Rice-Induced Anaphylaxis: IgE-Mediated Allergy against a 56-kDa Glycoprotein
Rice-Induced Anaphylaxis: IgE-Mediated Allergy against a 56-kDa Glycoprotein
复制标题
DOI：
10.1159/000330641
复制
发表时间：
2012-01-01
影响因子：
2.8
通讯作者：
Trautmann, Axel
中科院分区：
文献类型：
--
作者：
Trcka, Jiri;Schaed, Susanne G.;Trautmann, Axel
背景：大米是世界上最常见的粮食作物之一，但有关食用大米后的即刻过敏反应的报道很少。在亚洲，关于大米过敏的临床研究几乎没有关于鼻炎、哮喘和特应性皮炎的报道。在这项案例研究中，我们确定了一名德国患者摄入大米后可能导致过敏反应的过敏原。方法：采用点刺试验、特异性IgE测定和嗜碱性粒细胞活化试验(BAT)等方法确定IgE介导的变态反应。用免疫印迹法进一步分析了商品米饭制品中蛋白质提取物的免疫球蛋白反应性。对大米过敏原进行了纯化、N末端测序，并用8例大米过敏和/或大米摄取后有过敏症状的受试者的血清进行了IgE结合和IgE抑制试验。结果：生、熟大米(巴斯马蒂米和糯米)及不同大米提取物制剂的点对点试验均为阳性。对水稻的特异性IgE(F9)为1.87kU(A)/I。大米提取物刺激BAT后，显示出特异性的IgE介导的嗜碱性粒细胞活化。鉴定出4个表观分子量分别为49、52、56和98 kDa的IgE反应性大米蛋白。有趣的是，只有与56 kDa糖蛋白的结合至少部分独立于交叉反应碳水化合物决定因素(CCD)，而与其他大米蛋白的IgE结合通过预先孵育菠萝酶产生的CCDMUXF而完全被抑制。结论：然而，来自大米种子的未知高分子质量过敏原，主要是一种56 kDa的糖蛋白，似乎与德国患者食用大米后的过敏反应有关。版权所有(C)2011 S.Karger AG，巴塞尔
Background: Although rice (Oryza sativa) is one of the most common cereals produced and consumed around the world, there have been only a few reports on immediate hypersensitivity reactions after ingestion of rice. Few clinical studies on rice allergy in Asia have been reported concerning rhinitis, asthma and atopic dermatitis. In this case study, we identify allergens presumably responsible for anaphylaxis after ingestion of rice in a German patient. Methods: Prick-to-prick tests, determination of specific IgE and the basophil activation test (BAT) were performed to confirm IgE-mediated allergy. IgE reactivity was further analyzed by immuno-blotting of protein extracts from cooked commercial rice products. Rice allergens were purified, subjected to N-terminal sequencing and characterized by IgE binding and IgE inhibition assays using additional sera from 8 subjects with sensitization to rice and/or a history of hypersensitivity symptoms after rice ingestion. Results: Prick-to-prick tests were positive to raw and cooked rice (basmati rice and long-grain rice) and preparations of different rice extracts. Specific IgE against rice (f9) was 1.87 kU(A)/I. The BAT showed specific IgE-mediated activation of basophils after stimulation with rice extracts. Four IgE-reactive rice proteins with an apparent molecular weight of 49, 52, 56 and 98 kDa were identified. Interestingly, only binding to the 56-kDa glycoprotein was at least partially independent from cross-reactive carbohydrate determinants (CCD), whereas IgE binding to the other rice proteins was completely inhibited by pre-incubation with the CCD MUXF derived from bromelain. Conclusions: Yet unidentified high-molecular-weight allergens from rice seeds, predominantly a 56-kDa glycoprotein, seem to be responsible for anaphylaxis after consumption of rice in a German patient. Copyright (C) 2011 S. Karger AG, Basel