Wine anaphylaxis in a German patient: IgE-mediated allergy against a lipid transfer protein of grapes.
BACKGROUND
IgE-mediated allergy to grapes has very rarely been reported in patients from the Mediterranean area. Recently, endochitinase 4 and a lipid transfer protein (LTP) have been identified as major allergens in grape-allergic patients who do not have an associated pollinosis. The purpose of this case study was to identify the allergens responsible for severe anaphylactic reactions after consumption of wine, fresh grapes and raisins in a German patient.


METHODS
Prick-to-prick tests and the basophil activation test (BAT) were performed to confirm allergy. Specific IgE was further analyzed by immunoblotting and inhibition tests for the determination of crossreactivity. The IgE-binding protein was subjected to N-terminal microsequencing.


RESULTS
Prick-to-prick tests were positive to fresh and cooked white and blue grapes, to raisins, to white and red wine, and to grape extract. Specific IgE against grapes (f259) was 2.43 kU/l (class 2). The BAT showed specific IgE-mediated activation of basophils after stimulation with grape extract. IgE binding to a 15-kDa protein was completely inhibited by pre-incubation with recombinant cherry LTP Pru av 3. N-terminal sequencing identified this 15-kDa protein as grape LTP Vit v 1.


CONCLUSIONS
Our data show that sensitization to LTP can occur outside the Mediterranean area causing severe fruit allergy without association to pollinosis.
Schad
Susanne G
SG
Department of Dermatology, University of Wurzburg, Wurzburg, Germany.
Trcka
Jiri
J
Vieths
Stefan
S
Scheurer
Stephan
S
Conti
Amedeo
A
Brocker
Eva-B
EB
Trautmann
Axel
A
D000328:Adult; D000485:Allergens; D000707:Anaphylaxis / Q000276:immunology*; D052179:Antigens, Plant; D002352:Carrier Proteins / Q000276:immunology*; D005260:Female; D005858:Germany; D006801:Humans; D007073:Immunoglobulin E / Q000276:immunology; D010940:Plant Proteins; D012882:Skin Tests; D027843:Vitis / Q000009:adverse effects* / Q000276:immunology; D014920:Wine / Q000009:adverse effects*
D000485:Allergens; D052179:Antigens, Plant; D002352:Carrier Proteins; D010940:Plant Proteins; C511920:lipid transfer proteins, plant; D007073:Immunoglobulin E