RUBRICA SPECIALISTULUI

Proteine reglate de gibereline – relevanţa clinică

 Clinical relevance of gibberellin-regulated protein

First published: 31 octombrie 2023

Editorial Group: MEDICHUB MEDIA

DOI: 10.26416/Aler.7.3.2023.8788

Abstract

Since 2013, a total of nine allergenic sources of gibberellin-regulated protein (GRP) have been described in the literature. The first gibberellin-regulated protein considered to be an allergen was extracted from peach (Prunus persica) and was named Pru p 7. This article aims to provide an overview of the GRP’s characteristics, to emphasize their importance and relevance in clinical practice, and to bring to attention the methods of diagnosis and treatment proposed in the literature published to date. After certain fruit consumption in patients sensitized to GRP, it has been described the occurrence of allergic reactions of various degrees (oral allergy syndrome, up to severe anaphylactic reactions). This fact raises a series of questions regarding the clinical expression of this sensitization, but also confers a change of perspective in relation to fruit allergy. At this moment, it is not clear if the sensitization to food GRP is always a primary sensitization or if the sensitization to food GRP appears subsequent to sensitization to Cupresaceae pollen’s GRP. Pru p 7 is considered to be a potential marker of severity in case of sensitization to peach allergens. Furthermore, the presence of cofactors in GRP sensitized patients may induce systemic allergic reactions. The diagnosis of this type of allergy might be difficult, and the personalized treatment is not yet available.
 

Keywords
gibberellin, diagnosis, food allergen, oral allergy syndrome, peach

Rezumat

Începând cu 2013, în literatura de specialitate au fost descrise în total nouă surse alergenice de proteine reglate de gibereline (GRP) Prima proteină reglată de gibereline considerată ca fiind un alergen a fost extrasă din piersică (Prunus persica) şi a fost denumită Pru p 7. Acest articol îşi propune să ofere o imagine de ansamblu asupra caracteristicilor GRP, să sublinieze importanţa şi relevanţa lor în practica clinică şi să aducă în prim-plan metodele de diagnostic şi tratament propuse în literatura publicată până la momentul actual. A fost descrisă apariţia reacţiilor alergice de diferite grade (sindrom de alergie orală, până la reacţii anafilactice severe) după consumul de fructe la pacienţi sensibilizaţi la GRP, acest fapt ridicând o serie de întrebări cu privire la expresia clinică a acestei sensibilizări în cazul acestor pacienţi, dar conferind în acelaşi timp şi o schimbare de perspectivă asupra alergiei la fructe. În acest moment nu se cunoaşte încă dacă sensibilizarea la GRP din alimente este întotdeauna sensibilizare primară sau dacă sensibilizarea la GRP din alimente este obligatoriu consecutivă sensibilizării la GRP din polenul de Cupresacee. Pru p 7 este considerat ca potenţial marker de severitate în cazul sensibilizării la alergenele din piersică. De asemenea, prezenţa unor cofactori poate induce reacţii alergice sistemice. Diagnosticul acestui tip de alergie poate pune medicul în dificultate, iar tratamentul personalizat nu este încă disponibil. 
 

