title: Latex-vegetable syndrome due to custard apple and aubergine: new variations of the hevein symphony.
abstract: An increasing number of vegetables with crossreactions to latex are being described in patients with latex-vegetable syndrome. We present two of these vegetables, custard apple linked in two previous cases with latex sensitisation, and aubergine, that had not been described up to now in patients with latex sensitisation. The diagnosis of both cases was based on the clinical history, positive skin prick test (SPT) and specific IgE to the offending vegetables, as well as to positive SPT and specific IgE levels to latex and the major fruits involved in the latex-fruit syndrome (avocado, banana, and chestnut). Further, crude extracts from latex, custard apple and aubergine, as well as the purified allergens Hev b 6.02 and Prs a 1 were used in in vitro and in vivo assays: IgE immunodetection, histamine release (HRT) and basophil activation (BAT) tests and skin prick tests. In case 1, both purified Hev b 6.02 and Prs a 1 induced positive responses in skin prick tests, high levels of basophil activation and histamine release. Specific IgE immunodetection uncovered a reactive band of 45 kd in the crude custard apple extract, which was also recognized by anti-chitinase monospecific antibodies. The serum from patient 1 also detected Prs a 1 in immunodetection. Hev b 6.02 produced positive skin responses and showed high biological activity in HRT and BAT in the case of patient 2. However, Prs a 1 was reactive neither in SPT nor in IgE immunodetection. In fact, no band was detected using the serum of patient 2 in avocado or aubergine extracts. By contrast, Prs a 1 reached high values of basophil activation and over 10% of histamine release in case 2.
authors.affiliation: Servicio de Alergía, Hospital de Basurto, Bilbao, Spain.
authors.forename: P M
authors.initials: PM
authors.lastname: Gamboa
authors.forename: R
authors.initials: R
authors.lastname: Sánchez-Monge
authors.forename: A
authors.initials: A
authors.lastname: Díaz-Perales
authors.forename: G
authors.initials: G
authors.lastname: Salcedo
authors.forename: J
authors.initials: J
authors.lastname: Ansótegui
authors.forename: M L
authors.initials: ML
authors.lastname: Sanz
mesh_terms: D000328:Adult; D000485:Allergens / Q000276:immunology; D052179:Antigens, Plant; D023181:Antimicrobial Cationic Peptides / Q000276:immunology; D001491:Basophils / Q000276:immunology*; D002688:Chitinases / Q000276:immunology; D003429:Cross Reactions / Q000276:immunology; D005260:Female; D005512:Food Hypersensitivity / Q000276:immunology*; D006636:Histamine Release / Q000187:drug effects / Q000276:immunology; D006801:Humans; D006969:Hypersensitivity, Immediate / Q000276:immunology; D007073:Immunoglobulin E / Q000097:blood / Q000276:immunology; D066298:In Vitro Techniques; D007840:Latex / Q000009:adverse effects / Q000276:immunology; D020315:Latex Hypersensitivity / Q000276:immunology*; D027845:Malus / Q000009:adverse effects* / Q000276:immunology; D037121:Plant Lectins / Q000276:immunology; D010940:Plant Proteins; D012882:Skin Tests; D032323:Solanum melongena / Q000009:adverse effects* / Q000276:immunology
chemical_list: D000485:Allergens; D052179:Antigens, Plant; D023181:Antimicrobial Cationic Peptides; D007840:Latex; D037121:Plant Lectins; D010940:Plant Proteins; C045875:hevein; D007073:Immunoglobulin E; D002688:Chitinases; C115191:Prs a 1 allergen