title: Birch pollen sensitization with cross-reactivity to food allergens predominates in adults with eosinophilic esophagitis.
abstract: EoE patients show variable sensitization patterns to food and aeroallergens. The value of allergy testing in adult EoE patients is unclear. Component-resolved diagnosis (CRD) may offer additional insights into sensitization patterns. The aim of this study was to characterize sensitization patterns in adult EoE patients using CRD. Serum from 76 patients (17 female), age 38.6 ± 1.5 years, was analyzed for reactivity to 112 different allergen components using an immuno-solid-phase allergen chip (ISAC). We observed any sensitization in 59 patients (78%), of which 54 patients were polysensitized. Aeroallergen sensitization, mostly against components of grass or tree pollen, or house dust mite, was observed in 74% of the patients. Birch pollen (rBet v 1) sensitization with cross-reactivity to food allergen components was observed in 30 patients (39%). In conclusion, food sensitizations in EoE patients are mainly caused by cross-reactivity to food allergens after primary birch pollen sensitization. Pollen and food sensitizations may cause or maintain esophageal inflammation in EoE patients. CRD provides more insight into sensitization patterns, identifies additional food allergen sensitizations and might be useful to direct dietary therapy in EoE.
authors.affiliation: Department of Gastroenterology & Hepatology, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands.
authors.forename: B D
authors.initials: BD
authors.lastname: van Rhijn
authors.forename: R
authors.initials: R
authors.lastname: van Ree
authors.forename: S A
authors.initials: SA
authors.lastname: Versteeg
authors.forename: B J
authors.initials: BJ
authors.lastname: Vlieg-Boerstra
authors.forename: A B
authors.initials: AB
authors.lastname: Sprikkelman
authors.forename: I
authors.initials: I
authors.lastname: Terreehorst
authors.forename: A J P M
authors.initials: AJ
authors.lastname: Smout
authors.forename: A J
authors.initials: AJ
authors.lastname: Bredenoord
mesh_terms: D000328:Adult; D000485:Allergens / Q000276:immunology; D000818:Animals; D029662:Betula / Q000276:immunology*; D003429:Cross Reactions / Q000276:immunology; D031744:Cynodon / Q000276:immunology; D057765:Eosinophilic Esophagitis / Q000175:diagnosis / Q000178:diet therapy / Q000276:immunology*; D005260:Female; D005512:Food Hypersensitivity / Q000175:diagnosis / Q000276:immunology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011058:Pollen / Q000276:immunology*; D039981:Pyroglyphidae / Q000276:immunology; D012130:Respiratory Hypersensitivity / Q000175:diagnosis / Q000276:immunology*; D055815:Young Adult
chemical_list: D000485:Allergens
keywords: PR-10; component-resolved diagnosis; cross-reactivity; dysphagia; food allergy