Clinical Features of Wheat Allergy Are Significantly Different between Tri a 14 Sensitized Patients and Tri a 19 Sensitized Ones

2021 ◽  
pp. 1-9
Author(s):  
Elide Anna Pastorello ◽  
Alessandro Toscano ◽  
Giuseppe Scibilia ◽  
Chrysi Stafylaraki ◽  
Carlo Maria Rossi ◽  
...  
Keyword(s):  
Physical Exercise ◽  
Clinical Features ◽  
Food Challenge ◽  
Cross Reactivity ◽  
Clinical Aspects ◽  
Wheat Allergy ◽  
Inverse Relation ◽  
Food Avoidance ◽  
High Consumption ◽  
Clinical Pictures

<b><i>Introduction:</i></b> Wheat is the most important cereal for human nutrition but its high consumption is associated to an increasing complaint of wheat-related disorders, many of which are allergic in nature and different in respect to the involved allergens. In this study, we compared the clinical aspects of wheat allergy presented by patients sensitized to Tri a 19 in respect to those presented by patients sensitized to Tri a 14. <b><i>Methods:</i></b> With this aim, we selected patients sensitized to 1 or both of the 2 allergens, and among these we identified those who were really wheat allergic and reactive on the basis of a standardized methodology. We evaluated the clinical features such as the kind and severity of symptoms, the coexistence of triggering factors such as physical exercise and NSAIDs and alcohol consumption, and the association with other allergens and with various immunologic parameters. Wheat allergy in Tri a 19 sensitized patients was confirmed through a questionnaire while the patients sensitized to Tri a 14 underwent wheat challenge with 100 g of pasta followed by exercise on a treadmill. <b><i>Results:</i></b> Seventy-nine patients sensitized to Tri a 14 and 40 patients sensitized to Tri a 19 were recruited. The 2 sensitizations were independent with a significant inverse relation (<i>p</i> &#x3c; 0.00001). The Tri a 19 sensitized patients presented, in respect to the Tri a 14 sensitized ones, an older age (<i>p</i> = 0.0017), a higher risk to be wheat allergic (<i>p</i> &#x3c; 0.0001), a higher severity of the reactions (<i>p</i> &#x3c; 0.00001) and a higher association with some cofactors, namely alcohol (<i>p</i> &#x3c; 0.0005) and physical exercise (<i>p</i> = 0.003). On the contrary, Tri a 14 sensitization was associated with atopy (<i>p</i> &#x3c; 0.0001), with a higher probability of patients being asymptomatic (<i>p</i> &#x3c; 0.0001) and being sensitized to other foods, in particular to nuts and cereals (<i>p</i> &#x3c; 0.00001). <b><i>Conclusions:</i></b> Sensitization to Tri a 19 or Tri a 14 determines different clinical pictures. In particular, sensitization to Tri a 19 implies a higher probability of severe reactions, even dependent on daily triggers, while that to Tri a 14 implies a higher cross-reactivity with other foods but it’s more frequently asymptomatic, making a food challenge necessary to prevent useless food avoidance.

scholarly journals The clinical cross-reactivity and immunological cross-antigenicity of wheat and barley

2021 ◽  
Author(s):  
Shohei Kubota ◽  
Yuji Aoki ◽  
Tomomi Sskai ◽  
Katsumasa Kitamura ◽  
Teruaki Matsui ◽  
...  
Keyword(s):  
Oral Immunotherapy ◽  
Cross Reactivity ◽  
The Other ◽  
Enzyme Linked Immunosorbent Assay ◽  
Wheat Allergy ◽  
Extract Concentration ◽  
Low Concentrations ◽  
High Concentrations ◽  
Food Challenges ◽  
Elisa Inhibition

