Possible induction of food allergy during mite immunotherapy.
Sera of 17 patients receiving immunotherapy for house-dust mite allergy were tested for IgE antibodies against snail and shrimp. Serum samples were taken at the start of immunotherapy and 14-20 months later. While the average IgE response to mite, Der p 1, and Der p 2 did not alter significantly, the average response to snail showed a significant increase. This included two conversions from negative to strongly positive. These novel IgE antibodies against snail were shown to be cross-reactive with mite. Three patients had a positive RAST for shrimp. For one of them, a strong increase of IgE against shrimp (and snail) was observed. In 2/3 snail/shrimp-positive sera, IgE antibodies against the cross-reactive allergen tropomyosin from mite, snail, and shrimp were demonstrated. A clear IgE response to snail (> 10% binding in a snail RAST) was confirmed by a positive skin prick test (SPT) for 6/10 patients. The two patients with antitropomyosin IgE also had a positive SPT for shrimp, and demonstrated the oral allergy syndrome (OAS) after eating shrimp. The observations in this study indicate that house-dust mite immunotherapy is accompanied by the induction of IgE against foods, including tropomyosin-reactive IgE. Food allergy (OAS) was observed in patients that had IgE antibodies against this cross-reactive allergen. In conclusion, induction of IgE during mite immunotherapy might occasionally cause allergy to foods of invertebrate animal origin.
van Ree
R
R
Central Laboratory, The Netherlands Red Cross Blood Transfusion Service, Amsterdam, The Netherlands.
Antonicelli
L
L
Akkerdaas
J H
JH
Garritani
M S
MS
Aalberse
R C
RC
Bonifazi
F
F
D000485:Allergens / Q000276:immunology; D000818:Animals; D003429:Cross Reactions; D033364:Decapoda / Q000276:immunology; D005512:Food Hypersensitivity / Q000209:etiology*; D006801:Humans; D015151:Immunoblotting; D007073:Immunoglobulin E / Q000097:blood; D007167:Immunotherapy / Q000009:adverse effects*; D008925:Mites / Q000276:immunology*; D011852:Radioallergosorbent Test; D012882:Skin Tests; D012908:Snails / Q000276:immunology; D014020:Tissue Extracts / Q000276:immunology; D014335:Tropomyosin / Q000032:analysis
D000485:Allergens; D014020:Tissue Extracts; D014335:Tropomyosin; D007073:Immunoglobulin E