title: Recombinant Mal d 1 facilitates sublingual challenge tests of birch pollen-allergic patients with apple allergy.
abstract: It is still unclear whether allergen-specific immunotherapy (AIT) with birch pollen improves birch pollen-related food allergy. One reason for this may be the lack of standardized tests to assess clinical reactions to birch pollen-related foods, for example apple. We tested the applicability of recombinant (r) Mal d 1, the Bet v 1-homolog in apple, for oral challenge tests. Increasing concentrations of rMal d 1 in 0.9% NaCl were sublingually administered to 72 birch pollen-allergic patients with apple allergy. The dose of 1.6 μg induced oral allergy syndromes in 26.4%, 3.2 μg in 15.3%, 6.3 μg in 27.8%, 12.5 μg in 8.3%, 25 μg in 11.1%, and 50 μg in 4.2% of the patients. No severe reactions occurred. None of the patients reacted to 0.9% NaCl alone. Sublingual administration of 50 μg of rMal d 1 induced no reactions in three nonallergic individuals. Our approach allows straight forward, dose-defined sublingual challenge tests in a high number of birch pollen-allergic patients that inter alia can be applied to evaluate the therapeutic efficacy of birch pollen AIT on birch pollen-related food allergy.
authors.affiliation: Division of Immunology, Allergy and Infectious Diseases (DIAID), Department of Dermatology, Medical University of Vienna, Vienna, Austria.
authors.forename: T
authors.initials: T
authors.lastname: Kinaciyan
authors.affiliation: Department of Pathophysiology and Allergy Research, Medical University of Vienna, Vienna, Austria.
authors.forename: B
authors.initials: B
authors.lastname: Nagl
authors.affiliation: Department of Pathophysiology and Allergy Research, Medical University of Vienna, Vienna, Austria.|Christian Doppler Laboratory for Immunomodulation, Medical University of Vienna, Vienna, Austria.
authors.forename: S
authors.initials: S
authors.lastname: Faustmann
authors.affiliation: Biomay AG, Vienna, Austria.
authors.forename: S
authors.initials: S
authors.lastname: Kopp
authors.affiliation: Department of Production, Hospital Pharmacy, Salzburg, Austria.
authors.forename: M
authors.initials: M
authors.lastname: Wolkersdorfer
authors.affiliation: Department of Pathophysiology and Allergy Research, Medical University of Vienna, Vienna, Austria.|Christian Doppler Laboratory for Immunomodulation, Medical University of Vienna, Vienna, Austria.
authors.forename: B
authors.initials: B
authors.lastname: Bohle
mesh_terms: D000286:Administration, Sublingual; D000328:Adult; D000485:Allergens / Q000008:administration & dosage / Q000276:immunology*; D052179:Antigens, Plant / Q000276:immunology*; D029662:Betula / Q000009:adverse effects*; D005260:Female; D005512:Food Hypersensitivity / Q000150:complications / Q000175:diagnosis* / Q000276:immunology*; D006801:Humans; D008297:Male; D027845:Malus / Q000009:adverse effects*; D008875:Middle Aged; D010940:Plant Proteins / Q000276:immunology*; D011058:Pollen / Q000276:immunology*; D006255:Rhinitis, Allergic, Seasonal / Q000150:complications / Q000276:immunology*; D055815:Young Adult
chemical_list: D000485:Allergens; D052179:Antigens, Plant; C095551:MALD1 protein, Malus domestica; D010940:Plant Proteins
keywords: Bet v 1; Mal d 1; birch pollen-related food allergy; recombinant allergens