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1/12. tobacco allergy: demonstration of cross-reactivity with other members of solanaceae family and mugwort pollen.

    BACKGROUND: tobacco is a plant belonging to the solanaceae family. This plant is usually used as a contact insecticide for several infestations in some areas, such as the Canary islands. Allergy induced by inhalation of this plant is unusual. Identification of the potential allergen in growing areas is essential. OBJECTIVE: We report a patient with occupational sensitivity to an aqueous solution of cut tobacco whose clinical manifestations were rhinoconjunctivitis and urticaria. Past medical history was significant for seasonal allergic rhinoconjunctivitis to mugwort pollen and oral allergy syndrome with avocado. methods: Green tobacco and cured tobacco leaf extracts were prepared, skin prick tests were performed with green tobacco, cured tobacco leaf extracts, and certain aeroallergens. Conjunctival challenge test was carried out with green tobacco and cured tobacco leaf extract. serum-specific IgE against tobacco leaf was performed by commercial CAP. CAP inhibition experiments were carried out with tobacco and artemisia vulgaris. RESULTS: Skin prick tests and conjunctival challenge tests with green tobacco and cured tobacco leaf extracts were positive, as well as serum-specific IgE by CAP, indicating an IgE-mediated sensitization. CAP inhibition experiments were carried out and it was found that tobacco, mugwort pollen, and tomato extracts inhibited the binding of the patient's serum to solid-phase tobacco leaf. No inhibition was observed when alternaria, D. pteronyssinus, and potato were used as control inhibitors. Inhibition of immunoCAP to mugwort was obtained with mugwort and tobacco extracts and no cross-reactivity to D. pteronyssinus was shown. CONCLUSION: The results suggest that tobacco can induce IgE-mediated reactions that are mediated by the existence of common antigenic epitopes between tobacco and mugwort pollen. This allergy can be a hazard of employment in the agricultural areas.
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2/12. Rhinoconjunctivitis and occupational asthma caused by Diplotaxis erucoides (wall rocket).

    Wall rocket (Diplotaxis erucoides) is a common Crucifera plant that grows in European and American vineyards and olive groves. We present the cases of 2 farmers with rhinoconjunctivitis and asthma related to wine-growing tasks during D erucoides pollination (March-April). The aim of this work was to demonstrate that occupational symptoms were caused by D erucoides pollen sensitization. Cutaneous tests, specific IgE measurements, conjunctival and bronchial provocation tests, and peak-flow measurements during working days were performed.
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3/12. recurrence of allergic rhinitis, previously alleviated with allergen immunotherapy, after autologous bone marrow transplant.

    BACKGROUND: Several associations between immunoglobulin e and bone marrow transplantation (BMT) have been reported. OBJECTIVE: A patient whose allergic rhinitis (AR) resolved after allergen immunotherapy (AIT) but recurred after the patient received an autologous BMT is reported. methods: Allergy skin tests were performed before AIT began and after 4 years of therapy. skin tests were repeated after a recurrence of symptoms 6 years later after an autologous BMT for breast cancer. RESULTS: Six years of AIT led to a near complete resolution of AR symptoms. skin tests showed a marked reduction in reactivity to allergens in the AIT. After an additional 6-year symptom-free interval off AIT, symptoms returned after the BMT. Repeat skin tests showed a marked increase in reactivity. CONCLUSIONS: patients reconstituting their immune systems after autologous BMT may have a recurrence of AR previously suppressed with AIT.
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4/12. plantago lanceolata (English plantain) pollinosis in japan.

    OBJECTIVE: The objective was to ascertain the prevalence of plantago lanceolata (English plantain) pollinosis in japan. methods: A total of 160 patients with allergic rhinitis were examined at the Hokkaido University Hospital otolaryngology Clinic between January 2002 and December 2003. We investigated the frequency of P. lanceolata antigen-specific immunoglobulin e (IgE) antibody-positive serum using the radioallergosorbent test (RAST), the P. lanceolata pollen counts in the Sapporo area and the clinical symptoms of patients with allergic rhinitis caused by this pollen. RESULTS: P. lanceolata pollen was dispersed throughout the Sapporo area from mid-May to early September, peaking in the latter half of May. The airborne pollen count showed little variation between years. The P. lanceolata RAST-positive rate was 12.8%, which was close to those for ragweed and sagebrush. All subjects showed overlapping antigen sensitization, that is, none displayed sensitization (by RAST) exclusively to P. lanceolata. The onset of subjective symptoms peaked in June and the symptoms worsened from April to October. CONCLUSION: P. lanceolata was dispersed over a long period, from mid-May to early September. The P. lanceolata RAST-positive rate (12.8%) was similar to those for sagebrush and ragweed, which are dispersed during the fall. These results suggest that P. lanceolata is an important causative agent of pollinosis in japan.
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5/12. Occupational respiratory allergy to cyclamen pollen: a case report.