Background: Some patients with a wheat allergy have been reported to show clinical cross-reactivity to barley. However, it is not clear whether the development of barley allergy in patients with a wheat allergy is due to cross-antigenicity between wheat and barley. In our study, we aimed to determine the clinical cross-reactivity and immunological cross-antigenicity of wheat and barley. Methods: We compared the results of barley oral food challenges (OFCs) before oral immunotherapy (OIT) for wheat with those after OIT in nine patients with a wheat allergy to estimate the clinical cross-reactivity of wheat and barley. Moreover, we performed enzyme-linked immunosorbent assay (ELISA) inhibition and immunoblotting inhibition using serum from seven patients allergic to wheat and barley. Results: Nine patients who had positive barley-OFC results performed before OIT for wheat were all negative on barley-OFC performed after OIT. In ELISA inhibition, preincubation of serum from patients allergic to wheat and barley with a high barley extract concentration inhibited binding of IgE to wheat extract by less than 10%. On the other hand, wheat and barley extracts equally inhibited binding to barley sIgE at high concentrations. In the immunoblotting inhibition test, the spots of wheat were inhibited but weakly by barley extracts, and most of the spots of barley were inhibited even by low concentrations of the wheat and barley extract. Conclusion: We showed that barley allergy associated with wheat allergy is caused by cross-reactivity from wheat. The OIT for wheat was one of the promising options for barley allergy.

scholarly journals Salivary Gland Pathology in IgG4-Related Disease: A Comprehensive Review

2018 ◽  
Vol 2018 ◽  
pp. 1-7 ◽  
Author(s):  
Ilaria Puxeddu ◽  
Riccardo Capecchi ◽  
Filippo Carta ◽  
Antonio Gaetano Tavoni ◽  
Paola Migliorini ◽  
...  
Keyword(s):  
Salivary Glands ◽  
Imaging Techniques ◽  
Elevated Serum ◽  
Clinical Aspects ◽  
Related Disease ◽  
Multiple Organs ◽  
Igg4 Related Disease ◽  
Serum Igg4 ◽  
Organ Specific ◽  
Clinical Pictures

IgG4-related disease (IgG4-RD) is a rare fibroinflammatory condition that can affect almost any organ, characterized by swollen lesions and often by eosinophilia and elevated serum IgG4 concentrations. The diagnosis of IgG4-RD is a challenging task: in fact, single or multiple organs can be affected and clinical, serological, and histological findings can be heterogeneous. In IgG4-RD, the involvement of salivary glands is observed in 27% to 53% of patients. Several organ-specific conditions, now recognized as different manifestations of IgG4-related sialadenitis (IgG4-RS), were viewed in the past as individual disease entities. The study of salivary glands may sometimes be complex, because of the number of pathological conditions that may affect them, often with overlapping clinical pictures. Integration of different imaging techniques is often required in the case of swelling of salivary glands, even though biopsy remains the gold standard for a definite diagnosis of IgG4-RS. Thus, in this review, we discuss new insights in the pathogenesis of IgG4-RD, focusing on its clinical aspects and the tools that are currently available for a correct differential diagnosis when the salivary glands are involved.

scholarly journals Multiple Sulfatase Deficiency: A Disease Comprising Mucopolysaccharidosis, Sphingolipidosis, and More Caused by a Defect in Posttranslational Modification

2020 ◽  
Vol 21 (10) ◽  
pp. 3448 ◽  
Author(s):  
Lars Schlotawa ◽  
Laura A. Adang ◽  
Karthikeyan Radhakrishnan ◽  
Rebecca C. Ahrens-Nicklas
Keyword(s):  
Catalytic Activity ◽  
Disease Severity ◽  
Clinical Features ◽  
Age Of Onset ◽  
Systemic Disease ◽  
Clinical Aspects ◽  
Lysosomal Storage ◽  
Multiple Sulfatase Deficiency ◽  
Detection Of Mutations ◽  
Cellular Pathology

Multiple sulfatase deficiency (MSD, MIM #272200) is an ultra-rare disease comprising pathophysiology and clinical features of mucopolysaccharidosis, sphingolipidosis and other sulfatase deficiencies. MSD is caused by impaired posttranslational activation of sulfatases through the formylglycine generating enzyme (FGE) encoded by the sulfatase modifying factor 1 (SUMF1) gene, which is mutated in MSD. FGE is a highly conserved, non-redundant ER protein that activates all cellular sulfatases by oxidizing a conserved cysteine in the active site of sulfatases that is necessary for full catalytic activity. SUMF1 mutations result in unstable, degradation-prone FGE that demonstrates reduced or absent catalytic activity, leading to decreased activity of all sulfatases. As the majority of sulfatases are localized to the lysosome, loss of sulfatase activity induces lysosomal storage of glycosaminoglycans and sulfatides and subsequent cellular pathology. MSD patients combine clinical features of all single sulfatase deficiencies in a systemic disease. Disease severity classifications distinguish cases based on age of onset and disease progression. A genotype- phenotype correlation has been proposed, biomarkers like excreted storage material and residual sulfatase activities do not correlate well with disease severity. The diagnosis of MSD is based on reduced sulfatase activities and detection of mutations in SUMF1. No therapy exists for MSD yet. This review summarizes the unique FGE/ sulfatase physiology, pathophysiology and clinical aspects in patients and their care and outlines future perspectives in MSD.

