Cooking birch pollen-related food:: Divergent consequences for IgE- and T cell-mediated reactivity in vitro and in vivo
Cooking birch pollen-related food:: Divergent consequences for IgE- and T cell-mediated reactivity in vitro and in vivo
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DOI：
10.1016/j.jaci.2006.03.011
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发表时间：
2006-07-01
影响因子：
14.2
通讯作者：
Ebner, Christof
中科院分区：
文献类型：
--
作者：
Bohle, Barbara;Zwoelfer, Bettina;Ebner, Christof
背景：主要的桦树花粉过敏原Bet v 1与同源食物过敏原发生交叉反应，导致IgE介导的口腔变态反应综合征(OASs)。为了避免这种食物，过敏专家和指南建议患者在加热后食用桦树花粉相关的食物。目的：我们试图在体外和体内评估煮熟的Bet v 1相关食物过敏原是否会诱导IgE和T细胞介导的反应。方法：将重组Bet v 1、Mald 1(苹果)、Api g I(芹菜)和Dan c 1(胡萝卜)在升温条件下孵育。蛋白质结构用圆二色谱确定。嗜碱性粒细胞活化实验检测介质释放。具有已知表位特异性的PBMCs和Bet v I特异性T细胞系被天然和熟食变应原刺激。对因进食新鲜苹果、芹菜或胡萝卜而出现OAS和特应性皮炎(AD)加重的白桦树花粉过敏患者进行双盲、安慰剂对照食物挑战的重新测试。结果：在体外，熟食过敏原失去了结合IgE和诱导介质释放的能力，但具有与天然蛋白相同的Bet v I特异性T细胞的激活能力。在体内，摄入与白桦树花粉相关的熟食不会导致OAS，但会导致特应性湿疹的恶化。结论：Bet V I与相关食物过敏原之间的T细胞交叉反应在体外和体内不依赖于IgE交叉反应。在AD患者中，由此产生的免疫反应甚至可以表现为晚期湿疹皮肤反应。因此，应该重新考虑这样一种观点，即食用与花粉有关的煮熟食物不会产生过敏反应。临床意义：在花粉过敏和AD患者中，无症状的食用与花粉相关的食物过敏原可能会引起T细胞介导的晚期皮肤反应。
Background: The major birch pollen allergen Bet v 1 cross-reacts with homologous food allergens, resulting in IgE-mediated oral allergy syndromes (OASs). To avoid this food, allergy allergologists and guidebooks advise patients to consume birch pollen-related foods after heating.Objective: We sought to evaluate whether cooked Bet v 1-related food allergens induce IgE- and T cell-mediated reactions in vitro and in vivo.Methods: Recombinant Bet v 1, Mal d 1 (apple), Api g I (celery), and Dan c 1 (carrot) were incubated at increasing temperatures. Protein structures were determined by means of circular dichroism. Mediator release was tested in basophil activation assays. PBMCs and Bet v I-specific T-cell lines with known epitope specificity were stimulated with native and cooked food allergens. Patients with birch pollen allergy who experienced OAS and the exacerbation of atopic dermatitis (AD) on ingestion of fresh apple, celery, or carrot were retested in double-blind, placebo-controlled food challenges with the respective foods in cooked form.Results: In vitro, cooked food allergens lost the capacity to bind IgE and to induce mediator release but had the same potency to activate Bet v I-specific T cells as native proteins. In vivo, ingestion of cooked birch pollen-related foods did not induce OAS but caused atopic eczema to worsen.Conclusion: T-cell cross-reactivity between Bet v I and related food allergens occurs independently of IgE cross-reactivity in vitro and in vivo. In patients with AD, the resulting immune reaction can even manifest as late eczematous skin reactions. Therefore the view that cooked pollen-related foods can be consumed without allergologic consequences should be reconsidered. Clinical implications: Symptom-free consumed pollen-related food allergens might cause T cell-mediated late-phase skin reactions in patients with pollen allergy and AD.