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A systematic review of allergen cross-reactivity: Translating basic concepts into clinical relevance

Sharma, Ekansh, Vitte, Joana·2024·Journal of Allergy and Clinical Immunology: Global
DOI 10.1016/j.jacig.2024.100230PMC PMC10959674
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Fig 1 Allergic and nonallergic hypersensitivity reactions. Definitions of hypersensitivity versus allergy and main mechanisms of immediate and delayed hypersensitivity reactions are presented with selected examples. Gell and Coombs classification (type I to IV hypersensitivity) is shown. AD, Atopic dermatitis; Ba, basophil; MC, mast cell; MPS, mononuclear phagocyte system (monocyte, macrophage); Neu, neutrophil; TEN, toxic epidermal necrolysis. References 1, 11, 12, 13, 19, 20, 21, 22.
Fig 1 Allergic and nonallergic hypersensitivity reactions. Definitions of hypersensitivity versus allergy and main mechanisms of immediate and delayed hypersensitivity reactions are presented with selected examples. Gell and Coombs classification (type I to IV hypersensitivity) is shown. AD, Atopic dermatitis; Ba, basophil; MC, mast cell; MPS, mononuclear phagocyte system (monocyte, macrophage); Neu, neutrophil; TEN, toxic epidermal necrolysis. References 1, 11, 12, 13, 19, 20, 21, 22.CC BY-NC-ND · PubMed Central
Fig 2 Clinical vignette illustrating HDM, edible insects, and shrimp cross-reactivity. Consider assessing IgE to corresponding allergen extracts for accurate interpretation of IgE to MA. Tropomyosins from arthropods (HDM, insects, and crustaceans), mollusks, and gastropods exhibit extensive cross-reactivity. OFC, Oral food challenge. References 3, 41, 42, 43.
Fig 2 Clinical vignette illustrating HDM, edible insects, and shrimp cross-reactivity. Consider assessing IgE to corresponding allergen extracts for accurate interpretation of IgE to MA. Tropomyosins from arthropods (HDM, insects, and crustaceans), mollusks, and gastropods exhibit extensive cross-reactivity. OFC, Oral food challenge. References 3, 41, 42, 43.CC BY-NC-ND · PubMed Central
Fig 3 Clinical vignette illustrating pollen and food cross-reactivity. Consider assessing IgE to corresponding allergen extracts for accurate interpretation of IgE to MA. Here, molecular assessment of birch pollen is not useful because it does not contain nsLTP or GRP. Profilin, a plant panallergen family, exhibits extensive pollen–fruit cross-reactivity. Lack of sensitization to grass and weed pollens excludes profilin involvement. PR-10, a cross-reactive family of plant allergens comprising major birch allergen Bet v 1, is heat sensitive. Cupressaceae pollen and bell pepper lack characterized PR-10 homologs. nsLTP, Nonspecific LTP. References 3, 47, 48, 49.
Fig 3 Clinical vignette illustrating pollen and food cross-reactivity. Consider assessing IgE to corresponding allergen extracts for accurate interpretation of IgE to MA. Here, molecular assessment of birch pollen is not useful because it does not contain nsLTP or GRP. Profilin, a plant panallergen family, exhibits extensive pollen–fruit cross-reactivity. Lack of sensitization to grass and weed pollens excludes profilin involvement. PR-10, a cross-reactive family of plant allergens comprising major birch allergen Bet v 1, is heat sensitive. Cupressaceae pollen and bell pepper lack characterized PR-10 homologs. nsLTP, Nonspecific LTP. References 3, 47, 48, 49.CC BY-NC-ND · PubMed Central
Fig 4 Pollen marker and cross-reactive allergens. Selected examples are shown for marker and cross-reactive pollen allergen families. Genuine sensitization to major taxonomic groups of trees, weeds, and grasses can be identified using marker allergens. Examples include PR-10 allergens from Fagales trees (birch Bet v 1, alder Aln g 1, oak Que a 1), invertase inhibitors from Proteales (London plane Pla a 1), pectate lyases from Pinales (Arizona cypress Cup a 1, Japanese cedar Cry j 1, juniper Jun a 1), Ole e 1–related allergens from Lamiales (olive tree Ole e 1, ash tree Fra e 1, lilac Syr v 1), and Ole e 1–like allergens from tropical trees (sweet acacia Aca f 1, Prosopis juliflora Pro j 1). Allergen families comprising cross-reactive homologs across unrelated taxonomic groups are denoted as shared allergens. Profilins and polcalcins are ubiquitous in grass, weed, and tree pollen. Profilins, but not polcalcins, are also found in plant foods. Profilins and polcalcins display extensive cross-reactivity (pollen panallergens), while variable cross-reactivity is found with most other families of shared allergens. For example, nsLTP Par j 2 does not cross-react with other pollen nsLTP, while clinically relevant cross-reactivity has been described among other pollen and food nsLTP, such as plane pollen Pla a 3, mugwort pollen Art v 3, and