Kiwifruit is a common cause of food allergy in Europe

Kiwifruit is apparently a common cause of food allergy in Europe. Symptoms range from mild to anaphylactic reactions. Specific IgE to 6 allergens (Act d 1, Act d 2, Act d 5, Act d 8, Act d 9, and Act d 10) and kiwifruit extract can be tested by using ImmunoCAP or skin testing.

Kiwi can cross-react with birch pollen, thus causing oral allergy syndrome:


Cross-reactivity in Pollen-Food Allergy Syndrome (PFAS) or Oral Allergy Syndrome (OAS) (click to enlarge the image).

Profilin is an actin-binding protein involved in the restructuring of the actin cytoskeleton. It is found in all eukaryotic organisms in most cells. Profilin may be a pan-allergen among plants that crossreacts between pollen, fruits, vegetables and latex.

Kiwifruit allergen sensitization patterns differed across Europe:

- patients from Iceland were mainly sensitized to Act d 1 (32%)
- those from western/central and eastern Europe were mainly sensitized to Act d 8 (pathogenesis-related class 10 protein, 58% and 44%, respectively)
- those from southern Europe were mainly sensitized to Act d 9 (profilin, 31%) and Act d 10 (nonspecific lipid transfer protein, 22%)

Using a panel of 6 kiwifruit allergens in ImmunoCAP increased the diagnostic sensitivity to 65% compared with 20% for skin prick tests and 46% ImmunoCAP using kiwi extract.

Kiwifruit allergen sensitization patterns differ across Europe. The use of specific kiwifruit allergens improved the diagnostic performance compared with kiwifruit extract. Sensitization to Act d 1 and living in Iceland are strong risk factors for severe kiwifruit allergy.

References:

Kiwifruit allergy across Europe: Clinical manifestation and IgE recognition patterns to kiwifruit allergens. The Journal of Allergy and Clinical Immunology, Volume 131, Issue 1 , Pages 164-171, January 2013
http://www.jacionline.org/article/S0091-6749(12)01503-5/abstract