Clinical features of migraine aura: Results from a prospective diary-aided study

Cephalalgia ◽  
2016 ◽  
Vol 37 (10) ◽  
pp. 979-989 ◽  
Author(s):  
Michele Viana ◽  
Grazia Sances ◽  
Mattias Linde ◽  
Natascia Ghiotto ◽  
Elena Guaschino ◽  
...  
Keyword(s):  
Clinical Features ◽  
Migraine With Aura ◽  
Reliable Data ◽  
Visual Features ◽  
Clinical Aspects ◽  
Migraine Aura ◽  
Visual Symptom ◽  
Visual Symptoms ◽  
Detailed Evaluation ◽  
Temporal Succession

Background A detailed evaluation of migraine aura symptoms is crucial for classification issues and pathophysiological discussion. Few studies have focused on the detailed clinical aspects of migraine aura. Methods We conducted a prospective diary-based study of migraine aura features including presence, quality, laterality, duration of each aura symptom, their temporal succession; presence of headache and its temporal succession with aura. Results Seventy-two patients completed the study recording the characteristics of three consecutive auras ( n = 216 auras). Visual symptoms occurred in 212 (98%), sensory symptoms in 77 (36%) and dysphasic symptoms in 22 (10%). Most auras had more than one visual symptom (median 2, IQR 1–3, range 1–4). The majority of patients (56%) did not report a stereotyped aura on the three attacks with respect to visual features, the combination and/or temporal succession of the three aura symptoms. Fifty-seven percent of patients also reported a different scenario of temporal succession between aura and headache in the three attacks. Five per cent of aura symptoms were longer than four hours. Conclusion These findings show a high inter- and intravariability of migraine with aura attacks. Furthermore, they provide reliable data to enrich and clarify the spectrum of the aura phenotype.

Ranitidine-induced anaphylaxis: clinical features, cross-reactivity, and skin testing

2016 ◽  
Vol 46 (4) ◽  
pp. 631-639 ◽  
Author(s):  
K. H. Park ◽  
J. Pai ◽  
D.-G. Song ◽  
D. W. Sim ◽  
H. J. Park ◽  
...  
Keyword(s):  
Clinical Features ◽  
Skin Testing ◽  
Cross Reactivity

scholarly journals Clinical Features, Histopathology and Differential Diagnosis of Sarcoidosis

Cells ◽  
2021 ◽  
Vol 11 (1) ◽  
pp. 59
Author(s):  
Claudio Tana ◽  
Iginio Donatiello ◽  
Alessandro Caputo ◽  
Marco Tana ◽  
Teresa Naccarelli ◽  
...  
Keyword(s):  
Differential Diagnosis ◽  
Clinical Practice ◽  
Lymph Nodes ◽  
Clinical Features ◽  
Routine Clinical Practice ◽  
The Other ◽  
Unknown Etiology ◽  
Histopathological Findings ◽  
Clinical Pictures ◽  
Granulomatous Disorders

Sarcoidosis is a chameleon disease of unknown etiology, characterized by the growth of non-necrotizing and non-caseating granulomas and manifesting with clinical pictures that vary on the basis of the organs that are mainly affected. Lungs and intrathoracic lymph nodes are the sites that are most often involved, but virtually no organ is spared from this disease. Histopathology is distinctive but not pathognomonic, since the findings can be found also in other granulomatous disorders. The knowledge of these findings is important because it could be helpful to differentiate sarcoidosis from the other granulomatous-related diseases. This review aims at illustrating the main clinical and histopathological findings that could help clinicians in their routine clinical practice.

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