    A case of cyclamen (cyclamen persicum) pollen allergy is described on a flower cultivator. The diagnosis was assessed by skin test, methacoline test, nasal provocation test and RAST. SDS-PAGE and immunoblotting have shown an intense response against a 18 kDa component and a weaker one at 100 Kda. A RAST inhibition against cupressus sempervirens and acacia floribundia showed no identity with cyclamen. This case confirm the cyclamen allergenity, in professional exposure. The nasal challenge prove to be very useful to confirm allergic sensitizations an we emphasize the necessity of preventive measures of protection for those florists who cultivate cyclamen plants.
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6/12. Simultaneous allergy to vine pollen and grape.

    We report the case of an 18-year-old female student suffering from seasonal rhinoconjunctivitis with sensitization to pollens from vine and also from grass, olive, and chenopodiaceae plants who had recently developed episodes of itching, maculopapular rash, and facial angioedema after eating grapes. Testing revealed positive reactions to vine pollen and grapes, and specific IgE were found for both allergens. immunoblotting and inhibition assays revealed cross-reactivity between the allergenic structures of vine pollen and grape fruit and also among botanically unrelated pollens.
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7/12. A new indoor allergen from a common non-flowering plant.

    ficus benjamina or weeping fig (w-fig) is one of the most common indoor non-flowering green plants in northern europe. We have previously reported that occupational exposure to w-fig in plant keepers, both atopic and non-atopic, gives rise to IgE-mediated allergy with airway symptoms. About one-fourth of the plant keepers had become sensitized. We now report a study of sensitization in non-occupationally exposed persons comprising 395 patients, consecutively referred for allergological investigation, and 107 employees from two offices decorated with an abundance of w-figs. Of the patients, 56% were found to be atopic and more than half of them reported exposure to w-fig. Sensitization, as judged by a positive skin prick test and positive RAST, was found in 13 of the patients and in three of the employees. All of them suffered from rhinitis and/or asthma and were atopics and sensitized to one or several common allergens. We conclude that sensitization to w-fig is not uncommon and that in sweden it is of the same magnitude as sensitization to the most common mould, cladosporium herbarum. The risk that subjects with a genuine atopic constitution exposed to w-fig will become sensitized is about 6%. In approximately half of the patients the sensitization was considered to be clinically important.
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8/12. Tumbleweed dermatitis.

    Russian thistle (salsola kali), the most common plant referred to as "tumbleweed" in the western united states, can cause a dermatitis in persons who come into direct contract with it. Tests were conducted to determine the mechanism of this dermatitis. Mechanical contact with plant branches, as well as scratch, patch, and photopatch tests with Russian thistle extract and scratch tests with 1.5% potassium nitrate, a plant constituent, were employed. These tests, along with transparent adhesive tape preparations and a skin biopsy, showed that in nonsensitized persons, dermatitis was due only to mechanical irritation of plant floral bracts. In sensitized individuals, Russian thistle floral bracts pierced the skin and stimulated an urticarial reaction.
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9/12. Allergy associated with Paterson's Curse.

    A case of allergic rhinitis which occurred on exposure to Paterson's Curse (echium plantagineum) is described. Symptoms developed on exposure both to flowering and to dead, dried plants. Inhalational challenge tests with pure preparations of pollen and epidermal debris, including plant hairs, resulted in the symptoms and signs of allergic rhinitis. Field experiments in a large natural stand of Paterson's curse showed that pollen and particulate plant debris, including plant hairs, were airborne during the flowering season. These findings indicate that pollen, epidermal hairs, and particulate matter cause allergic symptoms in susceptible subjects, and suggest that allergies to Paterson's Curse may be encountered beyond the main flowering period.
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10/12. Severe isolated allergy to ficus benjamina after bedroom exposure.

    Allergies to ficus benjamina (Fb, weeping fig) have been described first as an occupational disease in plant keepers and later in clearly atopic subjects with known sensitizations to other inhalant allergens. We report a case of a hitherto nonatopic man with allergic rhinoconjunctivitis, contact urticaria, and asthma caused by a Fb kept in his bedroom for 18 months. Rubbing and skin prick test with native fig leaves and sap, and RAST to Fb were clearly positive. No other sensitization could be detected. After eliminating his Fb, he became asymptomatic within a few months. This case shows that private close contact to Fb can also induce allergy even in hitherto nonatopic subjects. Therefore, Fb should not be kept in bedrooms.
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