p>Protein and allergen composition of nine commercial SPT solutions was evaluated using standard protein detection methods and specific immunoassays for measurement of five individual allergens. Diagnostic performance was assessed by SPT in 30 hazelnut-allergic subjects, of which 15 were provocation proven.</p></div><div type="abstract" xml:lang="en"><p><b>RESULTS</b></p><p>Protein concentrations ranged from 0.2-14 mg/ml. SDS-PAGE/silver staining revealed clear differences in protein composition. The major allergen Cor a 1 was present in all extracts but concentrations differed up to a factor 50. An allergen associated with severe symptoms, Cor a 8 (lipid transfer protein), was not detected on immunoblot in three products, and concentrations varied by more than a factor 100 as was shown by RAST inhibition. Similar observations were made for profilin, thaumatin-like protein and a not fully characterized 38-kD allergen. Ratios of individual allergens were variable among the nine extracts. SPT showed significant difference, and 6/30 patients displayed false-negative results using 3/9 products.</p></div><div type="abstract" xml:lang="en"><p><b>CONCLUSION</b></p><p>Variability in the composition of products for the diagnosis of hazelnut allergy is extreme. Sometimes, allergens implicated in severe anaphylaxis are not detected by immunoblotting. These shortcomings in standardisation and quality control can potentially cause a false-negative diagnosis in subjects at risk of severe reactions to hazelnuts.</p></div></front></TEI><pubmed><MedlineCitation Status="MEDLINE" Owner="NLM"><PMID Version="1">14600425</PMID><DateCompleted><Year>2003</Year><Month>12</Month><Day>02</Day></DateCompleted><DateRevised><Year>2019</Year><Month>12</Month><Day>10</Day></DateRevised><Article PubModel="Print"><Journal><ISSN IssnType="Print">1018-2438</ISSN><JournalIssue CitedMedium="Print"><Volume>132</Volume><Issue>2</Issue><PubDate><Year>2003</Year><Month>Oct</Month></PubDate></JournalIssue><Title>International archives of allergy and immunology</Title><ISOAbbreviation>Int Arch Allergy Immunol</ISOAbbreviation></Journal><ArticleTitle>How accurate and safe is the diagnosis of hazelnut allergy by means of commercial skin prick test reagents?</ArticleTitle><Pagination><MedlinePgn>132-40</MedlinePgn></Pagination><Abstract><AbstractText Label="BACKGROUND" NlmCategory="BACKGROUND">Allergy to tree nuts, like hazelnuts, ranks among the most frequently observed food allergies. These allergies can start at early childhood and are, in contrast to other food allergies, not always outgrown by the patient. Tree nut allergy is frequently associated with severe reactions. Diagnosis partially relies on in vivo testing by means of a skin prick test (SPT) using commercially available SPT reagents.</AbstractText><AbstractText Label="METHODS" NlmCategory="METHODS">Protein and allergen composition of nine commercial SPT solutions was evaluated using standard protein detection methods and specific immunoassays for measurement of five individual allergens. Diagnostic performance was assessed by SPT in 30 hazelnut-allergic subjects, of which 15 were provocation proven.</AbstractText><AbstractText Label="RESULTS" NlmCategory="RESULTS">Protein concentrations ranged from 0.2-14 mg/ml. SDS-PAGE/silver staining revealed clear differences in protein composition. The major allergen Cor a 1 was present in all extracts but concentrations differed up to a factor 50. An allergen associated with severe symptoms, Cor a 8 (lipid transfer protein), was not detected on immunoblot in three products, and concentrations varied by more than a factor 100 as was shown by RAST inhibition. Similar observations were made for profilin, thaumatin-like protein and a not fully characterized 38-kD allergen. Ratios of individual allergens were variable among the nine extracts. SPT showed significant difference, and 6/30 patients displayed false-negative results using 3/9 products.</AbstractText><AbstractText Label="CONCLUSION" NlmCategory="CONCLUSIONS">Variability in the composition of products for the diagnosis of hazelnut allergy is extreme. Sometimes, allergens implicated in severe anaphylaxis are not detected by immunoblotting. These shortcomings in standardisation and quality control can potentially cause a false-negative diagnosis in subjects at risk of severe reactions to hazelnuts.</AbstractText><CopyrightInformation>Copyright 2003 S. Karger AG, Basel</CopyrightInformation></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Akkerdaas</LastName><ForeName>Jaap H</ForeName><Initials>JH</Initials><AffiliationInfo><Affiliation>Department of Immunopathology, Sanquin Research at CLB, Amsterdam, The Netherlands.