peach (fruit) Pru p 3. Cross-reactivity of olive pollen Ole e 1 with Ole e 1–like allergens is also variable: high cross-reactivity between Ole e 1 and ash tree Fra e 1, moderate cross-reactivity of Ole e 1 with other marker allergens from Lamiales order (lilac, privet), and no clinically relevant cross-reactivity with Ole e 1–like allergens from grass or weed pollen. While marker pollen allergens are typically major allergens—that is, sensitization is detected in >50% of allergic patients—shared allergens can present as either major or minor allergens depending on biochemical family and individual exposure. Marker allergens exhibit climate preferences in relationship to plants they are derived from. IFR, Isoflavone reductase; nsLTP, nonspecific LTP; PR-1, pathogenesis-related family 1; OAS, oral allergy syndrome; TLP, thaumatin-like protein. References 3, 47, 49, 50, 51, 52, 53.
Fig 4 Pollen marker and cross-reactive allergens. Selected examples are shown for marker and cross-reactive pollen allergen families. Genuine sensitization to major taxonomic groups of trees, weeds, and grasses can be identified using marker allergens. Examples include PR-10 allergens from Fagales trees (birch Bet v 1, alder Aln g 1, oak Que a 1), invertase inhibitors from Proteales (London plane Pla a 1), pectate lyases from Pinales (Arizona cypress Cup a 1, Japanese cedar Cry j 1, juniper Jun a 1), Ole e 1–related allergens from Lamiales (olive tree Ole e 1, ash tree Fra e 1, lilac Syr v 1), and Ole e 1–like allergens from tropical trees (sweet acacia Aca f 1, Prosopis juliflora Pro j 1). Allergen families comprising cross-reactive homologs across unrelated taxonomic groups are denoted as shared allergens. Profilins and polcalcins are ubiquitous in grass, weed, and tree pollen. Profilins, but not polcalcins, are also found in plant foods. Profilins and polcalcins display extensive cross-reactivity (pollen panallergens), while variable cross-reactivity is found with most other families of shared allergens. For example, nsLTP Par j 2 does not cross-react with other pollen nsLTP, while clinically relevant cross-reactivity has been described among other pollen and food nsLTP, such as plane pollen Pla a 3, mugwort pollen Art v 3, and peach (fruit) Pru p 3. Cross-reactivity of olive pollen Ole e 1 with Ole e 1–like allergens is also variable: high cross-reactivity between Ole e 1 and ash tree Fra e 1, moderate cross-reactivity of Ole e 1 with other marker allergens from Lamiales order (lilac, privet), and no clinically relevant cross-reactivity with Ole e 1–like allergens from grass or weed pollen. While marker pollen allergens are typically major allergens—that is, sensitization is detected in >50% of allergic patients—shared allergens can present as either major or minor allergens depending on biochemical family and individual exposure. Marker allergens exhibit climate preferences in relationship to plants they are derived from. IFR, Isoflavone reductase; nsLTP, nonspecific LTP; PR-1, pathogenesis-related family 1; OAS, oral allergy syndrome; TLP, thaumatin-like protein. References 3, 47, 49, 50, 51, 52, 53.CC BY-NC-ND · PubMed Central
Fig 5 Flowchart of systematic review. A systematic review of allergen cross-reactivity following the PRISMA-P guidelines (Basic concepts and clinical relevance of allergen cross-reactivity: a systematic review, PROSPERO Registry CRD42022312363) identified 134 PubMed articles. The full-text of original articles, position papers, consensus publications, guidelines, and official recommendations was searched for relevant information on allergen cross-reactivity. Exclusion of 72 nonrelevant publications and manual adjunction of 17 relevant original articles resulted in a final set of 79 relevant publications.
Fig 5 Flowchart of systematic review. A systematic review of allergen cross-reactivity following the PRISMA-P guidelines (Basic concepts and clinical relevance of allergen cross-reactivity: a systematic review, PROSPERO Registry CRD42022312363) identified 134 PubMed articles. The full-text of original articles, position papers, consensus publications, guidelines, and official recommendations was searched for relevant information on allergen cross-reactivity. Exclusion of 72 nonrelevant publications and manual adjunction of 17 relevant original articles resulted in a final set of 79 relevant publications.CC BY-NC-ND · PubMed Central

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Metadata

Authors
Sharma, E., & Vitte, J.
ORCID
Vitte, Joana
Venue
Journal of Allergy and Clinical Immunology: Global
Publisher
Elsevier BV
Published
2024-05
Volume
3
Issue
2
Pages
100230
ISSN
2772-8293
DOI
10.1016/j.jacig.2024.100230
PMC
PMC10959674
Cited by
31
References
2
Language
en
Licence

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