Background: A few cases of IgE-mediated chicory allergy with oral, cutaneous, and/or respiratory symptoms are reported. We present 4 patients with inhalant birch pollen allergy and oral allergy syndrome to chicory. IgE-binding proteins in chicory and cross-reactivity with birch pollen were studied. Methods: Chicory extract was prepared and immunoblotting was used to study IgE reactivity and cross-reactions with birch pollen. Results: The pattern of IgE binding to chicory was variable among the patients, with protein bands recognized at 18, 21, 40, 52 and 71 kD. Bet v 1-like proteins were detected in chicory by monoclonal antibody binding. Chicory-birch pollen cross-reactivity, as studied in 2 patients from whom enough serum was available, could be demonstrated but did not involve the Bet v 1 protein family. In one of these cases, a 51-kD protein of birch pollen was found to be responsible for cross-reactivity. Conclusions: Chicory should be added to the list of foods that can cross-react with birch pollen and cause the birch pollen-associated oral allergy syndrome.

Keywords:
Birch pollen, Chicory, Cross-reactivity, Food allergy, Oral allergy syndrome
1.
Nemery B, Demedts M: Occupational asthma in a chicory grower. Lancet 1989;8639:672–673.
2.
Cadot P, Kochuyt A-M, Deman R, Stevens EAM: Inhalative occupational and ingestive immediate-type allergy caused by chicory. Clin Exp Allergy 1996;26:940–944.
3.
Helbling A, Reimers A, Wälti M, Borgts R, Brander KA: Food allergy to Belgian endive (chicory). J Allergy Clin Immunol 1997;99:854–856.
4.
Escudero AI, Bartolomé B, Sánchez-Guerrero IM, Palacios R: Lettuce and chicory sensitization. Allergy 1999;54:183–184.
5.
Björkstén F, Halmepuro L, Hannuksela M, Lahti A: Extraction and properties of apple allergens. Allergy 1980;35:671–677.
6.
Cadot P, Lejoly M, Van Hoeyveld EM, Stevens EAM: Influence of the pH of the extraction medium on the composition of birch (Betula verrucosa) pollen extracts. Allergy 1995;50:431–437.
7.
Akkerdaas JH, van Ree R, Aalbers M, Stapel SO, Aalberse RC: Multiplicity of cross-reactive epitopes on Bet v I as detected with monoclonal antibodies and human IgE. Allergy 1995;50:215–220.
8.
Ortolani C, Ballmer-Weber BK, Hansen KS, Ispano M, Wuthrich B, Bindslev-Jensen C, Ansaloni R, Vanucci L, Pravettoni V, Scibilia J, Poulsen LK, Pastorello EA: Hazelnut allergy: A double-blind, placebo-controlled food challenge multicenter study. J Allergy Clin Immunol 2000;150:577–581.
9.
Wensing M, Akkerdaas JH, van Leeuwen WA, Stapel SO, Bruijnzeel-Koomen CAFM, Aalberse RC, Bast BJEG, Knulst AC, van Ree R: IgE to Bet v 1 and profilin: Cross-reactivity patterns and clinical relevance. J Allergy Clin Immunol 2002;110:435–442.
10.
van Ree R, Antonicelli L, Akkerdaas JH, Garritani MS, Aalberse RC, Bonifazi F: Possible induction of food allergy during mite immunotherapy. Allergy 1996;51:108–113.
11.
Peroni DG, Piacentini GL, Bodini A, Boner AL: Snail anaphylaxis during house dust mite immunotherapy. Pediatr Allergy Immunol 2000;11:260–261.
12.
Pajno GB, La Grutta S, Barberio G, Canonica GW, Passalacqua G: Harmful effect of immunotherapy in children with combined snail and mite allergy. J Allergy Clin Immunol 2002;109:627–629.
13.
Franck P, Kanny G, Dousset B, Nabet P, Moneret-Vautrin DA: Lettuce allergy. Allergy 2000;55:201–202.
14.
Vila L, Sánchez G, Sanz ML, Diéguez I, Martínez A, Palacios R, Martínez J: Study of a case of hypersensitivity to lettuce (Lactuca sativa). Clin Exp Allergy 1998;28:1031–1035.
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2003
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