Bibliografie

  1. European Academy of Allergy and Clinical Immunology. Molecular Allergology User’s Guide 2.0. 2022. (Cross-reactive Molecules; vol. C09). 
  2. Andersen MBS, Hall S, Dragsted LO. Identification of European Allergy Patterns to the Allergen Families PR-10, LTP, and Profilin from Rosaceae Fruits. Clinic Rev Allerg Immunol. 2011 Aug;41(1):4–19. 
  3. Zuidmeer L, Goldhahn K, Rona RJ, Gislason D, Madsen C, Summers C, et al. The prevalence of plant food allergies: A systematic review. Journal of Allergy and Clinical Immunology. 2008 May;121(5):1210-1218.e4. 
  4. Järvenpää J, Paassilta M, Salmivesi S, Sannisto T, Niitty S, Korppi M. Stability of parent‐reported food allergy in six and 7‐year‐old children: the first 5 years of the Finnish allergy programme. Acta Paediatrica. 2014 Dec;103(12):1297–300. 
  5. Spolidoro GCI, Amera YT, Ali MM, Nyassi S, Lisik D, Ioannidou A, et al. Frequency of food allergy in Europe: An updated systematic review and meta‐analysis. Allergy. 2023 Feb;78(2):351–68. 
  6. Inomata N. Gibberellin-regulated protein allergy: Clinical features and cross-reactivity. Allergology International. 2020 Jan;69(1):11–8. 
  7. Valenta R, Kraft D. Type I allergic reactions to plant-derived food: A consequence of primary sensitization to pollen allergens. Journal of Allergy and Clinical Immunology. 1996 Apr;97(4):893–5. 
  8. Poncet P, Sénéchal H, Charpin D. Update on pollen-food allergy syndrome. Expert Review of Clinical Immunology. 2020 Jun 2;16(6):561–78. 
  9. Iizuka T, Barre A, Rougé P, Charpin D, Scala E, Baudin B, et al. Gibberellin-regulated proteins: Emergent allergens. Front Allergy. 2022 Sep 9;3:877553. 
  10. Sénéchal H, Šantrůček J, Melčová M, et al. A new allergen family involved in pollen food-associated syndrome: Snakin/gibberellin-regulated proteins. J Allergy Clin Immunol. 2018;141(1):411-414.e4. 
  11. Klingebiel C, Chantran Y, Arif‐Lusson R, Ehrenberg AE, Östling J, Poisson A, et al. Pru p 7 sensitization is a predominant cause of severe, cypress pollen‐associated peach allergy. Clin Experimental Allergy. 2019 Apr;49(4):526–36. 
  12. Tuppo L, Alessandri C, Giangrieco I, Ciancamerla M, Rafaiani C, Tamburrini M, et al. Isolation of cypress gibberellin-regulated protein: Analysis of its structural features and IgE binding competition with homologous allergens. Molecular Immunology. 2019 Oct;114:189–95. 
  13. Su T, Han M, Cao D, Xu M. Molecular and Biological Properties of Snakins: The Foremost Cysteine-Rich Plant Host Defense Peptides. JoF. 2020 Oct 12;6(4):220. 
  14. Oliveira-Lima M, Benko-Iseppon A, Neto J, Rodriguez-Decuadro S, Kido E, Crovella S, et al. Snakin: Structure, Roles and Applications of a Plant Antimicrobial Peptide. CPPS. 2017 Feb 6;18(4):368–74. 
  15. Tanaka N, Konishi H, Khan MMK, Komatsu S. Proteome analysis of rice tissues by two-dimensional electrophoresis: an approach to the investigation of gibberellin regulated proteins. Mol Genet Genomics. 2004 Jan;270(6):485–96. 
  16. Tuppo L, Alessandri C, Pasquariello MS, Petriccione M, Giangrieco I, Tamburrini M, et al. Pomegranate Cultivars: Identification of the New IgE-Binding Protein Pommaclein and Analysis of Antioxidant Variability. J Agric Food Chem. 2017 Apr 5;65(13):2702–10. 
  17. Okazaki F, Momma K, Hirakawa Y, Kawai N, Yamaguchi-Murakami Y, Adachi R, et al. Determination of Severe Peach Allergens, Gibberellin-Regulated Protein, and Lipid Transfer Protein, Using Monoclonal Antibodies. J Nutr Sci Vitaminol. 2022 Jun 30;68(3):221–7. 
  18. Inomata N, Okazaki F, Moriyama T, Nomura Y, Yamaguchi Y, Honjoh T, et al. Identification of peamaclein as a marker allergen related to systemic reactions in peach allergy. Annals of Allergy, Asthma & Immunology. 2014 Feb;112(2):175-177.e3. 
  19. Inomata N, Miyakawa M, Aihara M. High prevalence of sensitization to gibberellin‐regulated protein (peamaclein) in fruit allergies with negative immunoglobulin E reactivity to Bet v 1 homologs and profilin: Clinical pattern, causative fruits and cofactor effect of gibberellin‐regulated protein allergy. The Journal of Dermatology. 2017 Jul;44(7):735–41. 
  20. Tuppo L, Alessandri C, Pomponi D, Picone D, Tamburrini M, Ferrara R, et al. Peamaclein - A new peach allergenic protein: similarities, differences and misleading features compared to Pru p 3. Clin Exp Allergy. 2013 Jan;43(1):128–40. 
  21. Inomata N, Miyakawa M, Aihara M. Gibberellin‐regulated protein in Japanese apricot is an allergen cross‐reactive to Pru p 7. Immunity Inflam Disease. 2017 Dec;5(4):469–79. 
  22. Asero R, Abbadessa S, Aruanno A, Barilaro G, Barzaghi C, Bignardi D, et al. Sensitization to Gibberellin-Regulated Protein (Peamaclein) Among Italian Cypress Pollen–Sensitized Patients. J Investig Allergol Clin Immunol. 2022 Feb 21;32(1):40–7. 
  23. Inuo C, Okazaki F, Shiraki R, Tanaka Y, Momma K, Kondo Y, et al. Generalized allergic reaction in response to exercise due to strawberry gibberellin-regulated protein: a case report. Allergy Asthma Clin Immunol. 2022 Dec;18(1):49. 
  24. Iizuka T, Takei M, Saito Y, Rumi F, Zheng J, Lu X, et al. Gibberellin‐regulated protein sensitization in Japanese cedar (Cryptomeria japonica) pollen allergic Japanese cohorts. Allergy. 2021 Jul;76(7):2297–302. 
  25. Ehrenberg AE, Klingebiel C, Östling J, Larsson H, Mattsson L, Vitte J, et al. Characterization of a 7 kDa pollen allergen belonging to the gibberellin‐regulated protein family from three Cupressaceae species. Clin Experimental Allergy. 2020 Aug;50(8):964–72. 
  26. Takei M, Nin C, Iizuka T, Pawlikowski M, Selva MA, Chantran Y, et al. Capsicum Allergy: Involvement of Cap a 7, a New Clinically Relevant Gibberellin-Regulated Protein Cross-Reactive With Cry j 7, the Gibberellin-Regulated Protein From Japanese Cedar Pollen. Allergy Asthma Immunol Res. 2022;14(3):328. 
  27. Poncet P, Aizawa T, Sénéchal H. The subtype of Cupressaceae pollinosis associated with Pru p 7 sensitization is characterized by a sensitization to a cross‐reactive gibberellin‐regulated protein in cypress pollen: BP 14. Clin Experimental Allergy. 2019 Aug;49(8):1163–6. 
  28. Hugues B, Didierlaurent A, Charpin D. Cross-reactivity between cypress pollen and peach: a report of seven cases. Allergy. 2006 Oct;61(10):1241–3. 
  29. Martinez S, Gouitaa M, Tummino C, Palot A, Charpin D, Chanez P. Le syndrome orange-cyprès. Revue Française d’Allergologie. 2014 Apr;54(3):231. 
  30. Sénéchal H, Keykhosravi S, Couderc R, Selva MA, Shahali Y, Aizawa T, et al. Pollen/Fruit Syndrome: Clinical Relevance of the Cypress Pollen Allergenic Gibberellin-Regulated Protein. Allergy Asthma Immunol Res. 2019;11(1):143. 

