REFERATE GENERALE

Sindromul polen-alimente (PFAS)

 Pollen-food allergy syndrome (PFAS)

First published: 31 octombrie 2023

Editorial Group: MEDICHUB MEDIA

DOI: 10.26416/Aler.7.3.2023.8793

Abstract

Pollen-food allergy syndrome (PFAS) is an immediate allergic reaction mediated by immunoglobulin E. This reaction occurs due to cross-reactivity between pollen and food in patients with previous pollen sensitization. PFAS causes symptoms such as itching, hives or oedema, mainly occurring in the lips, orally and pharyngeal, therefore being often referred to as oral allergy syndrome. However, systemic reactions such as anaphylaxis have been described more frequently recently. This diversity in the degree of symptoms is related to the types of trigger foods and the characteristics of the allergens (Jeon et al., 2020).
 

Keywords
oral allergy syndrome, cross-reactivity, immunoglobulin E, anaphylaxis, immunotherapy

Rezumat

Sindromul de alergie la polen-alimente (PFAS) reprezintă o reacţie alergică imediată mediată de imunoglobulina E (IgE). Această reacţie se produce ca urmare a reactivităţii încrucişate dintre polen şi alimente, la pacienţii cu sensibilizare anterioară la polen. PFAS determină apariţia unor simptome precum prurit, urticarie sau edem, apărute în principal la nivelul buzelor, la nivel oral şi faringian, de aceea este adesea denumit sindromul alergiei orale. Recent au fost descrise tot mai frecvent reacţii sistemice, respectiv anafilaxie. Această diversitate în ceea ce priveşte gradul simptomelor este legată de tipurile de alimente declanşatoare şi de caracteristicile alergenelor (Jeon et al., 2020).
 

