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Evaluation of food-pollen cross-reactivity by nose–mouth cross-challenge in pollinosis with oral allergy syndrome

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Oral allergy syndrome (OAS) is often associated with pollen-induced rhinitis, and there are preferential associations between causative substances. If OAS and rhinitis are both immunoglobulin (Ig)E-mediated and there are cross-reacting proteins, it is expected that similar reactions can be elicited in the nose and mouth. In order to test this hypothesis we performed a series of ‘cross-challenges’ with foods and pollens in both the nose and the mouth. Methods: 

Nine patients with ascertained OAS due to vegetables and rhinitis due to pollens were studied. On the first day a nasal challenge with pollen extracts and an oral challenge with fresh food was carried out. After a week, washout nasal challenge with food and an oral challenge with pollens were performed. Immediate symptoms, mucosal tryptase and soluble eosinophil cationic protein (ECP) were assessed after each challenge. Results: 

The administration of pollen into the nose and food into the mouth elicited symptoms as expected, but the cross-challenge had no clinical effect. In parallel, tryptase and ECP increased after nasal challenge with pollens, whereas foods did not elicit a measurable response. Conclusion: 

The cross-reactivity between foods and pollens, when evaluated at the shock organ, was not clinically evident. This data can be explained with a low concentration of cross-reagent epitopes in pollen extracts and food homogenized because of degradation. The different behaviour upon challenge suggests that different immunological mechanisms may act in the nose and mouth.
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Keywords: allergic rhinitis; cross-reactivity; nasal challenge; oral allergy syndrome; pollinosis

Document Type: Research Article

Affiliations: 1: Clinica Pediatrica, University of Perugia, Perugia 2: Clinica Pediatrica, University of Florence, Florence 3: Allergy and Respiratory Diseases, DIMI, University of Genoa, Genoa, Italy

Publication date: 2005-04-01

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