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Wensing</LastName><ForeName>Marjolein</ForeName><Initials>M</Initials></Author><Author ValidYN="Y"><LastName>Knulst</LastName><ForeName>André C</ForeName><Initials>AC</Initials></Author><Author ValidYN="Y"><LastName>Krebitz</LastName><ForeName>Monika</ForeName><Initials>M</Initials></Author><Author ValidYN="Y"><LastName>Breiteneder</LastName><ForeName>Heimo</ForeName><Initials>H</Initials></Author><Author ValidYN="Y"><LastName>de Vries</LastName><ForeName>Sacco</ForeName><Initials>S</Initials></Author><Author ValidYN="Y"><LastName>Penninks</LastName><ForeName>André H</ForeName><Initials>AH</Initials></Author><Author ValidYN="Y"><LastName>Aalberse</LastName><ForeName>Rob C</ForeName><Initials>RC</Initials></Author><Author ValidYN="Y"><LastName>Hefle</LastName><ForeName>Sue L</ForeName><Initials>SL</Initials></Author><Author ValidYN="Y"><LastName>van Ree</LastName><ForeName>Ronald</ForeName><Initials>R</Initials></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D023362">Evaluation Study</PublicationType><PublicationType UI="D016428">Journal Article</PublicationType><PublicationType UI="D013485">Research Support, Non-U.S. Gov't</PublicationType></PublicationTypeList></Article><MedlineJournalInfo><Country>Switzerland</Country><MedlineTA>Int Arch Allergy Immunol</MedlineTA><NlmUniqueID>9211652</NlmUniqueID><ISSNLinking>1018-2438</ISSNLinking></MedlineJournalInfo><ChemicalList><Chemical><RegistryNumber>0</RegistryNumber><NameOfSubstance UI="D003285">Contractile Proteins</NameOfSubstance></Chemical><Chemical><RegistryNumber>0</RegistryNumber><NameOfSubstance UI="C061277">Cor a I protein, hazel</NameOfSubstance></Chemical><Chemical><RegistryNumber>0</RegistryNumber><NameOfSubstance UI="D008840">Microfilament Proteins</NameOfSubstance></Chemical><Chemical><RegistryNumber>0</RegistryNumber><NameOfSubstance UI="D010940">Plant Proteins</NameOfSubstance></Chemical><Chemical><RegistryNumber>0</RegistryNumber><NameOfSubstance UI="D051304">Profilins</NameOfSubstance></Chemical><Chemical><RegistryNumber>0</RegistryNumber><NameOfSubstance UI="D011933">Reagent Kits, Diagnostic</NameOfSubstance></Chemical><Chemical><RegistryNumber>37341-29-0</RegistryNumber><NameOfSubstance UI="D007073">Immunoglobulin E</NameOfSubstance></Chemical></ChemicalList><CitationSubset>IM</CitationSubset><MeshHeadingList><MeshHeading><DescriptorName UI="D000293" MajorTopicYN="N">Adolescent</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D000328" MajorTopicYN="N">Adult</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D000368" MajorTopicYN="N">Aged</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D015153" MajorTopicYN="N">Blotting, Western</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D003285" MajorTopicYN="Y">Contractile Proteins</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D005188" MajorTopicYN="N">False Negative Reactions</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D006801" MajorTopicYN="N">Humans</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D007073" MajorTopicYN="N">Immunoglobulin E</DescriptorName><QualifierName UI="Q000276" MajorTopicYN="N">immunology</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D008840" MajorTopicYN="N">Microfilament Proteins</DescriptorName><QualifierName UI="Q000276" MajorTopicYN="N">immunology</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D008875" MajorTopicYN="N">Middle Aged</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D021184" MajorTopicYN="N">Nut Hypersensitivity</DescriptorName><QualifierName UI="Q000175" MajorTopicYN="Y">diagnosis</QualifierName><QualifierName UI="Q000276" MajorTopicYN="N">immunology</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D009754" MajorTopicYN="N">Nuts</DescriptorName><QualifierName UI="Q000276" MajorTopicYN="Y">immunology</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D010940" MajorTopicYN="N">Plant Proteins</DescriptorName><QualifierName UI="Q000737" MajorTopicYN="N">chemistry</QualifierName><QualifierName UI="Q000276" MajorTopicYN="Y">immunology</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D051304" MajorTopicYN="N">Profilins</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D011852" MajorTopicYN="N">Radioallergosorbent Test</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D011933" MajorTopicYN="N">Reagent Kits, Diagnostic</DescriptorName><QualifierName UI="Q000592" MajorTopicYN="Y">standards</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D012882" MajorTopicYN="N">Skin Tests</DescriptorName><QualifierName UI="Q000009" MajorTopicYN="N">adverse effects</QualifierName><QualifierName UI="Q000379" MajorTopicYN="Y">methods</QualifierName></MeshHeading></MeshHeadingList></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="received"><Year>2002</Year><Month>12</Month><Day>09</Day></PubMedPubDate><PubMedPubDate PubStatus="accepted"><Year>2003</Year><Month>07</Month><Day>14</Day></PubMedPubDate><PubMedPubDate PubStatus="pubmed"><Year>2003</Year><Month>11</Month><Day>6</Day><Hour>5</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="medline"><Year>2003</Year><Month>12</Month><Day>3</Day><Hour>5</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="entrez"><Year>2003</Year><Month>11</Month><Day>6</Day><Hour>5</Hour><Minute>0</Minute></PubMedPubDate></History><PublicationStatus>ppublish</PublicationStatus><ArticleIdList><ArticleId IdType="pubmed">14600425</ArticleId><ArticleId IdType="doi">10.1159/000073714</ArticleId><ArticleId IdType="pii">73714</ArticleId></ArticleIdList></PubmedData></pubmed></record>Pour manipuler ce document sous Unix (Dilib)
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