Abstract
Background: Oral allergy syndrome (OAS) or pollen-fruit syndrome is a type of food allergy. Its characteristics and associated allergens vary according to the studied population. There are few studies in Mexico about this topic, none in children.
Objective: To describe clinical and epidemiological characteristics of OAS among children in Mexico.
Methods: A descriptive, observational, transversal and prospective study was conducted. We included every patient from 6 to 18 years old with diagnostic suspicion of OAS, in which complete clinical history, skin test to food and pollens, and oral food challenge were performed.
Results: We found a prevalence of 5.3% (29 patients): 55% were males. Average age was 10 ± 3 years, and average number of food implicated were 6.8 ± 4.1. Apple, peach and banana, were the most frequent food associated, and sensitization to oak and European privet, the more prevalent pollens found in OAS.
Conclusion: OAS is a common type of food allergy, transient and mild in nature. In more than 90% of the cases is associated with allergic rhinitis and sensitization to pollens. In our population, profilins may be involved in its pathogenesis. However, more studies are required to prove this.
References
Tuft L, Blumstein G. Studies in food allergy. J Allergy. 1942;13(6):574-578. DOI: http://dx.doi.org/10.1016/S0021-8707(42)90070-4
Amlot PL, Kemeny DM, Zachary C, Parkes P, Lessof MH. Oral allergy syndrome (OAS): Symptoms of IgE-mediated hypersensitivity to foods. Clin Allergy. 1987;17(1):33-42. DOI: http://dx.doi.org/10.1111/j.1365-2222.1987.tb02317.x
Anderson LB Jr, Dreyfuss EM, Logan J, Johnstone DE, Glaser J. Melon and banana sensitivity coincident with ragweed pollinosis. J Allergy. 1970;45:310-319. DOI: http://dx.doi.org/10.1016/0021-8707(70)90037-7
Kazemi-Shirazi L, Pauli G, Purohit A, Spitzauer S, Fröschl R, Hoffmann-Sommergruber K, et al. Quantitative IgE inhibition experiments with purified recombinant allergens indicate pollen-derived allergens as the sensitizing agents responsible for many forms of plantfood allergy. J Allergy Clin Immunol. 2000;105(1 Pt 1):116-25.
Rodríguez-Mireles KA, Gaspar-López A, López-Rocha EG, Del Rivero-Hernández LG, Segura-Méndez NH, et al. Síndrome de alergia oral en adultos de un hospital de tercer nivel. Rev Alerg Mex. 2014;61:65-72. Disponible en: http://revistaalergia.mx/ojs/index.php/ram/article/view/28
Webber CM, England RW. Oral allergy syndrome: A clinical, diagnostic, and therapeutic challenge. Ann Allergy Asthma Immunol. 2010;104(2):101-108. DOI: http://dx.doi.org/10.1016/j.anai.2009.11.007
Ma S, Sicherer SH, Nowak-Wegrzyn A. A survey on the management of pollen-food allergy syndrome in allergy practices. J Allergy Clin Immunol. 2003;112(4):784-788. DOI: http://dx.doi.org/10.1016/S0091-6749(03)02008-6
Breiteneder H, Ebner C. Molecular and biochemical classification of plant derived food allergens. J Allergy Clin Immunol. 2000;106(1 Pt 1):27-36. DOI: http://dx.doi.org/10.1067/mai.2000.106929
Midoro-Horiuti T, Brooks EG, Goldblum RM. Pathogenesis-related proteins of plants as allergens. Ann Allergy Asthma Immunol. 2001;87(4):261-271. DOI: http://dx.doi.org/10.1016/S1081-1206(10)62238-7
Breiteneder H, Clare Mills EN. Plant food allergens-structural and functional aspects of allergenicity. Biotechnol Adv. 2005;23(6):395-399. DOI: https://doi.org/10.1016/j.biotechadv.2005.05.004
Ebo DG, Hagendorens MM, Bridts CH, De Clerck LS, Stevens WJ. Sensitization to cross-reactive carbohydrate determinants and the ubiquitous protein profilin: Mimickers of allergy. Clin Exp Allergy. 2004;34(1):137-144. DOI: http://dx.doi.org/10.1111/j.1365-2222.2004.01837.x
Lucas JS, Cochrane SA, Warner JO, Hourihane JO. The effect of digestion and pH on the allergenicity of kiwifruit proteins. Pediatr Allergy Immunol. 2008;19(5):392-398. DOI: http://dx.doi.org/10.1111/j.1399-3038.2007.00678.x
Saunders S, Platt MP. Oral allergy syndrome. Curr Opin Otolaryngol Head Neck Surg. 2015;23(3):230-234. DOI: http://dx.doi.org/10.1097/MOO.0000000000000160
Ortolani C, Pastorello EA, Farioli L, Ispano M, Pravettoni V, Berti C, et al. IgE-mediated allergy from vegetable allergens. Ann Allergy. 1993;71(5):470-476.
