title: Allergen cross reactions: a problem greater than ever thought?
abstract: BACKGROUND
  Cross reactions are an often observed phenomenon in patients with allergy. Sensitization against some allergens may cause reactions against other seemingly unrelated allergens. Today, cross reactions are being investigated on a per-case basis, analyzing blood serum specific IgE (sIgE) levels and clinical features of patients suffering from cross reactions. In this study, we evaluated the level of sIgE compared to patients' total IgE assuming epitope specificity is a consequence of sequence similarity.
  
  
  METHODS
  Our objective was to evaluate our recently published model of molecular sequence similarities underlying cross reactivity using serum-derived data from IgE determinations of standard laboratory tests. We calculated the probabilities of protein cross reactivity based on conserved sequence motifs and compared these in silico predictions to a database consisting of 5362 sera with sIgE determinations.
  
  
  RESULTS
  Cumulating sIgE values of a patient resulted in a median of 25-30% total IgE. Comparing motif cross reactivity predictions to sIgE levels showed that on average three times fewer motifs than extracts were recognized in a given serum (correlation coefficient: 0.967). Extracts belonging to the same motif group co-reacted in a high percentage of sera (up to 80% for some motifs).
  
  
  CONCLUSIONS
  Cumulated sIgE levels are exaggerated because of a high level of observed cross reactions. Thus, not only bioinformatic prediction of allergenic motifs, but also serological routine testing of allergic patients implies that the immune system may recognize only a small number of allergenic structures.
authors.affiliation: University Institute of Immunology, Bern, Switzerland Phadia AB, Uppsala, Sweden. pascal.pfiffner@iib.unibe.ch
authors.forename: P
authors.initials: P
authors.lastname: Pfiffner
authors.forename: R
authors.initials: R
authors.lastname: Truffer
authors.forename: P
authors.initials: P
authors.lastname: Matsson
authors.forename: C
authors.initials: C
authors.lastname: Rasi
authors.forename: A
authors.initials: A
authors.lastname: Mari
authors.forename: B M
authors.initials: BM
authors.lastname: Stadler
mesh_terms: D000485:Allergens / Q000737:chemistry / Q000276:immunology*; D020816:Amino Acid Motifs; D000595:Amino Acid Sequence; D000918:Antibody Specificity / Q000276:immunology*; D019295:Computational Biology; D003429:Cross Reactions; D006801:Humans; D006967:Hypersensitivity / Q000276:immunology; D007073:Immunoglobulin E / Q000276:immunology*; D008969:Molecular Sequence Data
chemical_list: D000485:Allergens; D007073:Immunoglobulin E