title: Minor interference of cross-reactive carbohydrates with the diagnosis of respiratory allergy in standard clinical conditions.
abstract: BACKGROUND
  Immunoglobulin E (IgE) to N-glycans from plant and invertebrate glycoproteins induces extensive in vitro cross-reactivity. This study investigates the prevalence and diagnostic relevance of IgE to these N-glycans [cross-reactive carbohydrate determinants (CCDs)] in patients with suspicion of respiratory allergy.
  
  
  METHODS
  A total of 1,025 adult subjects with symptoms of rhinitis and/or asthma from a reference allergy clinic were studied. Determinations included a structured questionnaire, skin prick tests (SPT), total IgE, a multiallergen IgE test and specific IgE (sIgE) to bromelain, MUXF (the bromelain-type N-glycan) and honeybee phospholipase-A2. Inhibition studies with CCDs were performed in selected cases.
  
  
  RESULTS
  The prevalence of CCD sensitization (MUXF sIgE and/or bromelain-sIgE ≥0.1 kU(A)/l) was 18.0%. Male sex and atopy (SPT positivity) were associated with CCD sensitization. Sensitization was more frequent in patients sensitized to pollens than in those sensitized to mites, the most common inhalant allergens in the area. A history of Hymenoptera stings was associated with CCD sensitization and multiallergen IgE test positivity. CCD sensitization was not significantly associated with age, rural residence, alcohol consumption or smoking. Only 58 patients (5.6%) showed CCD-sIgE levels ≥0.35 kU(A)/l. CCD-induced inhibition of pollen-sIgE or mite-sIgE in patients with respective positive SPT was minimal or absent in most cases.
  
  
  CONCLUSIONS
  In this population of predominantly mite-allergic patients, CCD sensitization is relatively rare and CCD-sIgE levels are low. Thus, CCDs do not represent a major obstacle for the diagnosis of respiratory allergy in a specialized setting. Hymenoptera stings are associated with CCD sensitization.
authors: Department of Allergy, Complejo Hospitalario Universitario, Santiago de Compostela, Spain.
authors: Carmen
authors: C
authors: Vidal
authors: Carolina
authors: C
authors: Sanmartín
authors: Margarita
authors: M
authors: Armisén
authors: Virginia
authors: V
authors: Rodríguez
authors: Allan
authors: A
authors: Linneberg
authors: Arturo
authors: A
authors: Gonzalez-Quintela
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000818:Animals; D001733:Bites and Stings / Q000209:etiology / Q000276:immunology; D002241:Carbohydrates / Q000276:immunology*; D003429:Cross Reactions / Q000276:immunology; D000939:Epitopes / Q000276:immunology; D005260:Female; D006801:Humans; D006927:Hymenoptera / Q000276:immunology; D007073:Immunoglobulin E / Q000097:blood / Q000276:immunology*; D008297:Male; D008875:Middle Aged; D012130:Respiratory Hypersensitivity / Q000175:diagnosis* / Q000453:epidemiology / Q000276:immunology*; D012307:Risk Factors; D055815:Young Adult
chemical_list: D002241:Carbohydrates; D000939:Epitopes; D007073:Immunoglobulin E