Anhoej C, Backer V, Nolte H. Diagnostic evaluation of grass and birch-allergic patients with oral allergy syndrome. Allergy. 2001;56(6):548-552. DOI: http://dx.doi.org/10.1034/j.1398-9995.2001.056006548.
Ortolani C, Ispano M, Pastorello EA, Ansaloni R, Magri GC. Comparison of results of skin prick tests (with fresh foods and commercial food extracts) and RAST in 100 patients with oral allergy syndrome. J Allergy Clin Immunol. 1989;83:683-690. Disponible en: http://www.jacionline.org/article/0091-6749(89)90083-3/pdf
Osterballe M, Scheller R, Stahl Skov P Andersen KE, Bindslev-Jensen C. Diagnostic value of scratch-chamber test, skin prick test, histamine release and specific IgE in birch-allergic patients with oral allergy syndrome to apple. Allergy. 2003;58(9):950-953. DOI: http://dx.doi.org/10.1034/j.1398-9995.2003.00272.x
Rodriguez J, Crespo JF, Burks W, Rivas-Plata C, Férnandez-Anaya S, Vives R, et al. Randomized, double-blind, crossover challenge study in 53 subjects reporting adverse reactions to melon (Cucumis melo). J Allergy Clin Immunol. 2000;106(5):968-972. DOI: http://dx.doi.org/10.1067/mai.2000.110467
American College of Allergy, Asthma, & Immunology. Food allergy: a practice parameter. Ann Allergy Asthma Immunol. 2006; 96(3 Suppl 2):S1-S68.
Kelso JM, Jones RT, Tellez R, Yunginger JW. Oral allergy syndrome successfully treated with pollen immunotherapy. Ann Allergy Asthma Immunol. 1995;74(5):391-396.
Herrmann D, Henzgen M, Frank E Rudeschko O, Jäger L. Effect of hyposensitization for tree pollinosis on associated apple allergy. J Investig Allergol Clin Immunol. 1995;5(5):259-267.
Asero R. Effects of birch pollen-specific immunotherapy on apple allergy in birch pollen-hypersensitive patients. Clin Exp Allergy. 1998;28(11):1368-1373. DOI: http://dx.doi.org/10.1046/j.1365-2222.1998.00399.x
Bolhaar ST, Tiemessen MM, Zuidmeer L, van Leeuwen A, Hoffmann-Sommergruber K, Bruijnzeel-Koomen CA, et al. Efficacy of birch-pollen immunotherapy on cross-reactive food allergy confirmed by skin tests and double-blind food challenges. Clin Exp Allergy. 2004;34(5):761-769. DOI: http://dx.doi.org/10.1111/j.1365-2222.2004.1939.x
Asero R. How long does the effect of birch pollen injection SIT on apple allergy last? Allergy. 2003;58(5):435-438. DOI: http://dx.doi.org/10.1034/j.1398-9995.2003.00139.x
Eriksson NE, Formgren H, Svenonius E. Food hypersensitivity in patients with pollen allergy. Allergy. 1982;37(6):437-443. DOI: http://dx.doi.org/10.1111/j.1398-9995.1982.tb02323.x
Medina-Hernández A, Huerta-Hernández RE, Góngora-Meléndez MA. Perfil clínico-epidemiológico de pacientes con sospecha de alergia alimentaria en México. Estudio Mexipreval. Rev Alerg Mex. 2015;62(1):28-40. Disponible en: http://revistaalergia.mx/ojs/index.php/ram/article/view/57
Bedolla-Barajas M, Morales-Romero J, Ortiz-Miramontes L, Jáuregui-Franco RO. Frecuencia y características clínicas del síndrome de alergia oral en adultos mexicanos con polinosis nasal. Estudio de casos y controles. Rev Alergia Mex. 2013;60(1):17-25.
Skypala IJ, Calderon MA, Leeds AR, Emery P, Till SJ, Durham SR.. Development and validation of a structured questionnaire for the diagnosis of oral allergy syndrome in subjects with seasonal allergic rhinitis during the UK birch pollen season. Clin Exp Allergy. 2011;41(7):1001-1011. DOI: http://dx.doi.org/10.1111/j.1365-2222.2011.03759.
Konstantinou GN, Grattan CE. Food contact hypersensitivity syndrome: the mucosal contact urticaria paradigm. Clin Exp Dermatol. 2008;33(4):383-389. DOI: http://dx.doi.org/10.1111/j.1365-2230.2008.02893.x
Schmidt-Andersen MB, Hall S, Dragsted LO. Identification of European allergy patterns to the allergen families PR-10, LTP, and profilin from Rosaceae fruits. Clinic Rev Allerg Immunol. 2011;41(1):4-19. DOI: http://dx.doi.org/10.1007/s12016-009-8177-3
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