title: Evaluation of food-pollen cross-reactivity by nose-mouth cross-challenge in pollinosis with oral allergy syndrome.
abstract: BACKGROUND
  Oral allergy syndrome (OAS) is often associated with pollen-induced rhinitis, and there are preferential associations between causative substances. If OAS and rhinitis are both immunoglobulin (Ig)E-mediated and there are cross-reacting proteins, it is expected that similar reactions can be elicited in the nose and mouth. In order to test this hypothesis we performed a series of 'cross-challenges' with foods and pollens in both the nose and the mouth.
  
  
  METHODS
  Nine patients with ascertained OAS due to vegetables and rhinitis due to pollens were studied. On the first day a nasal challenge with pollen extracts and an oral challenge with fresh food was carried out. After a week, washout nasal challenge with food and an oral challenge with pollens were performed. Immediate symptoms, mucosal tryptase and soluble eosinophil cationic protein (ECP) were assessed after each challenge.
  
  
  RESULTS
  The administration of pollen into the nose and food into the mouth elicited symptoms as expected, but the cross-challenge had no clinical effect. In parallel, tryptase and ECP increased after nasal challenge with pollens, whereas foods did not elicit a measurable response.
  
  
  CONCLUSIONS
  The cross-reactivity between foods and pollens, when evaluated at the shock organ, was not clinically evident. This data can be explained with a low concentration of cross-reagent epitopes in pollen extracts and food homogenized because of degradation. The different behaviour upon challenge suggests that different immunological mechanisms may act in the nose and mouth.
authors.affiliation: Clinica Pediatrica, University of Perugia, Perugia, Italy.
authors.forename: F
authors.initials: F
authors.lastname: Marcucci
authors.forename: F
authors.initials: F
authors.lastname: Frati
authors.forename: L
authors.initials: L
authors.lastname: Sensi
authors.forename: G D
authors.initials: GD
authors.lastname: Cara
authors.forename: E
authors.initials: E
authors.lastname: Novembre
authors.forename: R
authors.initials: R
authors.lastname: Bernardini
authors.forename: G W
authors.initials: GW
authors.lastname: Canonica
authors.forename: G
authors.initials: G
authors.lastname: Passalacqua
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D003429:Cross Reactions; D047150:Eosinophil Cationic Protein / Q000097:blood; D005260:Female; D005512:Food Hypersensitivity / Q000209:etiology / Q000276:immunology*; D006801:Humans; D006967:Hypersensitivity / Q000097:blood / Q000150:complications* / Q000276:immunology; D008297:Male; D009055:Mouth / Q000276:immunology*; D009666:Nose / Q000276:immunology*; D011058:Pollen / Q000276:immunology*; D012220:Rhinitis / Q000209:etiology*; D012697:Serine Endopeptidases / Q000097:blood; D013577:Syndrome; D053802:Tryptases; D014675:Vegetables / Q000009:adverse effects
chemical_list: D047150:Eosinophil Cationic Protein; D012697:Serine Endopeptidases; D053802:Tryptases