title: Allergy to beer in LTP-sensitized patients: beers are not all the same.
abstract: BACKGROUND
  Most cases of beer allergy reported so far have been associated with hypersensitivity to the non-specific lipid transfer protein (LTP). In view of the marked differences in brewing processes we assessed IgE reactivity as well as tolerance to many different beers in an allergic patient.
  
  
  METHODS
  A 45 year-old man hypersensitive to grass pollen, cat dander and Alternaria tenuis with a history of urticaria and dyspnoea after drinking beer and a weak skin reactivity to commercial corn extract was studied. The patient underwent SPT with 36 different brands of beer and an open challenge with those scoring negative was performed. An immunoblot analysis was carried out using 2 SPT-positive beers, 2 SPT-negative beers, and barley, wheat, and maize extracts using both patient's serum and a maize LTP-specific in-house developed polyclonal antibody from rabbit. Further, the immune reactive LTP of one beer was separated by HPLC and the chromatogram was compared to that of purified maize LTP.
  
  
  RESULTS
  Beer SPT scored positive in 30/36 cases. The immunoblot analysis showed IgE reactivity at about 10 kDa against the two SPT-positive beers and against maize with both patient's serum and the polyclonal anti-LTP rabbit serum, whereas the two SPT-negative beers, and barley extract scored negative. The immunodetected protein co-migrated with maize LTP.
  
  
  CONCLUSIONS
  In beer-allergic patients the diagnostic workup may point to the detection of some tolerated products that can be consumed risk-free.
authors: Allergy Unit, Faenza Hospital, Italy.
authors: O
authors: O
authors: Quercia
authors: G
authors: G
authors: Zoccatelli
authors: G F
authors: GF
authors: Stefanini
authors: G
authors: G
authors: Mistrello
authors: S
authors: S
authors: Amato
authors: M
authors: M
authors: Bolla
authors: F
authors: F
authors: Emiliani
authors: R
authors: R
authors: Asero
mesh_terms: D000818:Animals; D001515:Beer / Q000009:adverse effects* / Q000145:classification; D002352:Carrier Proteins / Q000276:immunology*; D002415:Cats; D005260:Female; D005512:Food Hypersensitivity / Q000175:diagnosis* / Q000209:etiology / Q000276:immunology*; D006801:Humans; D015151:Immunoblotting; D007073:Immunoglobulin E / Q000097:blood; D008297:Male; D011817:Rabbits; D003313:Zea mays / Q000276:immunology
chemical_list: D002352:Carrier Proteins; C030363:lipid transfer protein; D007073:Immunoglobulin E