Bibliografie

  1. Alvarado MI, Jimeno L, De La Torre F, et al. Profilin as a severe food allergen in allergic patients overexposed to grass pollen. Allergy. 2014 Dec;69(12):1610-6. doi: 10.1111/all.12509. .
  2. Asero R. Is there a role for birch pollen immunotherapy on concomitant food allergy? Curr Treat Options Allergy. 2015 Nov;2:83–89 https://doi.org/10.1007/s40521-015-0045-1..
  3. Bohle B. The impact of pollen-related food allergens on pollen allergy. Allergy. 2007 Jan;62(1):3-10. doi: 10.1111/j.1398-9995.2006.01258.x. . 
  4. Brown CE, Katelaris CH. The prevalence of the oral allergy syndrome and pollen-food syndrome in an atopic paediatric population in south-west Sydney. J Paediatr Child Health. 2014 Oct;50(10):795-800. doi: 10.1111/jpc.12658. .
  5. Carlson G, Coop C. Pollen food allergy syndrome (PFAS): A review of current available literature. Ann Allergy Asthma Immunol. 2019 Oct;123(4):359-365. doi: 10.1016/j.anai.2019.07.022. .
  6. Carlsson L, Nyström LE, Sundkvist I, et al. Actin polymerizability is influenced by profilin, a low molecular weight protein in non-muscle cells. J Mol Biol. 1977 Sep 25;115(3):465-83. doi: 10.1016/0022-2836(77)90166-8. .
  7. Chardin H, Mayer C, Sénéchal H, et al. Lipid transfer protein 1 is a possible allergen in Arabidopsis thaliana. Int Arch Allergy Immunol. 2003 Jun;131(2):85-90. doi: 10.1159/000070923. .
  8. Di Fraia M, Arasi S, Castelli S, et al. A new molecular multiplex IgE assay for the diagnosis of pollen allergy in Mediterranean countries: A validation study. Clin Exp Allergy. 2019 Mar;49(3):341-349. doi: 10.1111/cea.13264. .
  9. Fukutomi Y, Sjölander S, Nakazawa T, et al. Clinical relevance of IgE to recombinant Gly m 4 in the diagnosis of adult soybean allergy. J Allergy Clin Immunol. 2012 Mar;129(3):860-863.e3. doi: 10.1016/j.jaci.2012.01.031. .
  10. Geroldinger-Simic M, Kinaciyan T, Nagl B, et al. Oral exposure to Mal d 1 affects the immune response in patients with birch pollen allergy. J Allergy Clin Immunol. 2013 Jan;131(1):94-102. doi: 10.1016/j.jaci.2012.06.039. 1.
  11. Ibrahim AR, Kawamoto S, Nishimura M, et al. A new lipid transfer protein homolog identified as an IgE-binding antigen from Japanese cedar pollen. Biosci Biotechnol Biochem. 2010;74(3):504-9. doi: 10.1271/bbb.90685. .
  12. Jeon YH. Pollen-food allergy syndrome in children. Clin Exp Pediatr. 2020 Dec;63(12):463-468. doi: 10.3345/cep.2019.00780. .
  13. Kondo Y, Tokuda R, Urisu A, Matsuda T. Assessment of cross-reactivity between Japanese cedar (Cryptomeria japonica) pollen and tomato fruit extracts by RAST inhibition and immunoblot inhibition. Clin Exp Allergy. 2002 Apr;32(4):590-4. doi: 10.1046/j.0954-7894.2002.01337.x. . 
  14. Ma S, Sicherer SH, Nowak-Wegrzyn A. A survey on the management of pollen-food allergy syndrome in allergy practices. J Allergy Clin Immunol. 2003 Oct;112(4):784-8. doi: 10.1016/s0091-6749(03)02008-6. . 
  15. Mastrorilli C, Cardinale F, Giannetti A, et al. Pollen-Food Allergy Syndrome: A not so Rare Disease in Childhood. Medicina (Kaunas). 2019 Sep 26;55(10):641. doi: 10.3390/medicina55100641. . 
  16. Mittag D, Vieths S, Vogel L, et al. Soybean allergy in patients allergic to birch pollen: clinical investigation and molecular characterization of allergens. J Allergy Clin Immunol. 2004 Jan;113(1):148-54. doi: 10.1016/j.jaci.2003.09.030. 1.
  17. Mogensen JE, Wimmer R, Larsen JN, et al. The major birch allergen, Bet v 1, shows affinity for a broad spectrum of physiological ligands. J Biol Chem. 2002 Jun 28;277(26):23684-92. doi: 10.1074/jbc.M202065200. . 
  18. Muraro A, Werfel T, Hoffmann-Sommergruber K, et al. EAACI Food Allergy and Anaphylaxis Guidelines Group. EAACI food allergy and anaphylaxis guidelines: diagnosis and management of food allergy. Allergy. 2014 Aug;69(8):1008-25. doi: 10.1111/all.12429. . 
  19. Ortolani C, Ispano M, Pastorello E, et al. The oral allergy syndrome. Ann Allergy. 1988 Dec;61(6 Pt 2):47-52.  
  20. Osterballe M, Hansen TK, Mortz CG, et al. The clinical relevance of sensitization to pollen-related fruits and vegetables in unselected pollen-sensitized adults. Allergy. 2005 Feb;60(2):218-25. doi: 10.1111/j.1398-9995.2005.00674.x. .
  21. Poncet P, Sénéchal H, Charpin D. Update on pollen-food allergy syndrome. Expert Rev Clin Immunol. 2020 Jun;16(6):561-578. doi: 10.1080/1744666X.2020.1774366. .
  22. Scheurer S, Lauer I, Foetisch K, et al. Strong allergenicity of Pru av 3, the lipid transfer protein from cherry, is related to high stability against thermal processing and digestion. J Allergy Clin Immunol. 2004 Oct;114(4):900-7. doi: 10.1016/j.jaci.2004.06.017. 2.
  23. Skypala IJ, Bull S, Deegan K, et al. The prevalence of PFS and prevalence and characteristics of reported food allergy; a survey of UK adults aged 18-75 incorporating a validated PFS diagnostic questionnaire. Clin Exp Allergy. 2013 Aug;43(8):928-40. doi: 10.1111/cea.12104. . 
  24. Soares-Weiser K, Takwoingi Y, Panesar SS, et al. EAACI Food Allergy and Anaphylaxis Guidelines Group. The diagnosis of food allergy: a systematic review and meta-analysis. Allergy. 2014 Jan;69(1):76-86. doi: 10.1111/all.12333. .
  25. Valenta R, Duchene M, Ebner C, et al. Profilins constitute a novel family of functional plant pan-allergens. J Exp Med. 1992 Feb 1;175(2):377-85. doi: 10.1084/jem.175.2.377. .
  26. Waserman S, Bégin P, Watson W. IgE-mediated food allergy. Allergy Asthma Clin Immunol. 2018 Sep 12;14(Suppl 2):55. doi: 10.1186/s13223-018-0284-3. .
  27. Werfel T, Asero R, Ballmer-Weber BK, et al. Position paper of the EAACI: food allergy due to immunological cross-reactions with common inhalant allergens. Allergy. 2015 Sep;70(9):1079-90. doi: 10.1111/all.12666. .
  28. Yagami A, Ebisawa M. New findings, pathophysiology, and antigen analysis in pollen-food allergy syndrome. Curr Opin Allergy Clin Immunol. 2019 Jun;19(3):218-223. doi: 10.1097/ACI.0000000000000533. 

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