Articole din ediţiile anterioare

LUCRĂRI ORIGINALE | Ediţia 4 4 / 2020

Diagnosticul molecular al alergiilor în practica clinică

Laura Haidar, Maria Roxana Buzan, Camelia Felicia Bănărescu, Anca-Daniela Cotuna-Coste, Raluca Maria Giurgiu, Carmen Panaitescu

Prevalenţa bolilor alergice este în creştere, atât în ţările dezvoltate, cât şi în cele în curs de dezvoltare (Pawankar et al., 2013).

22 decembrie 2020
REFERATE GENERALE | Ediţia 4 6 / 2022

Alergia la ou. Diagnostic în alergia de tip imediat şi tardiv

Alice-Florentina Şerban, Ancuţa-Mădălina Nedelcu, Maria-Lucia Apostol, Camelia Elena Berghea

Conform definiţiei EAACI, alergia la alimente este o reacţie adversă cu mecanisme imunologice mediate de anticorpi specifici de tip imunoglobulină ...

19 decembrie 2022
REFERATE GENERALE | Ediţia 1 8 / 2024

Diagnosticul molecular în alergia la grâu

Alice-Florentina Şerban, Ancuţa-Mădălina Nedelcu, Denisa-Mihaela Nedelcu, Camelia Elena Berghea

Alergia la grâu este o patologie frecventă în rândul pacienţilor pediatrici, dar poate fi întâlnită şi la adulţi, având potenţialul de a genera div...

28 martie 2024
REFERATE GENERALE | Ediţia 2 4 / 2020

Ţintind un diagnostic mai precis în hipersensibilitatea la betalactamine

Antonino Romano, Marina Atanaskovic-Markovic, Annick Barbaud, Andreas J. Bircher, Knut Brockow, Jean-Christoph Caubet, Gulfem Celik, Josefina Cernadas, Anca-Mirela Chiriac, Pascal Demoly, Lene H. Garvey, Cristobalina Mayorga, Alla Nakonechna, Paul Whitaker, María José Torres

Un studiu recent al Grupului de interes pentru alergia medicamentoasă (DAIG) al Academiei Europene de Alergologie şi Imunologie Clinică (EAACI), de...

10 iunie 2020